1
|
Bijelic T, Nilsson IM, List T, Ekberg E. Internet-Based Behavioural Therapy for Adolescents With Temporomandibular Disorder Pain: A Feasibility Multicenter Randomised Controlled Trial. J Oral Rehabil 2025. [PMID: 40256847 DOI: 10.1111/joor.13976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 03/19/2025] [Accepted: 04/07/2025] [Indexed: 04/22/2025]
Abstract
BACKGROUND Temporomandibular disorder (TMD) pain in adolescents is common, has a negative impact on quality of life, and is a predictor of pain in young adulthood. A common and symptomatic treatment is occlusal appliance therapy (OAT). Internet-based behavioural therapy (IBT) is a novel, multimodal, and patient-centred self-management therapy for adolescents with TMD pain. OBJECTIVE To evaluate the adherence and effect of IBT compared to OAT in adolescents with TMD pain. METHODS Participants were recruited from public dental care and specialist clinics in orofacial pain in Sweden between January 2016 and March 2020. Screening of adolescents, 13-19 years, was performed using three questions for TMD (3Q/TMD). Eligible subjects were examined according to the DC/TMD and randomly allocated to IBT or OAT. The IBT group performed the 7-week programme online with individualised feedback through phone after each section. The OAT group used a stabilisation splint night time for 3 months. A 3-month questionnaire follow-up on pain intensity, pain disability, and psychosocial outcomes was conducted. RESULTS In total, 52 patients were randomised to IBT and 48 to OAT. There was a low adherence to IBT with a 75% drop-out. Positive expectations of treatment were significantly (p = 0.001) greater in the OAT group. OAT was related to better outcomes for characteristic pain intensity (p = 0.047) and pain-related disability (p = 0.049) when compared to IBT. No significant difference within or between the groups regarding the psychosocial outcomes was observed. CONCLUSIONS The current version of IBT was overly comprehensive for adolescents with TMD pain and needs to be revised.
Collapse
Affiliation(s)
- Tessa Bijelic
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ing-Marie Nilsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| |
Collapse
|
2
|
Klur T, Portegys S, Graf I, Scharf S, Braumann B, Kruse T. Temporomandibular Disorders: Management of Diagnostics and Therapy in the Context of Orthodontic Treatment-A Survey Among German Orthodontists. Dent J (Basel) 2025; 13:167. [PMID: 40277497 PMCID: PMC12025647 DOI: 10.3390/dj13040167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2025] [Revised: 03/22/2025] [Accepted: 04/14/2025] [Indexed: 04/26/2025] Open
Abstract
Background/Objectives: To evaluate the role of temporomandibular disorder (TMD)-related diagnostics in orthodontic treatment routines and investigate what consequences are drawn from symptoms concerning orthodontic treatment planning and therapy. Methods: All officially listed orthodontists in Germany were surveyed about their professional background, TMD-related specialization, and concrete clinical procedures. Anonymized responses were systematized, manually checked, and statistically analyzed. Differences in reported TMD-related procedures depending on orthodontists' professional experience and specialization were determined using Fisher's exact tests. Results: A total of 2359 questionnaires were sent out, of which 630 could be evaluated. The majority of the orthodontists surveyed stated that they perform either a brief TMD screening or a complete functional analysis. In total, 21.1% of the respondents base their examination on the patient's medical history. A second complete functional analysis is performed by 33% of the responding orthodontists during the course of orthodontic therapy, and by 56.6% only in the case of an initial pathological finding. For 60.1% of the respondents, pre-therapeutically diagnosed, non-painful temporomandibular joint clicking has an influence on orthodontic treatment planning. Only 4.3% of respondents take no further action prior to orthodontic therapy in the case of TMD symptoms. There is an indication that professional experience has no influence on the procedure, whereas a specialization in the field of TMDs does. Conclusions: A discrepancy between the current state of research and standard procedures in German orthodontic practices may lead to an overly detailed examination. However, this has no health disadvantages for the patient.
Collapse
Affiliation(s)
| | | | | | | | | | - Teresa Kruse
- Department of Orthodontics, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50931 Cologne, Germany; (T.K.); (S.P.); (I.G.); (S.S.); (B.B.)
| |
Collapse
|
3
|
Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Gerreth K, Spagnuolo G, Woźniak K, Czajka-Jakubowska A. The impact of malocclusion on the prevalence of pain-related temporomandibular disorders in children and adolescents: a systematic review. Front Neurol 2025; 16:1550110. [PMID: 40248012 PMCID: PMC12004977 DOI: 10.3389/fneur.2025.1550110] [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: 12/22/2024] [Accepted: 03/07/2025] [Indexed: 04/19/2025] Open
Abstract
Background The connection between occlusion and temporomandibular disorders (TMD) remains a topic of discussion, and current research does not provide a definitive answer. Pain-related TMD are the most common types of TMD. They include myalgia, arthralgia, and headaches attributed to TMD. This systematic review aims to synthesize the current scientific evidence regarding impact of malocclusion on the prevalence of pain-related TMD in individuals under 18 years. Methods The study was based on a searching of the PubMed, Scopus, Embase, and Web of Science databases. Selection was limited to studies that explored the link between malocclusion and pain-related TMD in young individuals. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the selected research. The certainty of evidence was assessed using the Grading Recommendations Assessment, Development and Evaluation (GRADE) approach. A visual representation of the screening and inclusion processes was created using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. The information from the research was then summarized in a descriptive format. Results Out of 868 potentially relevant articles initially identified, 13 studies were selected based on the inclusion criteria. The majority of these studies were determined to be of moderate quality, according to the NOS assessment. The certainty of evidence was assessed as low, according to the GRADE approach. Most of the studies showed that malocclusion may be associated with TMD-pain signs/symptoms in children and adolescents. The most frequent relationship was found between the prevalence of pain-related TMD and posterior crossbite, Class II malocclusion, Class III malocclusion, and anterior open bite. Conclusion Certain types of malocclusion may have an impact on the prevalence of some TMD-pain signs and symptoms in young individuals. However, given the limited reliability of existing research and the inconsistencies observed across studies, additional well-structured, long-term investigations are necessary. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42024570950.
Collapse
Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Laboratory for Propaedeutics of Orthodontics and Facial Congenital Defects, Chair of Maxillofacial Orthopaedics and Orthodontics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Magdalena Sycińska-Dziarnowska
- Department of Maxillofacial Orthopaedics and Orthodontics, Chair of Maxillofacial Orthopaedics and Orthodontics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Karolina Gerreth
- Department of Risk Group Dentistry, Chair of Pediatric Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Napoli, Italy
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Krzysztof Woźniak
- Department of Maxillofacial Orthopaedics and Orthodontics, Chair of Maxillofacial Orthopaedics and Orthodontics, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Agata Czajka-Jakubowska
- Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
4
|
Wang Y, Xu J, Ding C, Deng T, Shen Z, Huang W, Wan Y, Xing T. The Link Between Temporomandibular Disorders and Jaw Functional Limitations Among Chinese Adolescents. Int Dent J 2025; 75:554-563. [PMID: 39142918 PMCID: PMC11976616 DOI: 10.1016/j.identj.2024.07.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Currently, there is still controversy surrounding the relationship between temporomandibular disorders (TMDs) symptoms and jaw functional limitations. We investigated the distribution of TMDs in senior high school students, including both the number and types of symptoms, and assessed their association with jaw functional limitations. Furthermore, we explored sex differences in these associations. METHODS This study was conducted at a public high school in Hefei, Anhui Province, China, with data collected from September to October 2022. All subjects completed questionnaires assessing the anamnestic symptoms of TMDs and the Jaw Functional Limitation Scale (JFLS), and examinations were performed by trained dentists according to the Diagnostic Criteria for TMD. Data were analysed using the Kruskal-Wallis, Mann-Whitney U, and Chi-square tests. RESULTS The mean age of the participants (N = 2890) was 17.2 ± 0.14 years and 38.9% were females (61.1% were males). Limitations in self-assessed jaw function were associated with the presence of TMDs (P < .05). Participants with more symptoms reported significantly high levels of functional limitations (P < .05). Compared to male adolescents, female adolescents more commonly experienced TMDs pain and tended to have more symptoms (P < .05). However, no sex differences were observed in most associations between TMDs and jaw functional limitations. CONCLUSION TMDs-positive symptoms are common in adolescents. Female adolescents were more affected by TMDs symptoms than male adolescents. Individuals with more TMDs symptoms have greater jaw functional limitations.
Collapse
Affiliation(s)
- Yifan Wang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Jingyi Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Chunmeng Ding
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Tongyan Deng
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zhenguo Shen
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - WuanJing Huang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yuhui Wan
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China.
| | - Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China.
| |
Collapse
|
5
|
Dong Y, Zhou X, Xiang J, Zheng Y, Zheng Y, Xiong X, Wang J. The Association Between Insomnia and Temporomandibular Disorders in Orthodontic Patients. J Pain Res 2025; 18:243-254. [PMID: 39846003 PMCID: PMC11752927 DOI: 10.2147/jpr.s499428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2024] [Accepted: 01/07/2025] [Indexed: 01/24/2025] Open
Abstract
Objective This cross-sectional study aimed to investigate the association between insomnia and the presence of temporomandibular disorders (TMD) and its subtypes in orthodontic patients. Methods A total of 648 adult orthodontic patients (158 males and 490 females, median age 26) were included and completed a questionnaire containing sociodemographic information, insomnia severity index (ISI), the five major temporomandibular disorder symptoms (5Ts) checklist, and self-reported sleep bruxism. Presence of insomnia and TMD of the included patients was determined according to the diagnostic criteria, and statistical analyses were conducted as appropriate to compare ISI-related scores between TMD and non-TMD participants. Further, multivariable regressions were performed to detect the potential correlation between insomnia and TMD in orthodontic patients. Results Orthodontic patients with TMD scored significantly higher in both the individual items and the total sum of ISI than those without TMD. More patients were bothered by insomnia in the TMD group than the non-TMD counterparts (26.6% vs 16.7%, p=0.003). After adjusting for confounding variables, insomnia was found to be significantly correlated with TMD in orthodontic patients (OR=1.677, 95% CI 1.128, 2.511). Subgroup analysis of TMD subtypes showed a significant positive association of insomnia with pain-related TMD (OR=2.007, 95% CI 1.331, 3.015). Conclusion Insomnia was associated with a higher prevalence of pain-related TMD rather than intra-articular TMD in orthodontic patients.
Collapse
Affiliation(s)
- Yanhua Dong
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xueman Zhou
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jie Xiang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yunhao Zheng
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yingcheng Zheng
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| |
Collapse
|
6
|
Moyano-Cuevas JL, Pagador JB, Saeed N, Sánchez-Margallo FM, Monje-Gil F. Validation of a training simulator for temporomandibular joint arthroscopy. J Craniomaxillofac Surg 2025; 53:52-56. [PMID: 39592370 DOI: 10.1016/j.jcms.2024.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 05/05/2024] [Accepted: 10/20/2024] [Indexed: 11/28/2024] Open
Abstract
OBJECTIVE This study aims to evaluate a temporomandibular joint (TMJ) arthroscopy simulator using construct and face analyses. METHODS Thirty participants attending a TMJ training course were divided into novice and expert surgeons (more than 100 procedures) and performed two arthroscopic tasks (cavity access/cavity exploration) during which the surgical tool movements were tracked. Five objective metrics were used to measure surgeon ability and construct validity was assessed by comparing novel and expert performance. Face validity was assessed by subjective questionnaires rating simulator realism and utility (1-5 scale) and tissue consistency (1-4 scale). RESULTS Expert surgeons spent less total time (76.58 ± 47.40 vs. 27.60 ± 5.52; novices vs. experts) with higher average speed (7.40 ± 5.32 vs. 12.65 ± 5.37) and average acceleration (198.33 ± 2.42 vs. 325.93 ± 87.36). Movement smoothness revealed lower values in novice surgeons (3638.33 ± 1083.95 mm/s3; 2553.70 ± 768.01 mm/s3) than in expert surgeons (4655.63 ± 837.05 mm/s3; 4172.08 ± 1098.61 mm/s3). All these outcomes reached statistical significance (p ≤ 0.05) but in contrast total path of the instruments did not. Face validity scores averaged 4.75/5 for utility and over 4/5 for realism except for watertightness. Tissue consistency was regarded as lower than human tissue but without impact on the training experience. There were no statistically significant differences between the two groups. CONCLUSIONS Both the construct and face validity analyses confirmed the TMJ simulator can be regarded as a valuable, safe, economic adjunctive tool to train TMJ arthroscopy.
Collapse
Affiliation(s)
- José Luis Moyano-Cuevas
- Bioengineering and Health Technology Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - J Blas Pagador
- Bioengineering and Health Technology Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain.
| | | | | | - Florencio Monje-Gil
- Fundación para el estudio y desarrollo de la implantología, cirugía oral y maxilofacial, Badajoz, Spain
| |
Collapse
|
7
|
Visholm T, Saeed N. Current thinking in the management of temporomandibular disorders in children: A narrative review. Br J Oral Maxillofac Surg 2024; 62:929-936. [PMID: 39489678 DOI: 10.1016/j.bjoms.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/24/2024] [Accepted: 09/06/2024] [Indexed: 11/05/2024]
Abstract
The aim of this narrative review is to discuss current opinions on paediatric temporomandibular disorders (TMDs) due to their increasing incidence in routine secondary care maxillofacial clinics. A MEDLINE and EMBASE search was performed of the literature published in the past three years concerning paediatric TMD. Of 261 papers identified, 89 were selected for relevance, of which 52 full texts were eligible and 41 included. The narrative of this paper follows three domains: myogenous and arthogenous pain, juvenile idiopathic arthritis (JIA), and reconstruction. The principles of treating mild TMD in children are similar to those in adults, with even more emphasis on the management of psychosocial issues and self-care. The use of medication, however, needs to be more cautious. Symptomatic disc displacement should be treated to reduce inflammation, so early arthrocentesis or arthroscopy is relevant. Controversy exists on disc repositioning to reduce or even reverse condylar degeneration in the growing condyle. If undertaken it should ideally be performed arthroscopically by surgeons with significant experience. Arthritic disease is usually associated with JIA so a multidisciplinary approach is the focus of treatment. The role of arthroscopy in the management of symptoms is increasing but it does not prevent disease progression. Surgical correction may be required for secondary deformity. Reconstruction remains a challenge with no ideal autogenous method. Alloplastic joints are gaining popularity, but the long-term outcomes are unknown. Surgery can be undertaken with minimal morbidity, and the use of joint replacements, even as space maintainers, may therefore be more beneficial than repeated failed autogenous treatments.
Collapse
Affiliation(s)
- Toby Visholm
- Oral and Maxillofacial Surgery Department, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.
| | - Nadeem Saeed
- Oral and Maxillofacial Surgery Department, Great Ormond Street Hospital, London, Greater London WC1N 3JH, UK
| |
Collapse
|
8
|
Borges REA, Mendonça LDRA, Roncalli da Costa Oliveira AG, Dos Santos Calderon P. Development and Validation of the Epidemiological Diagnostic Instrument for Temporomandibular Disorders. J Oral Rehabil 2024; 51:2548-2558. [PMID: 39238186 DOI: 10.1111/joor.13853] [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: 11/27/2023] [Revised: 08/09/2024] [Accepted: 08/21/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a highly misreported health problem. Its diagnosis is complex and requires the use of valid and reliable instruments. OBJECTIVE To develop and validate the Epidemiological Diagnostic Instrument for TMD (EDI/TMD). METHODS Content validity (CV), response process (RP), construct validity (EFA), reliability (inter and intraobserver consistency), and convergence validity of the EDI/TMD were assessed and compared to the Diagnostic Criteria for TMD (DC/TMD). RESULTS An instrument composed of a 9-question questionnaire and a 12-step clinical protocol was developed. CV analysis reduced the instrument to a 5-question and 7-step clinical protocol (CVI = 0.93). Some instructions were included after the RP. The EFA found three factors: myogenous TMD, arthrogenous TMD, and differential diagnosis. The reliability scores ranged from substantial to excellent. When compared to the DC/TMD, the EDI/TMD total score indicated that this instrument is valid and provides satisfactory diagnostic criteria (Kappa = 0.906; p < 0.001), and can distinguish non-TMD and TMD individuals, with a cut-off point of 4.9 (Sensitivity = 1.0; Specificity = 1.0; AUC = 1.0). For individuals who had both myogenous and arthrogenous TMD, the cut-off point was 14 or higher (Sensitivity = 0.8; Specificity = 1.0; AUC = 0.987). For individuals who had either myogenous TMD (Sensitivity = 1.0; Specificity = 0.88; PPV = 0.89; NPV = 1.0) or arthrogenous TMD (Sensitivity = 0.95; Specificity = 0.87; PPV = 0.83; NPV = 0.96), the cut-off point was between 5 and 13.9, with the highest EFA score being the determinant factor for final diagnosis. CONCLUSION Based on its psychometric properties, the EDI/TMD is a valid and reliable assessment tool that is capable of diagnosing TMD and classifying its subtypes.
Collapse
|
9
|
Jin L, Yao Y, Fang Z, Fan S, Cai B, Xu L, Liu S. Long-Term Prognosis and Influencing Factors of Chinese Adolescents With Temporomandibular Disorder After Physical Therapy. J Oral Rehabil 2024; 51:2611-2621. [PMID: 39305035 DOI: 10.1111/joor.13865] [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: 07/08/2023] [Revised: 08/27/2024] [Accepted: 09/05/2024] [Indexed: 11/15/2024]
Abstract
BACKGROUND Physical therapy is the preferred conservative treatment for patients with temporomandibular disorder (TMD). However, few studies have investigated the application of physical therapy in adolescents, especially follow-up studies on the long-term prognosis of these patients. This study investigated the short-term effects and long-term prognosis of physical therapy in adolescent patients with TMD and the factors influencing long-term symptoms. METHODS Information regarding baseline data, specific treatment methods, treatment times and evaluation results was collected retrospectively for adolescent patients with TMD who received physical therapy. Patients were followed up via telephone and online questionnaires, and the influence of age, sex, disease course, mouth opening, pain intensity, oral parafunctional habits and treatment methods on long-term symptoms was analysed. RESULTS Pain intensity, maximum mouth opening and the joint noise score improved significantly in 270/286 patients who received individualised comprehensive physical therapy. TMD-related symptoms improved with no noticeable impact on daily life in 187/199 patients who were followed up for an extended period (average, 30.71 ± 10.86 months) and were divided into asymptomatic or symptomatic groups according to the persistence of symptoms. Logistic regression analysis revealed that uncorrected oral parafunctional habits and fewer treatments were related to long-term symptoms. CONCLUSION The long-term prognosis of adolescent patients with TMD after physical therapy was satisfactory. However, 52.8% of the patients experienced persistent TMD-related symptoms for an extended period, possibly due to insufficient treatment times and parafunctional habits. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05781607.
Collapse
Affiliation(s)
- Lei Jin
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Yao
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongyi Fang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuai Fan
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Xu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China
| | - Shasha Liu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China
| |
Collapse
|
10
|
Wang K, Li C, Zhou J, Ren J, You M. Diagnostic Accuracy of Dynamic High-Resolution Ultrasonography in Assessing Anterior Disc Displacement in Temporomandibular Joint Disorders: A Prospective Observational Study. Healthcare (Basel) 2024; 12:2355. [PMID: 39684977 DOI: 10.3390/healthcare12232355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2024] [Revised: 11/13/2024] [Accepted: 11/22/2024] [Indexed: 12/18/2024] Open
Abstract
Objective: The objective of this study was to assess the diagnostic efficacy of dynamic high-resolution ultrasonography (HRUS) in detecting anterior disc displacement with reduction (ADDWR) and anterior disc displacement without reduction (ADDWoR) in the temporomandibular joint (TMJ). Methods: A total of 144 TMJs was categorized into three groups according to the magnetic resonance imaging (MRI) findings, which served as the reference standard: the normal disc position (NDP) group, the ADDWR group, and the ADDWoR group. Static images of the TMJ in full opening and maximum intercuspal positions, along with dynamic sequences during jaw opening, were obtained utilizing a 14 MHz L-shaped linear array transducer. The diagnostic efficacy of dynamic HRUS for identifying ADDWR and ADDWoR was evaluated in terms of accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), and the Youden index. Results: According to the MRI findings, the NDP, ADDWR, and ADDWoR groups consisted of 42 (29.2%), 47 (32.6%), and 55 (38.2%) TMJs, respectively. HRUS data revealed 54 TMJs (37.5%) in the NDP group, 26 TMJs (18.1%) in the ADDWR group, and 64 TMJs (44.4%) in the ADDWoR group. With MRI as the reference standard, HRUS exhibited a diagnostic accuracy of 71.4%, sensitivity of 51.4%, and specificity of 91.4% for ADDWR. For the ADDWoR, HRUS attained a diagnostic accuracy of 86.5%, sensitivity of 90.0%, and specificity of 82.1%. Conclusions: With MRI serving as the reference standard, dynamic HRUS has high diagnostic value for ADDWoR, with better diagnostic accuracy than ADDWR. Ultrasonography has the potential to be used as a highly effective and non-invasive imaging modality for the early screening of ADD in future clinical practice.
Collapse
Affiliation(s)
- Kaili Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chenyang Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jinbo Zhou
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiayin Ren
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Meng You
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Oral Medical Imaging, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
11
|
Barad M, Romero-Reyes M. Orofacial Pain. Continuum (Minneap Minn) 2024; 30:1397-1426. [PMID: 39445927 DOI: 10.1212/con.0000000000001488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
OBJECTIVE This article explores the multiple etiologies, diagnosis, and management of orofacial pain. LATEST DEVELOPMENTS Published in 2019, the International Classification of Orofacial Pain has become the internationally accepted classification system for primary and secondary facial pain. New discoveries in temporomandibular disorders have demonstrated that they are far more complex than the traditional dental mechanistic point of view. A 2020 consensus report released by the National Academies of Sciences, Engineering, and Medicine entitled "Temporomandibular Disorders: Priorities for Research and Care" highlighted this paradigm shift and its importance for patient care, education, and research. ESSENTIAL POINTS Orofacial pain comprises many disorders with different etiologies and pathophysiologies. The subjectivity of the pain experience and the interrelated anatomy and physiology of the craniofacial area add to the complexity of diagnosis when the source and etiology of pain are not clear. As orofacial pain straddles the expertise of multiple disciplines, a multidisciplinary approach combining medication, physical therapy, and procedural and psychological strategies is essential in treating patients with orofacial pain.
Collapse
|
12
|
Torul D, Yılmaz MF, Örnek Akdoğan E, Omezli MM. Temporomandibular joint disorders and associated factors in a Turkish pediatric population. Oral Dis 2024; 30:4454-4462. [PMID: 38287493 DOI: 10.1111/odi.14875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. METHODS A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis. RESULTS One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16). CONCLUSIONS Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.
Collapse
Affiliation(s)
- Damla Torul
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
| | - Muhammed Furkan Yılmaz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
| | | | - Mehmet Melih Omezli
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
| |
Collapse
|
13
|
Yap AU, Lai YC, Ho HCW. Prevalence of temporomandibular disorders and their associated factors in Confucian heritage cultures: A systematic review and meta-analysis. J Oral Rehabil 2024; 51:2169-2194. [PMID: 38873743 DOI: 10.1111/joor.13779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/12/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) may be an 'idiom' of psychological distress in Confucian heritage cultures (CHCs). OBJECTIVES This systematic review/meta-analysis estimated the prevalence of TMDs in CHCs and compared the differences in TMD occurrence between time periods and age groups. Additionally, the associated biopsychosocial risk factors were also examined. METHODS The study protocol was developed a priori following the PRISMA guidelines and Joanna Briggs Institute systematic review methodology (CRD42021245526). Electronic searches of seven databases were conducted from January 2002 to Dec 2021. Reference lists of identified studies were hand-searched for additional articles. Study selection, quality assessment, and data extraction were done. Meta-analysis was performed using the RevMan 5.4 software. RESULTS Forty-eight articles were included in the systematic review. Overall prevalences were: TMDs-15% (95% CI: 15-16%); TMD pain-8% (95% CI: 7-9%); TMJ sounds-24% (95% CI: 21-27%); and TMJ locking-7% (95% CI: 1-13%). While TMD prevalence appeared to have declined from 2002 to 2011 to 2012-2021, the occurrence of TMD pain, TMJ sounds, and locking increased marginally or remained constant. TMD prevalence in children/adolescents was 18% (95% CI: 14-22%) and 17% (95% CI: 16-18%) among adults. Significant associations between TMDs and bruxism/psychological distress/education levels were specified by 73%/90%/88% of the relevant studies. CONCLUSIONS TMDs are prevalent in CHCs and a slight increase in TMD pain (2%) and TMJ sounds (8%) were discerned over the past two decades. TMDs are related to a myriad of biopsychosocial variables, particularly psychological distress, and these factors must be addressed within the cultural context of patients.
Collapse
Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Ye Choung Lai
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
| | - Henry Chee Wai Ho
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
| |
Collapse
|
14
|
Fang Z, Yao Y, Fan S, Jin L, Yang Y, Liu S. Physical therapy and non-surgical manual disc reduction combined with anterior repositioning splint for acute disc displacement without reduction of the temporomandibular joint in adolescents. Clin Oral Investig 2024; 28:517. [PMID: 39243315 DOI: 10.1007/s00784-024-05910-0] [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: 06/19/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVES Current studies on the treatment of adolescent patients with disc displacement without reduction (DDWOR) are limited by short follow-up periods and small sample sizes, and there are few comparative studies on the efficacy of conservative treatment with and without disc reduction for acute DDWOR. This study compared the therapeutic effects of two conservative treatment methods: physical therapy alone and physical therapy combined with non-surgical manual disc reduction and anterior repositioning splints (ARS), in adolescent patients with acute DDWOR. MATERIALS AND METHODS This retrospective study included adolescent patients with DDWOR who underwent physical therapy at the Temporomandibular Joint Rehabilitation Department of the Shanghai Ninth People's Hospital from January 2018 to December 2021. Patient assessment data were collected before and after treatment. Patients were followed up through telephone and online questionnaires from March to August 2023. RESULTS The results indicate that compared to physical therapy alone, the combination of physical therapy and non-surgical manual disc reduction with ARS showed better short-term efficacy, improved mouth opening, and better long-term pain control. Also, it may be effective in preventing degenerative joint disease. CONCLUSIONS This combination therapy is recommended for clinical application in adolescent patients with acute DDWOR. CLINICAL RELEVANCE The present research demonstrates the superior efficacy of physical therapy and non-surgical manual disc reduction combined with anterior repositioning splint in adolescent patients with acute DDWOR.
Collapse
Affiliation(s)
- Zhongyi Fang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China
| | - Yuan Yao
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China
| | - Shuai Fan
- Department of Rehabilitation Medicine, The Third Xiangya Hospital, Central South University, Hunan, China
| | - Lei Jin
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China
| | - Yang Yang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China
| | - Shasha Liu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 500 Quxi Road, Shanghai, 200011, China.
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, China.
| |
Collapse
|
15
|
Renner N, Costa YM, Castrillon EE, Exposto FG. Reliability of an intraoral extension for intraoral palpation and assessment of mechanical sensitivity of the temporal tendon. J Oral Rehabil 2024; 51:1848-1861. [PMID: 38767032 DOI: 10.1111/joor.13743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/30/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND The temporal tendon is a structure often compromised in patients suffering from temporomandibular disorders (TMD), yet its intraoral location makes a standardised assessment difficult. OBJECTIVES To evaluate the variability and accuracy to target force of a newly designed intraoral extension for a palpometer device (Palpeter, Sunstar Suisse) when compared to manual palpation, in addition to clinically assessing the mechanical sensitivity and referred sensations of the temporal tendon in healthy individuals. METHODS Experiment 1: 12 individuals were asked to target on a scale 0.5, 1 and 2 kg, for 2 and 5 s by using five different methods (Palpeter, Palpeter with three different extension shapes and manual palpation). Experiment 2: 10 healthy participants were recruited for a randomised double-blinded assessment by applying pressure of 0.5, 1 and 2 kg to the right temporal tendon with the three extensions and manual palpation. Participants rated the intensity of their sensation/pain on a 0-50-100 numeric rating scale (NRS), unpleasantness on a 0-100 NRS, and if present, they rated and drew the location of referred sensations. Repeated measures analysis of variance (ANOVA) was used in both experiments to compare differences between palpation methods. Tukey's HSD tests were used for the post hoc comparisons, and p values below .05 were considered significant. RESULTS Experiment 1: The extensions showed no significant differences between them regarding reliability and accuracy for all forces and durations (p > .05). The manual method was significantly less reliable and accurate when compared to the other methods (p < .05). Experiment 2: There were no significant differences between the Palpeter extensions regarding pain intensity or unpleasantness NRS scores (p > .05), but all the extensions had significantly increased pain intensity and unpleasantness when compared to manual palpation (p < .05). Similarly, the frequency of referred sensations was similar between extensions but increased when compared to manual palpation. CONCLUSIONS The new Palpeter extensions proved to be significantly more accurate and have lower test-retest variability than the manual method in a non-clinical setting. Clinically, they showed no significant differences in NRS scores for pain intensity nor unpleasantness, with no major differences in referred sensations, making any of the extensions suitable for clinical testing of the temporal tendon in future studies.
Collapse
Affiliation(s)
- Nicole Renner
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Yuri M Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Eduardo E Castrillon
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Fernando G Exposto
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Health, Aarhus University, Aarhus, Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| |
Collapse
|
16
|
Pellicano C, Leodori G, Floridia S, Colalillo A, Gigante A, Rosato E, Paoloni M. Reciprocal effects of scleroderma and temporomandibular dysfunction between patient cohorts. Cranio 2024; 42:547-554. [PMID: 34962456 DOI: 10.1080/08869634.2021.2019425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To estimate the prevalence of temporomandibular dysfunction in scleroderma patients according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and to correlate it with disease variables. METHODS Temporomandibular dysfunction was evaluated in 75 scleroderma patients and 74 healthy controls using DC/TMD. Gastrointestinal symptoms were evaluated through the University of California Los Angeles (UCLA) score in scleroderma patients. RESULTS There was no difference of prevalence in temporomandibular dysfunction [30 (40%) vs 30 (40.5%); p > 00.05] between scleroderma patients and healthy controls. Scleroderma patients had a significant reduction in all oral movements compared to healthy controls. Scleroderma patients with temporomandibular dysfunction had a statistically higher score in the UCLA distention/bloating item [1.75 (0.5-2.38) vs 0.75 (0.25-1.75); p < 0.05] than scleroderma patients without temporomandibular dysfunction. DISCUSSION Temporomandibular dysfunction prevalence between scleroderma patients and healthy controls is similar. In scleroderma patients, temporomandibular dysfunction reduces oral mobility and opening, which worsens distension/bloating.
Collapse
Affiliation(s)
- Chiara Pellicano
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giorgia Leodori
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Stefano Floridia
- Department of Anatomy, Histology, Forensic Medicine and Locomotor Sciences, Sapienza University of Rome, Rome, Italy
| | - Amalia Colalillo
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonietta Gigante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Rosato
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Anatomy, Histology, Forensic Medicine and Locomotor Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
17
|
Mejersjö C, Bergström EK, Hagquist C, Wänman A. Impact of temporomandibular disorder symptoms among 15-year-old girls. Acta Odontol Scand 2024; 83:441-445. [PMID: 39177399 PMCID: PMC11407104 DOI: 10.2340/aos.v83.41113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/29/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE Many adolescents, especially girls, report temporomandibular disorder (TMD) symptoms that may impact their daily life. METHODS At 19 different schools participating in the preventive program with dental nurses of FRAMM (Fluoride, Advise, Arena, Motivation, Food), at the Västra Götaland Region in Sweden, 15-year-old girls were invited to a cohort study about symptoms of TMD that also included headaches. Three hundred twenty-nine girls attended the study and answered a questionnaire regarding TMD symptoms and their consequences such as sick leave from school and consumption of analgesics. The girls were asked about the symptom's influence on their daily life, about their general health, use of regular medication, physical activity, and they answered the PHQ4 regarding experienced symptoms of anxiety and depression. RESULTS There was a significant correlation between TMD symptoms and sick leave with 31% of the girls having stayed home due to symptoms. Of the girls who answered affirmative in the screening questions (3QTMD), nearly half the group had stayed at home due to their symptoms, 24% had consulted a physician, 42% had used analgesics weekly and 59% reported that they felt the symptoms negatively affected their school performance. The girls who had regular medication had more TMD symptoms. Anxiety and depression were associated with TMD symptoms. CONCLUSION The study showed that TMD symptoms had a negative impact on the 15-year-old girls' daily life resulting in sick leave from school, consumption of analgesics, and experiences of negative impacts on their behavior and performance at school.
Collapse
Affiliation(s)
- Christina Mejersjö
- Sahlgrenska Academy of Gothenburg University and the Public Dental Service of Västra Götaland, Gothenburg, Sweden.
| | - Eva-Karin Bergström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Curt Hagquist
- Department of Education and Special Education, Gothenburg University, Gothenburg, Sweden
| | - Anders Wänman
- Department of Clinical Oral Physiology, Umeå University, Umeå, Sweden
| |
Collapse
|
18
|
Tagawa DT, Wolosker AMB, Florez BM, Dominguez GC, Yamashita HK, Aidar LADA, Junior HC. Temporomandibular joint disc position and shape in patients submitted to two protocols of rapid maxillary expansion and face mask therapy: A randomized clinical trial. Orthod Craniofac Res 2024; 27:615-625. [PMID: 38456750 DOI: 10.1111/ocr.12777] [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] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The objective of this prospective study was to assess possible changes in the position and shape of the temporomandibular joint (TMJ) articular disc in patients treated with two protocols of rapid maxillary expansion (RME) and face mask (FM) therapy. METHODS A sample of 88 patients with Class III or Class III subdivision malocclusions, aged between 6 and 13 years, were consecutively selected and divided into three groups (G): G1-34 patients were treated with RME, followed by FM therapy; G2-34 patients were treated using RME according to modified alternate rapid maxillary expansion and constriction (ALT-RAMEC) protocol, followed by FM therapy. These treated groups were randomly (1:1 allocation ratio) distributed according to the two treatment protocols. G3 - Control Group - 20 untreated patients were followed. Magnetic resonance imaging (MRI) TMJs were obtained before (T1) and after (T2) a treatment period or follow-up. McNemar test, Fisher's exact test and intra- and inter-observer concordance (K) were performed (p ≤ .05). RESULTS There were no statistically significant differences in the baseline cephalometric variables at T1 between the groups. There were statistically significant differences between the groups (p < .001) in relation to the disc shape in T1, since G1 (8 TMJs -11.76%) presented higher occurrences of altered forms in comparison with G2 (no changes). No significant differences were observed in disc position CM and OM (G1 - p > .999; G2 - p = .063; G3 - p = .500) and shape (G1 - p > 0.999; G2 - p = .250; G3 - not calculable), between T1 × T2, in any of the groups studied. CONCLUSION The two treatment protocols did not have adverse effects on the position and shape of the TMJ disc, in a short-term evaluation.
Collapse
Affiliation(s)
- Daniella Torres Tagawa
- Graduate Program in Medicine (Clinical Radiology), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Department of Orthodontics, Universidade Santa Cecília, Santos, Brazil
| | - Angela Maria Borri Wolosker
- Graduate Program in Medicine (Clinical Radiology), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | | | - Helio Kiitiro Yamashita
- Graduate Program in Medicine (Clinical Radiology), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Henrique Carrete Junior
- Graduate Program in Medicine (Clinical Radiology), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| |
Collapse
|
19
|
Bliźniak F, Chęciński M, Chęcińska K, Lubecka K, Kamińska M, Szuta M, Chlubek D, Sikora M. Non-Steroidal Anti-Inflammatory Drugs Administered Intra-Articularly in Temporomandibular Joint Disorders: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:4056. [PMID: 39064095 PMCID: PMC11278433 DOI: 10.3390/jcm13144056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: This systematic review was designed to summarize randomized controlled trials of intra-articular administration of non-steroidal anti-inflammatory drugs (NSAIDs) for temporomandibular disorders. Methods: Randomized controlled trials regarding intra-articular injections of non-steroidal anti-inflammatory drugs for temporomandibular disorders were included in the review. The final search was conducted on 16 June 2024 in the Bielefeld Academic Search Engine, PubMed, and Scopus databases. Results: Of the 173 identified studies, 6 were eligible for review. In trials comparing arthrocentesis alone to arthrocentesis with NSAIDs, slight differences in joint pain were noted. For tenoxicam, differences were under 1 point on a 0-10 scale after 4 weeks, with inconsistent results. Piroxicam showed no significant difference, and pain levels were minimal in both groups. For maximum mouth opening (MMO), tenoxicam showed no significant difference. Piroxicam increased MMO by nearly 5 mm, based on one small trial with bias concerns. Conclusions: Currently, there is no strong scientific evidence supporting the injection of NSAIDs into the temporomandibular joint to relieve pain or increase jaw movement. Preliminary reports on piroxicam with arthrocentesis and tenoxicam or diclofenac without rinsing justify further research.
Collapse
Affiliation(s)
- Filip Bliźniak
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (F.B.); (M.C.); (K.L.)
| | - Maciej Chęciński
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (F.B.); (M.C.); (K.L.)
| | - Kamila Chęcińska
- Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Kraków, Poland;
| | - Karolina Lubecka
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (F.B.); (M.C.); (K.L.)
| | - Monika Kamińska
- Provincial Hospital in Kielce, ul. Grunwaldzka 45, 25-736 Kielce, Poland;
| | - Mariusz Szuta
- Department of Oral Surgery, Medical College, Jagiellonian University, Montelupich 4, 31-155 Kraków, Poland;
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Maciej Sikora
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland
| |
Collapse
|
20
|
Šimunović L, Lapter Varga M, Negovetić Vranić D, Čuković-Bagić I, Bergman L, Meštrović S. The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders-A Cross-Sectional Study. Dent J (Basel) 2024; 12:213. [PMID: 39057000 PMCID: PMC11275482 DOI: 10.3390/dj12070213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/27/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years. METHODS TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth. RESULTS At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom. CONCLUSIONS Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.
Collapse
Affiliation(s)
- Luka Šimunović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.Š.); (M.L.V.)
| | - Marina Lapter Varga
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.Š.); (M.L.V.)
| | - Dubravka Negovetić Vranić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (D.N.V.); (I.Č.-B.)
| | - Ivana Čuković-Bagić
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (D.N.V.); (I.Č.-B.)
| | - Lana Bergman
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Senka Meštrović
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia; (L.Š.); (M.L.V.)
| |
Collapse
|
21
|
Lubecka K, Chęcińska K, Bliźniak F, Chęciński M, Turosz N, Rąpalska I, Michcik A, Chlubek D, Sikora M. Update on Evidence and Directions in Temporomandibular Joint Injection Techniques: A Rapid Review of Primary Research. J Clin Med 2024; 13:4022. [PMID: 39064062 PMCID: PMC11277300 DOI: 10.3390/jcm13144022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/25/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
This rapid review summarizes the latest primary research in temporomandibular joint (TMJ) injection treatment. The final literature searches were conducted on 4 January 2024. Selection was performed systematically following predefined eligibility criteria. Randomized control trials concerning the treatment of TMJ disorders with intra-articular injections were included. Studies on more invasive interventions were excluded. Quality of life, joint pain and range of mandibular mobility were assessed. Ultimately, 12 studies covering a total of 603 patients qualified. They concerned: (1) arthrocentesis (AC) and the administration of, (2) injectable platelet-rich fibrin (I-PRF), (3) platelet-rich plasma (PRP), (4) hyaluronic acid (HA), (5) non-steroidal anti-inflammatory drugs (NSAIDs), and (6) hypertonic dextrose (HD) with a local anesthetic. The dominant approach was to perform arthrocentesis before administering the appropriate injection substance (I-PRF, PRP, HA, or NSAID). Two current studies on the intra-articular administration of NSAIDs, specifically tenoxicam and piroxicam, are noteworthy. A mixture of PRP and HA was injected in another two trials. These two innovative approaches may prove to be significant directions for further research on injection treatment of TMJs.
Collapse
Affiliation(s)
- Karolina Lubecka
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (K.L.); (F.B.); (M.C.); (I.R.)
| | - Kamila Chęcińska
- Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Kraków, Poland;
| | - Filip Bliźniak
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (K.L.); (F.B.); (M.C.); (I.R.)
| | - Maciej Chęciński
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (K.L.); (F.B.); (M.C.); (I.R.)
| | - Natalia Turosz
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland;
| | - Iwona Rąpalska
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Kraków, Poland; (K.L.); (F.B.); (M.C.); (I.R.)
- Chair of Oral Surgery, Medical College, Jagiellonian University, Montelupich 4, 31-155 Kraków, Poland
| | - Adam Michcik
- Department of Maxillofacial Surgery, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214 Gdańsk, Poland;
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Maciej Sikora
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland;
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| |
Collapse
|
22
|
Yap AU, Sultana R, Natu VP. Somatic and temporomandibular disorder symptoms - Idioms of psychological distress in Southeast Asian youths. Cranio 2024; 42:364-371. [PMID: 34569454 DOI: 10.1080/08869634.2021.1982496] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the prevalence/severity of somatic and temporomandibular disorder (TMD) symptoms in Southeast Asian youths and determine their associations with psychological distress. METHODS Demographic information, Patient Health Questionnaire-15 (PHQ-15), Fonseca Anamnestic Index (FAI), and Depression, Anxiety, Stress Scale-21 (DASS-21) responses were gathered electronically and analyzed using non-parametric statistical and logistic regression analysis (p < 0.05). RESULTS Of 400 youths (mean age 18.7 ± 1.7 years; 52.3% females), 65.0%/47.0% reported somatic/TMD symptoms, and 10.5% had TMDs. Significant differences in psychological distress were observed among the varying severity of somatic/TMD symptoms. Correlations between PHQ-15/FAI and DASS-21 scores were weak to moderately strong (rs = 0.30-0.61). Stepwise logistic regression indicated that female gender, TMD symptoms, and stress were risk factors for somatic symptoms, while somatic symptoms and stress were probable factors for TMDs. CONCLUSION Somatic and TMD symptoms are common in Southeast Asian youths and may be a manifestation of psychological distress.
Collapse
Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital, Jurong East, Singapore, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- National Dental Research Institute, National Dental Centre Singapore, Singapore
- School of Health and Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| | | | - Vaishali Prakash Natu
- Faculty of Dentistry, National University of Singapore, Singapore
- School of Health and Social Sciences, Nanyang Polytechnic, Singapore, Singapore
| |
Collapse
|
23
|
Ettlin DA, Mishra SS. Temporomandibular Disorders in Relation to Mandibular Advancement Devices for Treating Obstructive Sleep Apnea. Dent Clin North Am 2024; 68:533-540. [PMID: 38879285 DOI: 10.1016/j.cden.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Mandibular advancement devices (MADs) keep the upper airways patent by holding the mandible and attached soft tissues forward via altered position of its condyles relative to the articulating surfaces of the temporal bones. During the first weeks of MAD therapy, pain may occur in the area of the temporomandibular joints, masticatory muscles, and/or teeth with a tendency of spontaneous resolution. In patients reporting temporomandibular disorder (TMD) symptoms prior to therapy, the MAD-related anterior condylar position during sleep may result in a reduction of TMD signs and symptoms.
Collapse
Affiliation(s)
- Dominik A Ettlin
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland; São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil.
| | - Sovna Shivani Mishra
- Craniofacial Pain Center, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, One Kneeland Street, Boston 02111, USA
| |
Collapse
|
24
|
Alpaydin MT, Alpaydin T, Torul D. Do symptoms and signs of temporomandibular disorders have an association with breathing pattern: a cross-sectional study on Turkish children and adolescents. BMC Oral Health 2024; 24:721. [PMID: 38914975 PMCID: PMC11194946 DOI: 10.1186/s12903-024-04482-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 06/13/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND This paper aimed to explore the prevalence of temporomandibular disorders (TMDs) signs/symptoms, and to investigate the possible link between signs/symptoms of TMDs and mouth breathing (MB) by evaluating along with other risk factors, in a Turkish subpopulation of children and adolescence. METHODS This study was conducted with the archival data of the patients who applied with orthodontic complaints. Data on demographic characteristics, family-related factors, systemic status, occlusion, breathing patterns, oral habits, and bruxism were retrieved from the archival records. RESULTS Nine hundred forty-five children and adolescents with a mean age of 14.82 ± 2.06 years were included in the study. Of the participants, 66% were girls, 60.4% were delivered by C-section, 8.4% of the participants had at least one systemic disease, 9.2% of the participants had allergy, and 4.3% of the participants' parents were divorced, 18.7% have an oral habit, 6.6% have bruxism, 29.8% have malocclusion and 14.1% have MB. Eight-point-five percent of participants have signs/symptoms of TMD. Among them 2.9% have pain, 3.7% have joint sounds, 1.4% have deflection, and 3.9% have deviation. Evaluation of the risk factors revealed a significant relation between the signs/symptoms of TMD and bruxism (OR 8.07 95% CI 4.36-14.92), gender (OR 2.01 95% CI 1.13-3.59), marital status of parents (OR 2.62 95% CI 1.07-6.42), and MB (OR 3.26 95% CI 1.86-5.71). CONCLUSIONS According to the study's findings, girls and those with bruxism, divorced parents, and MB behavior are more likely to have signs/symptoms of TMD. Age found to have significant effect on the occurrence of the signs/symptoms of TMD alone, but together with other factors the effect of the age is disappeared. Early screening and intervention of MB as well as the signs/symptoms of TMD can help to limit detrimental effects of these conditions on growth, and quality of life of children and adolescents.
Collapse
Affiliation(s)
| | - Tugce Alpaydin
- Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey.
| | - Damla Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, Turkey
| |
Collapse
|
25
|
Mejersjö C, Wänman A, Wenneberg B, Bergström EK. Can temporomandibular disorder symptoms and headaches be prevented in 13- to 15-year-old girls by information provided in a school setting? J Oral Rehabil 2024. [PMID: 38873731 DOI: 10.1111/joor.13773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/29/2024] [Accepted: 05/28/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Temporomandibular disorders (TMD) may develop, especially among girls, during the adolescence period. The aim of this study was to study if information and advice in a school setting could prevent development of TMD symptoms and headaches during the early teenage period. METHODS Thirteen-year-old girls, at 19 upper elementary schools were invited to participate in a study with structured information about the jaw system, TMD symptoms and risk factors, as well as advice how to manage risk factor and TMD. Six hundred and fifty-one girls enrolled, of which 507 girls were followed for 2-2.5 years. Half received information on three occasions (cases), and the other half served as controls. Included in the analysis of incidence of TMD symptoms were those without frequently occurring TMD symptoms (not including headaches) at baseline (n = 396) and included in the analysis of incidence of headaches were those without frequent headaches at baseline (n = 297). RESULT The 2-year incidence of TMD symptoms was significantly lower in the information cohort (19%) compared to the controls (28%) (p = .03). The 2-year incidence of headaches was lower among those who were allocated to information (30%) compared to controls (40%), but the difference was not statistically significant (p = .099). Cases who had headaches at baseline reported a significantly lower prevalence at follow-up compared to controls (p = .03). CONCLUSION Standardized information in school settings can prevent development of TMD symptoms and headaches among young girls.
Collapse
Affiliation(s)
- Christina Mejersjö
- Sahlgrenska Academy, Gothenburg University and Public Dental Health, Gothenburg, Sweden
| | - Anders Wänman
- Department of Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Bengt Wenneberg
- Institution of Odontology, Gothenburg University, Gothenburg, Sweden
| | - Eva-Karin Bergström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
26
|
Hansen C, Bakke M, Sonnesen L. Oro-facial function and quality of life in children and adolescents with large horizontal maxillary overjet-A case-control study. J Oral Rehabil 2024; 51:982-991. [PMID: 38414127 DOI: 10.1111/joor.13669] [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: 10/24/2023] [Revised: 12/22/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Large horizontal maxillary overjet (overjet) is associated with reduced bite force (BF) and number of contacts, which influence the chewing effectivity (CE). Oral health, oro-facial function (OF) and malocclusion have great impact on psychological well-being and quality of life (QoL). OBJECTIVES The aims of the study were to examine OF, temporomandibular disorders (TMD), BF, CE, QoL and well-being in children and adolescents with large overjet. METHODS The study was a case-control study including healthy children with large overjet in the study group compared to a control group of healthy children with neutral occlusion, all 9-14 years old. OF was examined by use of Nordic Orofacial Test-Screening (NOT-S), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and registration of morphological and functional occlusion. QoL and well-being were examined using KIDSCREEN-10 and Strengths and Difficulties Questionnaire. RESULTS The study and control groups included 37 and 32 participants, respectively. Significantly increased NOT-S score (p < .001) and reduced BF (p = .011), numbers of contacts (p < .001) and CE (p = .005) were found in the study group. BF, numbers of contacts and CE were negatively associated with erupting canines and premolars. No significant difference was found in age, gender, dental eruption, TMD diagnosis or QoL between the groups. Significantly increased emotional symptoms (p = .007), hyperactivity (p = .043) and total difficulties score (p = .009) were found in the study group. CONCLUSION The study group showed higher NOT-S score and reduced BF, number of contacts and CE. No difference in QoL were found between the groups, although reduced well-being and increased emotional symptoms, hyperactivity and total difficulties were found in the study group.
Collapse
Affiliation(s)
- Camilla Hansen
- Section of Orthodontics and Dental Sleep Clinic, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Bakke
- Section of Clinical Oral Physiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Liselotte Sonnesen
- Section of Orthodontics and Dental Sleep Clinic, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
27
|
Tariq M, Fatima K, Khan SFA, Mahmood W, Mahmood T, Khurshaid S, Khalid M, Khoosa M, Babur MN. Efficacy of massage versus massage with post isometric relaxation in temporomandibular disorders: a randomized controlled trial. BMC Sports Sci Med Rehabil 2024; 16:110. [PMID: 38750518 PMCID: PMC11097573 DOI: 10.1186/s13102-024-00865-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/15/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Temporomandibular joint disorder (TMD) is a common condition affecting the masticatory muscles and joint mobility. OBJECTIVES The primary objective was to compare the effects of massage therapy alone and massage therapy combined with post-isometric relaxation exercises in patients with TMD for pain and maximal mouth opening. DESIGN Assessor-blinded randomized controlled trial. SETTING Sir Ganga Ram Hospital, Chaudhry Muhammad Akram Dental Hospital, Lahore Medical and Dental Hospital. SUBJECTS Temporomandibular joint disorder patients. INTERVENTION Group A (n = 23) received conventional treatment including massage and therapeutic exercises consecutively for 2 weeks. Group B (n = 23) received post-isometric relaxation technique along with conventional treatment for consecutive 2 weeks. MAIN MEASURES The main outcome measures were pain and maximal mouth opening. Pain was measured using the Visual Analogue Scale (VAS) and maximal mouth opening (MMO) was measured using the TheraBite Scale. RESULTS Both groups demonstrated significant improvements in pain and MMO scores post-treatment. However, Group B (massage with post-isometric relaxation exercises) showed significantly better outcomes compared to Group A (massage alone). There was a statistically significant difference in post-treatment pain scores (P = 0.000) and MMO scores (P = 0.000) between the two groups. CONCLUSION The results suggest that massage therapy combined with post-isometric relaxation is more effective than massage therapy alone in managing pain and improving mouth opening in TMD patients. The study provides evidence supporting the use of these therapies in TMD management. TRIAL REGISTRY NUMBER NCT05810831. Date of registration/First submission: 15 March 2023.
Collapse
Affiliation(s)
- Mahnoor Tariq
- Department of Physical therapy & Rehabilitation Sciences, Faculty of Allied health Sciences, Superior University, Lahore, Pakistan
| | - Kainaat Fatima
- Department of Physical therapy & Rehabilitation Sciences, Faculty of Allied health Sciences, Kainaat Fatima Demonstrator, Superior University, Lahore, Pakistan
| | - Shahzada Faiz Ahmad Khan
- Department of Oral & Maxillofacial Surgery, Azra Naheed Dental College, The Superior University, Lahore, Pakistan
| | - Wajeeha Mahmood
- Department of Physical therapy, University of Health Sciences, Lahore, Pakistan.
| | - Tahir Mahmood
- Department of Physical Therapy, Rashid Latif Khan University [RLKU] Lahore, Lahore, Pakistan
| | - Sarma Khurshaid
- Physical Therapy Department Jinnah Hospital, Lahore, Pakistan
| | | | - Mehrunisa Khoosa
- Physical Therapy Department, Allama Iqbal Teaching Hospital, Dera Ghazi Khan, DGK, Pakistan
| | | |
Collapse
|
28
|
Kollmuss M, Edelhoff D, Schwendicke F, Wuersching SN. In Vitro Cytotoxic and Inflammatory Response of Gingival Fibroblasts and Oral Mucosal Keratinocytes to 3D Printed Oral Devices. Polymers (Basel) 2024; 16:1336. [PMID: 38794529 PMCID: PMC11125196 DOI: 10.3390/polym16101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The purpose of this study was to examine the biocompatibility of 3D printed materials used for additive manufacturing of rigid and flexible oral devices. Oral splints were produced and finished from six printable resins (pairs of rigid/flexible materials: KeySplint Hard [KR], KeySplint Soft [KF], V-Print Splint [VR], V-Print Splint Comfort [VF], NextDent Ortho Rigid [NR], NextDent Ortho Flex [NF]), and two types of PMMA blocks for subtractive manufacturing (Tizian Blank PMMA [TR], Tizian Flex Splint Comfort [TF]) as controls. The specimens were eluted in a cell culture medium for 7d. Human gingival fibroblasts (hGF-1) and human oral mucosal keratinocytes (hOK) were exposed to the eluates for 24 h. Cell viability, glutathione levels, apoptosis, necrosis, the cellular inflammatory response (IL-6 and PGE2 secretion), and cell morphology were assessed. All eluates led to a slight reduction of hGF-1 viability and intracellular glutathione levels. The strongest cytotoxic response of hGF-1 was observed with KF, NF, and NR eluates (p < 0.05 compared to unexposed cells). Viability, caspase-3/7 activity, necrosis levels, and IL-6/PGE2 secretion of hOK were barely affected by the materials. All materials showed an overall acceptable biocompatibility. hOK appeared to be more resilient to noxious agents than hGF-1 in vitro. There is insufficient evidence to generalize that flexible materials are more cytotoxic than rigid materials. From a biological point of view, 3D printing seems to be a viable alternative to milling for producing oral devices.
Collapse
Affiliation(s)
- Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany;
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
| | - Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
| |
Collapse
|
29
|
Feng X, Li S, Wang S, Meng Y, Zheng S, Liu C, Chang B, Shi C, Sun H. Piezo1 mediates the degradation of cartilage extracellular matrix in malocclusion-induced TMJOA. Oral Dis 2024; 30:2425-2438. [PMID: 37184045 DOI: 10.1111/odi.14615] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To evaluate the role of Piezo1 in the malocclusion-induced osteoarthritic cartilage of the temporomandibular joint. METHODS A temporomandibular joint osteoarthritis model was established using a unilateral anterior crossbite in vivo, and cartilage degeneration and Piezo1 expression were observed by histological and immunohistochemical staining. ATDC5 cells were loaded with 24 dyn/cm2 fluid flow shear stress using the Flexcell device in vitro and expression and function of Piezo1 were evaluated. After identifying the function of Piezo1 in YAP translocation under FFSS conditions, the influence of Piezo1 and YAP on metabolism-related enzymes under FFSS was detected through a real-time polymerase chain reaction analysis and western blotting. A UAC-TMJ injection model was established to observe the therapeutic effect of intra-articular injection of a Piezo1 inhibitor on osteoarthritic cartilage matrix loss. RESULTS Piezo1 was overexpressed in the osteoarthritic cartilage and cultured chondrocytes under shear stress. Piezo1 Silencing inhibited the nuclear translocation of YAP and subsequently downregulated the expression of MMP13 and ADAMTS5. Intra-articular injection of the Piezo1 inhibitor, GsMTx4, could ameliorate proteoglycan degradation in malocclusion-induced TMJOA and suppressed MMP13 and ADAMTS5 expression. CONCLUSIONS Our results revealed that the activation of Piezo1 promotes mechanical-induced cartilage degradation through the YAP-MMP13/ADAMTS5 signaling pathway.
Collapse
Affiliation(s)
- Xu Feng
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Siwen Li
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Department of Prosthodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Shuangshuang Wang
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yuan Meng
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Shize Zheng
- Department of Oral Pathology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Cangwei Liu
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Department of Prosthodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Bei Chang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Ce Shi
- Department of Oral Pathology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Hongchen Sun
- Department of Oral Pathology, School and Hospital of Stomatology, China Medical University, Shenyang, China
| |
Collapse
|
30
|
de Almeida Hoff E, Grossi RK, Bozzetti Pigozzi L, Bueno CH, Pattussi MP, Rossi T, Quarti Irigaray T, Weber JBB, Grossi ML. Depression and the risk of developing temporomandibular disorders in different diagnostic groups: A systematic review with meta-analysis. Cranio 2024:1-13. [PMID: 38461514 DOI: 10.1080/08869634.2024.2323424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To evaluate the role of depression in the development of TMD groups. METHODS This systematic review with meta-analysis compared the prevalence and scores of depression between TMD groups and controls. RESULTS The results showed that depression was a significant risk factor in the development of RDC/TMD axis I muscle disorders (group I) and arthralgia/osteoarthritis/osteoarthrosis (group III), and non-significant for disc displacements (group II). Severe depression had almost four times the risk of developing TMD as compared to moderate depression. CONCLUSION These findings suggest that addressing psychological factors in general, and depression in particular, in the managemenof TMD is crucial, especially in those TMD groups with higher pain levels (I and III), and the TMD pain reduction is crucial in reducing depression levels.
Collapse
Affiliation(s)
- Elisa de Almeida Hoff
- Undergraduate Student, School of Health and Life Sciences, Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Rafaela Krieger Grossi
- Undergraduate Student, Psychology Program (Specialist), University of Toronto, Mississauga, Canada
| | - Lucas Bozzetti Pigozzi
- Faculty of Serra Gaúcha, Program in Dentistry, Department of Prosthodontics, City of Caxias do Sul, Brazil
| | - Caroline Hoffmann Bueno
- Post-Graduate Program in Dentistry (Oral and Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Marcos Pascoal Pattussi
- Post-Graduate Program in Public Health, Vale do Rio dos Sinos University (UNISINOS), City of São Leopoldo, Brazil
| | - Tainá Rossi
- (Clinical Psychology), Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Tatiana Quarti Irigaray
- Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - João Batista Blessmann Weber
- Post-Graduate Program in Dentistry (Oral and Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Márcio Lima Grossi
- Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| |
Collapse
|
31
|
Shalish M, Leibovich A, Zakuto A, Slutzky H, Chaushu S, Almoznino G. The association between orthodontic treatment and temporomandibular disorders diagnosis and disease characteristics. J Oral Rehabil 2024; 51:487-499. [PMID: 38054581 DOI: 10.1111/joor.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/29/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The association between orthodontic treatment and temporomandibular disorders (TMD) has been contentious in the literature. OBJECTIVES To analyse the associations between orthodontic treatment and TMD diagnosis and diseases characteristics. METHODS This case-control study included 291 individuals, 192 TMDs and 99 controls. All patients underwent assessment based on a questionnaire and a clinical examination according to Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Differences in orthodontic treatment between TMDs and controls, as well as across different TMD diagnoses within the TMD group were analysed. Patients who underwent orthodontic treatment were compared to those who did not, regarding their trauma history, bruxism, aggressive teeth brushing, level of oral hygiene, pain scores, muscle tenderness scores and subjective sleep quality. RESULTS Of the 291 participants, 119 (40.9%) underwent orthodontic treatment and 172 (59.1%) had no orthodontics experience. Orthodontic treatment included: mandibular orthodontic treatment (102 subjects) and maxillary orthodontic treatment (113 subjects) of those 47 used a headgear. Following multivariate analysis among TMDs, orthodontic treatment was associated with a good level of oral hygiene versus poor (Odds ratio [OR]: 5.17 [1.04-25.59]), lower number of tender muscles [OR = 0.84 (0.74-0.96)] and lower (better) Pittsburgh Sleep Quality Index (PSQI) scores (OR = 0.86 [0.76-0.97]). None of the studied parameters maintained a statistically significant association with orthodontic treatment in the multivariate analysis among the entire study population. CONCLUSIONS Utilising a holistic approach, this study supports the main hypothesis that orthodontic treatment is not associated with TMD diagnosis and disease characteristics.
Collapse
Affiliation(s)
- Miriam Shalish
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Orthodontics, Hadassah Medical Center, Jerusalem, Israel
| | - Avi Leibovich
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Orthodontics, Hadassah Medical Center, Jerusalem, Israel
| | - Avraham Zakuto
- Temporomandibular Joint Disorders Clinic, Department of Prosthodontics, Oral and Maxillofacial Center, Israel Defense Forces, Medical Corps, Tel-Hashomer, Tel-Aviv, Israel
| | - Hulio Slutzky
- Temporomandibular Joint Disorders Clinic, Department of Prosthodontics, Oral and Maxillofacial Center, Israel Defense Forces, Medical Corps, Tel-Hashomer, Tel-Aviv, Israel
| | - Stella Chaushu
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Orthodontics, Hadassah Medical Center, Jerusalem, Israel
| | - Galit Almoznino
- Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Big Biomedical Data Research Laboratory, Dean's Office, Hadassah Medical Center, Jerusalem, Israel
- Department of Oral Medicine, Sedation & Maxillofacial Imaging, Hadassah Medical Center, Jerusalem, Israel
| |
Collapse
|
32
|
Yazıcıoğlu İ, Çiftçi V. Evaluation of signs and symptoms of temporomandibular disorders and incisal relationships among 7-10-year-old Turkish children with sleep bruxism: A cross-sectional study. Cranio 2024; 42:243-249. [PMID: 34176445 DOI: 10.1080/08869634.2021.1939932] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To study the signs and symptoms of temporomandibular disorders (TMDs) and incisal relationships related to sleep bruxism and parafunctional habits among children. METHODS The study consisted of 106 children (53 with and 53 without bruxism) between the ages of 7 and 10. A general questionnaire and Diagnostic Criteria for Temporomandibular Disorders Axis I examination form were used for each child. RESULTS There were significant differences between children according to pain, headache, midline deviation, opening pattern, temporomandibular joint noise, overjet, overbite, corrected deviation, and pain disorders (p < 0.05). According to the logistic regression, the higher scores of "mouth breathing" and "horizontal incisal overjet" were independent risk factors for TMDs. The lack of "bruxism" and "sleeping with open mouth" were protective factors for TMDs. CONCLUSION Children with bruxism showed signs and symptoms of TMDs and divergence in incisal relationships.
Collapse
Affiliation(s)
- İffet Yazıcıoğlu
- Department of Pediatric Dentistry, Çukurova University, Adana, Turkey
| | - Volkan Çiftçi
- Department of Pediatric Dentistry, Çukurova University, Adana, Turkey
| |
Collapse
|
33
|
Caetano JP, Goettems ML, Nascimento GG, Jansen K, da Silva RA, Svensson P, Boscato N. Influence of malocclusion on sleep bruxism and orofacial pain: data from a study in school children. Clin Oral Investig 2024; 28:142. [PMID: 38347236 DOI: 10.1007/s00784-024-05545-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES This cross-sectional school-based study explored the influence of malocclusion on temporomandibular disorders (TMD) pain complaints, and whether this association would be mediated by sleep bruxism in a representative sample of 7- to 8-year-old children. METHODS Path analysis estimated direct, indirect, and total effects of occlusal features on sleep bruxism and TMD pain in 7- to 8-year-old children. Occlusal features were assessed with Dental Aesthetic Index (DAI), orofacial pain complaints using the TMD pain screener, possible sleep bruxism based on self-reports, and probable sleep bruxism based on self-reports combined with clinical findings. Structural equation modeling analyzed data with confounding factors. RESULTS From 580 participants, possible sleep bruxism was observed in 136 children (31.5%), probable sleep bruxism in 30 children (6.7%), and TMD pain complaints in 78 children (13.8%). Malocclusion had no direct effect on either possible sleep bruxism [standardized coefficient (SC) 0.000; p = 0.992], or TMD pain complaints (SC - 0.01; p = 0.740). When probable sleep bruxism was set as the mediator of interest, malocclusion did not directly affect probable sleep bruxism (SC 0.01; p = 0.766), nor TMD pain complaints (SC - 0.02; p = 0.515). A direct effect of probable sleep bruxism on TMD pain complaints was observed with an SC of 0.60 (p < 0.001). However, in neither case, malocclusion indirectly affected TMD pain complaints via bruxism. CONCLUSION Malocclusion in 7- to 8-year-old children did not directly influence possible or probable sleep bruxism or TMD pain complaints. Instead, probable sleep bruxism was strongly associated with TMD pain complaints. CLINICAL SIGNIFICANCE The impact of occlusal features on TMD pain complaints and bruxism has been a long-standing controversy in dentistry. However, the scientific literature linking this association may be inconsistent, mainly due to biased sample selection methods with inadequate consideration of confounders. Further research should try to identify additional risk factors for TMD pain in addition to probable sleep bruxism in children.
Collapse
Affiliation(s)
- João Pedro Caetano
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil
| | - Marilia Leão Goettems
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil
| | - Gustavo G Nascimento
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen Jansen
- Graduate Program in Health & Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Graduate Program in Health & Behavior, Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Noéli Boscato
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, RS, Brazil.
- Department of Restorative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves 457, Room 505, Pelotas, Brazil.
| |
Collapse
|
34
|
Lu T, Mei L, Li BC, Huang ZW, Li H. Hybrid treatment of varied orthodontic appliances for a patient with skeletal class II and temporomandibular joint disorders: A case report and review of literature. World J Clin Cases 2024; 12:431-442. [PMID: 38313641 PMCID: PMC10835688 DOI: 10.12998/wjcc.v12.i2.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/11/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The relation between orthodontic treatment and temporomandibular disorders (TMDs) is under debate; the management of TMD during orthodontic treatment has always been a challenge. If TMD symptoms occur during orthodontic treatment, an immediate pause of orthodontic adjustments is recommended; the treatment can resume when the symptoms are managed and stabilized. CASE SUMMARY This case report presents a patient (26-year-old, female) with angle class I, skeletal class II and TMDs. The treatment was a hybrid of clear aligners, fixed appliances and temporary anchorage devices (TADs). After 3 mo resting and treatment on her TMD, the patient's TMD symptom alleviated, but her anterior occlusion displayed deep overbite. Therefore, the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves. After the levelling, the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion. After careful examination of temporomandibular joints (TMJ) position, the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion. Eventually, the improved facial appearance and relatively stable occlusion were achieved. The 1-year follow-up records showed there was no obvious change in TMJ morphology, and her occlusion was stable. CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients. Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.
Collapse
Affiliation(s)
- Tong Lu
- Department of Orthodontics, Nanjing Stomatological Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Li Mei
- Discipline of Orthodontics, Department of Oral Science, Faculty of Dentistry, University of Otago, Dunedin 9016, New Zealand
| | - Bao-Chao Li
- Department of Orthodontics, Nanjing Stomatological Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Zi-Wei Huang
- Department of Orthodontics, Nanjing Stomatological Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China
| |
Collapse
|
35
|
Losev FF, Nadtochiy AG, Starikov NA, Babunashvili GB, Rudakov AM, Vataeva AA. [Analysis of changes in the position of the temporomandibular joint articular disc during positioning splint therapy according to magnetic resonance imaging data]. STOMATOLOGIIA 2024; 103:30-34. [PMID: 39704996 DOI: 10.17116/stomat202410306130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2024]
Abstract
THE AIM OF THE STUDY Was to assess an impact of positioning occlusal splints made by various methods on the position of the articular disc of the temporomandibular joint according to MRI data. MATERIALS AND METHODS 40 patients (8 men and 32 women) aged from 18 to 60 years with temporomandibular joint pain dysfunction syndrome were examined (ICD-10 code K07.60). Patients were treated with splint therapy using traditional splints made with combined method (20 patients) and subtractive occlusal splints made by CAD/CAM technology (20 patients). All patients had MRI of the temporomandibular joints before splint therapy and at the final stage of treatment to determine the position of the articular disc in the habitual occlusion and at maximum mouth opening. RESULTS After splint therapy, patients in both groups showed an improvement in the position of the articular disc in the usual occlusion: the rate of patients with bilateral dislocation of the articular disc decreased from 85% to 67.5%, and with unilateral articular disc dislocation decreased from 15% to 10%. With maximum mouth opening, complete reposition of the articular disc in both joints were recorded in 22.5%; the rate of patients with bilateral disorder of articular disc repositioning decreased from 85% to 67.5%, and with unilateral disorder of articular disc repositioning decreased from 15% to 10%. CONCLUSIONS Splint therapy had a pronounced positive clinical effect in patients with pain dysfunction syndrome in the temporomandibular joints. Splint therapy is more effective in correcting sagittal dislocation of the articular disc than transversal dislocation. The study showed comparable treatment results when using traditional and digital occlusal splints.
Collapse
Affiliation(s)
- F F Losev
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
- First Moscow State Medical University named after I.V. Sechenov, Moscow, Russia
| | - A G Nadtochiy
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - N A Starikov
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
- First Moscow State Medical University named after I.V. Sechenov, Moscow, Russia
| | - G B Babunashvili
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - A M Rudakov
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - A A Vataeva
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| |
Collapse
|
36
|
Nazzal H, Baccar M, Ziad T, Al-Musfir T, Al Emadi B, Matoug-Elwerfelli M, Narasimhan S, Khan Y, Reagu S. Prevalence of anxiety, sleep bruxism and temporomandibular disorders during COVID-19 in Qatari children and adolescents: a cross-sectional study. Eur Arch Paediatr Dent 2023; 24:787-795. [PMID: 37848680 PMCID: PMC10657298 DOI: 10.1007/s40368-023-00847-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE Understanding the impact of coronavirus disease-2019 (COVID-19) pandemic social restrictions on the lives of children and adolescents is of utmost importance to enable timely diagnosis and treatment. Therefore, the aim of this study was to explore the prevalence of anxiety, sleep bruxism, temporomandibular disorders (TMD) and change in dietary and brushing habits and their association with COVID-19 social restrictions. METHODS Parents of fit and healthy Qatari children and adolescents were recruited and interviewed by the research team, whereby validated questioners were used to assess the prevalence of children's/adolescents' anxiety, sleep bruxism and TMD. Furthermore, changes in dietary and brushing habits were also evaluated. RESULTS A total of 199 parents of children and adolescents (mean age = 9.3 ± 3.2 years old) were included. Overall anxiety symptoms, sleep bruxism and TMD were evident in 29.6%, 5.7% and 23.1%, respectively. An increased consumption of food, sweets and worsening of brushing habits were evident in 51.8%, 62.8% and 31.2%, respectively. CONCLUSION Within the limitations of this study, pandemic-related social restrictions could result in elevated levels of anxiety, specifically, social phobia, amongst children and adolescents, which could inevitably lead to unwanted dental consequences.
Collapse
Affiliation(s)
- H Nazzal
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - M Baccar
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - T Ziad
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
- NYU Langone Dental Medicine, Advanced Education in Pediatric Dentistry, Brooklyn, NY, USA
- Pediatric Dental Services, Sun Life Health, Casa Grande, Arizona, USA
| | - T Al-Musfir
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | - B Al Emadi
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | | | - S Narasimhan
- Hamad Dental Centre, Hamad Medical Corporation, Doha, Qatar
| | - Y Khan
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - S Reagu
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine, Doha, Qatar
| |
Collapse
|
37
|
Ekberg E, Nilsson IM, Michelotti A, Al-Khotani A, Alstergren P, Rodrigues Conti PC, Durham J, Goulet JP, Hirsch C, Kalaykova S, Kapos FP, King CD, Komiyama O, Koutris M, List T, Lobbezoo F, Ohrbach R, Palermo TM, Peck CC, Penlington C, Restrepo C, Rodrigues MJ, Sharma S, Svensson P, Visscher CM, Wahlund K, Rongo R. Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for adolescents. J Oral Rehabil 2023; 50:1167-1180. [PMID: 37144484 DOI: 10.1111/joor.13488] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 02/24/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed. OBJECTIVE To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings. METHODS International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents. RESULTS The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents. CONCLUSION The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
Collapse
Affiliation(s)
- EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ing-Marie Nilsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Center for Oral Rehabilitation, Norrköping, Sweden
| | - Ambrosina Michelotti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - Amal Al-Khotani
- Dental Department, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
- Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Paulo Cesar Rodrigues Conti
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry-University of São Paulo, Bauru, Sao Paulo, Brazil
- Bauru Orofacial Pain Group, University of São Paulo, Bauru, Sao Paulo, Brazil
| | - Justin Durham
- Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Jean-Paul Goulet
- Faculty of Dental Medicine, Laval University, Quebec, Quebec, Canada
| | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Stanimira Kalaykova
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Christopher D King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Pediatric Pain Research Center (PPRC), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Osamu Komiyama
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Christopher C Peck
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Chris Penlington
- Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Maria Joao Rodrigues
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sonia Sharma
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York, USA
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Wahlund
- Department of Orofacial Pain and Jaw Function, Kalmar County Hospital, Kalmar, Sweden
| | - Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| |
Collapse
|
38
|
Kolçakoğlu K, Doğan S, Zararsız G, Kütük N, Gönen ZB. Relationship Between Temporomandibular Ankylosis And Maximum Mouth Opening In Children. J Oral Rehabil 2023; 50:940-947. [PMID: 37221976 DOI: 10.1111/joor.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/28/2023] [Accepted: 05/06/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Pediatric dentists should have information regarding whether mouth opening is limited. In clinical practice, these professionals should collect and record oral area measurements at the pediatric patient's first medical examination. OBJECTIVES The study's aim developed the standard mouth opening measurement in children by using ordinary least squares regression to develop a clinical prediction model in children with Temporomandibular Joint Ankylosis before preoperative surgery. METHODS All participants completed their age, gender, and calculated height, weight, body mass index, and birth weight. Pediatric dentist performed all mouth-opening measurements. The oral-maxillofacial surgeon marked subnasal and pogonion points for the lower facial length of soft tissue. It was measured using the distance between the subnasal and pogonion with a digital vernier caliper. The widths of the three fingers (index, middle, and ring fingers) and four fingers (index, middle, ring, and little fingers) were also measured using a digital vernier caliper. RESULTS Maximum mouth opening showed that three-finger width (R2 = 0.566, F = 185.479) and four-finger width (R2 = 0.462, F = 122.209) had a significant influence on the Maximum mouth opening (MMO) (p < 0.001). CONCLUSION Pediatric dentists should collaborate with the treating maxillofacial surgeon to manage long-term treatment needs for individuals with Temporomandibular Joint Ankylosis.
Collapse
Affiliation(s)
- Kevser Kolçakoğlu
- Department of Pediatric Dentistry, Erciyes University Faculty of Dentistry, Kayseri, Turkey
| | - Salih Doğan
- Department of Pediatric Dentistry, Erciyes University Faculty of Dentistry, Kayseri, Turkey
| | - Gökmen Zararsız
- Faculty of Medicine, Department of Biostatistics, Erciyes University, Kayseri, Turkey
- Erciyes University, Drug Application and Research Center (ERFARMA), Kayseri, Turkey
| | - Nükhet Kütük
- Department of Oral Maxillofacial Surgery, Bezmialem University Faculty of Dentistry, İstanbul, Turkey
| | - Zeynep Burçin Gönen
- Department of Oral Maxillofacial Surgery, Erciyes University Faculty of Dentistry, Kayseri, Turkey
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| |
Collapse
|
39
|
Alhammadi MS, Almashraqi AA, Thawaba AA, Fayed MMS, Aboalnaga AA. Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders. Clin Oral Investig 2023; 27:5011-5020. [PMID: 37358688 PMCID: PMC10492742 DOI: 10.1007/s00784-023-05120-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/08/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders. METHODS A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography. RESULTS The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients. CONCLUSION There were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients. CLINICAL RELEVANCE The temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.
Collapse
Affiliation(s)
- Maged S. Alhammadi
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abeer A. Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ahmed A. Thawaba
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mona M. Salah Fayed
- Department of Orthodontics, Faculty of Dentistry, Cairo University and Vice Dean for Postgraduate Studies and Research, Faculty of Dentistry, MSA University, Cairo, Egypt
| | - Amira A. Aboalnaga
- Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| |
Collapse
|
40
|
Walker BM, Donnell CC. Does dental rehabilitation under general anaesthetic contribute to the development of temporomandibular disorders in children and adolescents? A scoping review. J Oral Rehabil 2023; 50:902-913. [PMID: 37247258 DOI: 10.1111/joor.13525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 02/04/2023] [Accepted: 05/23/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMDs) have multiple aetiological factors. Although some evidence suggests invasive and lengthy dental procedures may contribute towards TMD development, there is a relative paucity in the literature regarding an association between elements of paediatric dental general anaesthesia (pDGA) and TMDs. This review aims to consider the impact of dental rehabilitation (and its constituent elements) performed under general anaesthesia on the development of TMDs in childhood and adolescence and identify theories and/or gaps in knowledge which may benefit from future research. METHODS Due to the need to preliminarily examine the nature and extent of the current evidence base, a scoping review approach was chosen. The review was conducted based on the framework provided by the methodological working group of the Joanna Briggs Institute (JBI) for conducting systematic scoping reviews. Electronic databases MEDLINE, Embase, Scopus, Web of Science and Cochrane Library were searched as well as the grey literature using OpenGrey, Nexis, Ethos, Google Scholar and ProQuest, with eligible studies uploaded onto Zotero (Mac Version 5.0.96.2). RESULTS A total of 810 records were identified. After removing duplicates and those not available in English, 260 were identified for title and abstract screening. Seventy-six records underwent full-text review of which only one met the broad inclusion criteria. The most common reasons for exclusion were no specific relation to general anaesthesia, not specifically relating to dental treatment and only being concerned with TMD management. The included study found that while development of TMDs following dental rehabilitation under GA did occur in children, whether the problems caused by treatment were exacerbated by other elements of the pDGA process remains unknown. CONCLUSION This review has confirmed a distinct paucity of research in this field. While there is no current tangible scientific evidence that common and routine dental procedures lead to TMD, the literature shows that alterations to any one or a combination of critical factors can contribute to TMD development, which may be collectively exacerbated by iatrogenic macrotrauma during the pDGA process. We have highlighted elements of pre-, peri- and post-operative pDGA, alongside biopsychosocial factors, which may contribute to TMD development in childhood and adolescence and may benefit from future research.
Collapse
Affiliation(s)
- Benjamin M Walker
- Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - Christopher C Donnell
- Department of Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| |
Collapse
|
41
|
Rentsch M, Zumbrunn Wojczyńska A, Gallo LM, Colombo V. Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7-14 Years. J Clin Med 2023; 12:4109. [PMID: 37373802 DOI: 10.3390/jcm12124109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7-14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7-10) and adolescents (aged 11-14) of both sexes were invited to participate in this study (n = 1468). Descriptive statistics for all observed variables and Mann-Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants (n = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low.
Collapse
Affiliation(s)
- Mathias Rentsch
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
- Public-School Dental Services of the City of Zurich, 8002 Zurich, Switzerland
| | | | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Vera Colombo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
| |
Collapse
|
42
|
Wuersching SN, Westphal D, Stawarczyk B, Edelhoff D, Kollmuss M. Surface properties and initial bacterial biofilm growth on 3D-printed oral appliances: a comparative in vitro study. Clin Oral Investig 2023; 27:2667-2677. [PMID: 36576565 PMCID: PMC10264496 DOI: 10.1007/s00784-022-04838-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the initial bacterial adhesion on 3D-printed splint materials in relation to their surface properties. MATERIALS AND METHODS Specimens of five printable splint resins (SHERAprint-ortho plus UV, NextDent Ortho Rigid, LuxaPrint Ortho Plus, V-Print Splint, KeySplint Soft), one polymethylmethacrylate (PMMA) block for subtractive manufacturing (Astron CLEARsplint Disc), two conventional powder/liquid PMMA materials (FuturaGen, Astron CLEARsplint), and one polyethylene terephthalate glycol (PETG) thermoplastic sheet for vacuum forming (Erkodur Thermoforming Foil) were produced and finished. Surface roughness Ra was determined via contact profilometry. Surface morphology was examined under a scanning electron microscope. Multi-species bacterial biofilms were grown on entire splints. Total biofilm mass and viable bacterial counts (CFU/ml) within the biofilms were determined. Statistical analyses were performed with a one-way ANOVA, Tukey's post hoc test, and Pearson's test (p < 0.05). RESULTS Astron CLEARsplint and KeySplint Soft specimens showed the highest surface roughness. The mean total biofilm mass on KeySplint Soft splints was higher compared to all other materials (p < 0.05). Colony-forming unit per milliliter on FuturaGen, Astron CLEARsplint, and KeySplint Soft splints was one log scale higher compared to all other materials. The other four printable resins displayed overall lower Ra, biofilm mass, and CFU/ml. A positive correlation was found between Ra and CFU/ml (r = 0.69, p = 0.04). CONCLUSIONS The 3D-printed splints showed overall favorable results regarding surface roughness and bacterial adhesion. Thermoplastic materials seem to display a higher surface roughness, making them more susceptible to microbial adhesion. CLINICAL RELEVANCE The development of caries and gingivitis in patients with oral appliances may be affected by the type of material.
Collapse
Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - David Westphal
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| |
Collapse
|
43
|
Mélou C, Sixou JL, Sinquin C, Chauvel-Lebret D. Temporomandibular disorders in children and adolescents: A review. Arch Pediatr 2023:S0929-693X(23)00053-2. [PMID: 37147156 DOI: 10.1016/j.arcped.2023.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/21/2023] [Accepted: 03/25/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are generally observed in individuals between the ages of 20 and 40 years. TMD have also been described in children and adolescents but are still not widely detected and treated in routine practice. Through a literature review, this work aims to improve the diagnosis and management of TMD in children and adolescents by dentists. METHODS This literature review was performed by a computerized search of the database PubMed for published articles on TMD in children and adolescents. Articles evaluating the prevalence, etiologies and risk factors, diagnosis, signs, and symptoms as well as the comorbidities of TMD, published between 2001 and 2022, were included in this review. RESULTS A total of 51 articles were included. Most of studies reported a prevalence of over 20%, with a higher prevalence in females. The two most common diagnoses were myofascial pain and disk displacement with reduction. Headaches were often associated with the condition. The management of TMD in children and adolescents has been poorly studied. CONCLUSION TMD frequently affect children and adolescents. Therefore, for prevention purposes, an examination of the masticatory system should be included in the dental check-up. Early diagnosis is essential in order to limit effects on their growth, development, and quality of life. TMD management is not currently validated for children and adolescents. Noninvasive and reversible care should be preferred.
Collapse
Affiliation(s)
- C Mélou
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France
| | - J L Sixou
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France
| | - C Sinquin
- 20 avenue des ibis 44500 la baule, France
| | - D Chauvel-Lebret
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France.
| |
Collapse
|
44
|
Alrizqi AH, Aleissa BM. Prevalence of Temporomandibular Disorders Between 2015-2021: A Literature Review. Cureus 2023; 15:e37028. [PMID: 37143640 PMCID: PMC10152905 DOI: 10.7759/cureus.37028] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/04/2023] Open
Abstract
The prevalence of temporomandibular disorder (TMD) is significantly high around the world. We conducted a literature review to determine the prevalence of TMD globally and in Saudi Arabia based on published studies. This review article collected 35 full-text articles after searching PubMed for TMD prevalence between 2015-2021. Assessing the prevalence of TMDs is important for several reasons, including providing an overview of the incidence of such disorders, educating the community, clarifying the gender and age group with the highest prevalence, establishing a program to prepare specialists to treat these disorders, and identifying the appropriate number of specialists by comparing TMD prevalence to Saudi Arabia's census. Out of 35 selected articles, thirty studies were done outside Saudi Arabia, and five were local. Less than 40% prevalence of TMD has been reported with associated factors such as gender, psychological status, and age. The female gender has shown a higher TMD rate than the male gender. Some authors have suggested conducting a temporomandibular joint (TMJ) assessment in the pediatric clinic. Moreover, TMD screening is an important tool for every patient visiting the dental clinic to assess TMJ status and treat TMD at early stages, especially in non-painful cases.
Collapse
|
45
|
Minervini G, Franco R, Marrapodi MM, Fiorillo L, Cervino G, Cicciù M. Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular Disorders: A systematic review with meta-analysis. J Oral Rehabil 2023; 50:522-530. [PMID: 36912441 DOI: 10.1111/joor.13446] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/23/2023] [Accepted: 03/02/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND The prevalence of temporomandibular disorders (TMDs) in children and adolescents is not well-known. This is partly because TMD is not often diagnosed in children and partly because there is no agreed-upon definition of TMD. There is a growing body of evidence to suggest that there are gender differences in the prevalence and presentation of TMD in adult. The aim was to assess the prevalence of TMDs in subjects aged 8-19 evaluated with Diagnostic Criteria for TMDs (DC/TMD) and to assess gender differences. METHODS PubMed, Web of Science and Lilacs were systematically searched until 30 November 2022, to identify studies presenting children and adolescents patients affected by TMDs. RESULTS Out of 40 papers, three studies were included. The included subjects in this review were 1914 (1093 female and 821 male). Seven hundred and thirty-six on 1914 patients (38.4%) presented TMD. Among 1093 female, 489 (44.7%) presented TMD, while 247/821 male (30%) experienced TMD. Meta-analysis revealed that the female had a higher TMD prevalence than male (RR 2.10; 95% CI: 1.21-3.65). CONCLUSION TMD prevalence in children and adolescence varies between 20% and 60%. Female had a higher prevalence of TMDs compared to male.
Collapse
Affiliation(s)
- Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of University of Rome "Tor Vergata", 00100, Rome, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luca Fiorillo
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125, Messina, via Consolare Valeria, 1, Italy
| | - Gabriele Cervino
- School of Dentistry Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125, Messina, via Consolare Valeria, 1, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| |
Collapse
|
46
|
Araújo Sarmento J, Valadas LAR, Sousa JADS, Gualberto AVS, Rodrigues LLFR, Guimarães AS. Development and application of a questionnaire to evaluate signs of temporomandibular disorder observed by caregivers of children with autism spectrum disorder. SPECIAL CARE IN DENTISTRY 2023; 43:232-237. [PMID: 35965388 DOI: 10.1111/scd.12767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to develop and validate a questionnaire to detect signs of temporomandibular disorders (TMD), verifying whether the perception of signs observed by caregivers of non-verbal autistic children are the same as those observed by caregivers of verbal ones. METHODS This is a cross-sectional, exploratory and analytical study. The sample consisted of forty individuals with Autism Spectrum Disorders (ASD), thirty non-verbal and ten verbal, besides their respective caregivers. For this, an experimental questionnaire was applied and compared to the European Academy of Orofacial Pain (EAOP) questionnaire, which is already validated and widely used throughout the world. All responses were compared using the chi-square test and the questionnaires were compared with the McNemar test, considering p < .05. RESULTS When comparing the number of coincident responses to the questionnaire between caregivers and children, the mean was 8.2 ± 1.61 responses. After performing the binomial test, no statistically significant discrepancy was found between the results of the two tests adopted when the questionnaires were compared (Mc Nemar test, p > .05) CONCLUSION: The development of this questionnaire and its validation serve as a support for health professionals in the TMD area, for the detection of TMD in non-verbal autistic children, providing them and their caregivers, who are faced with several difficulties in their day-by-day, a facilitating instrument.
Collapse
Affiliation(s)
- Juliana Araújo Sarmento
- São Leopoldo Mandic College of Dentistry, Campinas, São Paulo, Brazil
- Dental School, Floriano College, Piauí, Brazil
| | | | | | | | | | - Antônio Sérgio Guimarães
- Laboratory of Neuroimmune Interface of Pain Research, São Leopoldo Mandic College of Dentistry, Campinas, Brazil
| |
Collapse
|
47
|
Tuncer A, Kastal E, Tuncer AH, Yazıcıoğlu İ. The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic. J Back Musculoskelet Rehabil 2023; 36:1047-1059. [PMID: 37482974 DOI: 10.3233/bmr-220235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND Sleep bruxism has been associated with temporomandibular dysfunction, pain, fatigue, and poor sleep quality. OBJECTIVE The aim of this study was to determine the gender and age distribution of sleep and oral habits of children with sleep bruxism and to examine the effect of a sleep hygiene and physiotherapy program. METHODS In this cross-sectional study, 82 children aged 6-13 years with sleep bruxism were initially screened between March 2020 and June 2021, from which 37 of them voluntarily attended an 8-week sleep hygiene and physiotherapy program. Evaluations were made using a Visual Analogue Scale (VAS), the Children's Sleep Habits Questionnaire (CSHQ), and the Oral Habits Questionnaire (OHQ) at the beginning and at the end of the 8-week program. RESULTS Statistically significant differences were determined between the 6-9 years and 10-13-year age groups in respect of the sleep habits subcategories of resistance to bedtime (p= 0.001), sleep anxiety (p= 0.043), parasomnia (p= 0.040), and sleep respiratory disorder (p= 0.041). Following the 8-week treatment program, a significant reduction was obtained in the VAS value (p< 0.05), CSHQ subcategories of resistance to bedtime (p= 0.001), sleep duration (p= 0.008), parasomnia (p= 0.000), and in the OHQ score (p= 0.000). CONCLUSION There was no relationship between sleep bruxism and gender, but a relationship was found with age. The rate of bruxism was seen to decrease with an increase in age. It was determined that oral, sleep habits, and bruxism are closely related, and the rates at which bruxism is seen are affected by the oral habits. Sleep hygiene and physiotherapy have been effective in children with sleep bruxism.
Collapse
Affiliation(s)
- Aysenur Tuncer
- Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Eren Kastal
- Department of Physiotherapy and Rehabilitation, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Abidin Hakan Tuncer
- Department of Pediatric Dentistry, Children's Hospital Colorado, Aurora, CO, USA
| | - İffet Yazıcıoğlu
- Department of Pediatric Dentistry, Çukurova University, Adana, Turkey
| |
Collapse
|
48
|
Seo YS, Park HJ, Yu SK, Jeong SR, Ryu JW. Evaluation of Cortical Bone Formation on Mandibular Condyle in Asymptomatic Adolescents and Young Adults Using Cone-Beam Computed Tomography. Life (Basel) 2022; 12:life12122032. [PMID: 36556397 PMCID: PMC9785755 DOI: 10.3390/life12122032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 12/09/2022] Open
Abstract
The aim of this study was to evaluate cortical bone formation on the mandibular condyle using cone-beam computed tomography (CBCT) in asymptomatic adolescents and young adults and to evaluate the relationship between age and sex. CBCT images that can evaluate the shape of the mandibular condyle were selected from asymptomatic patients aged 13−25. The degree of cortication on the mandibular condyle (CMC) was evaluated using CBCT images reconstructed in the axial, sagittal, and coronal planes. CBCT data of 829 patients (413 males, 416 females) were selected and then the left and right images of all patients were acquired; consequently, a total of 1658 temporomandibular joint-related images were evaluated in this study. The degree of CMC was correlated with age in men and women (p < 0.05). The frequency of CMC 0 disappeared in woman aged 20 years and in men aged 21 years. Cortical bone formation of the mandibular condyle was completed at age 22 years in women and 24 years in men. The degrees of cortical bone formation of the mandibular condyle between men and women showed significant differences between the ages of 15−19 and 22 years. This difference can be interpreted as a different mandible growth period between the sexes.
Collapse
Affiliation(s)
- Yo-Seob Seo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Hyun-Jeong Park
- Department of Oral Medicine, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Sun-Kyoung Yu
- Department of Oral Anatomy, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Seo-Rin Jeong
- Department of Orthodontics, School of Dentistry, Gwangju 61452, Republic of Korea
| | - Ji-Won Ryu
- Department of Oral Medicine, School of Dentistry, Gwangju 61452, Republic of Korea
- Correspondence:
| |
Collapse
|
49
|
Alhammadi MS. Dimensional and Positional Characteristics of the Temporomandibular Joint of Skeletal Class II Malocclusion with and without Temporomandibular Disorders. J Contemp Dent Pract 2022; 23:1203-1210. [PMID: 37125517 DOI: 10.5005/jp-journals-10024-3441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
AIM This study sought to evaluate dimensional and positional temporomandibular joint (TMJ) features in three-dimensions in skeletal class II malocclusion with and without temporomandibular disorders (TMDs). MATERIALS AND METHODS A total of 91 (182 joints) adult patients were divided into the following two groups: (1) Group I - TMD (n = 56; 112 joints) and (2) group II - non-TMD (n = 35; 70 joints). Dimensional and positional TMJ characteristics including glenoid fossae, mandibular condyles, and joint spaces were assessed using cone-beam computed tomography (CBCT). RESULTS The mandibular fossa in the TMD group was significantly more lateral than in the non-TMD group, and the mandibular fossa anterior wall inclination to the horizontal plane showed a significantly more vertically inclined wall in the TMD group compared to the non-TMD group. Significantly vertical mandibular condylar changes in the form of less vertical inclination, more vertical position, and lower vertical dimension (height) in addition to more upward position within the joint space were found. The TMD group showed significantly decreased superior and posterior joint spaces in addition to significantly increased medial joint spaces. CONCLUSION Patients with TMDs are associated with laterally positioned mandibular fossa with the more vertically inclined anterior wall. They are characterized by vertical mandibular condylar changes in the form of less vertical inclination, more vertical position, and lower vertical dimension (height) in addition to more upward positioning within the joint space is accompanied by a decrease in superior and posterior and an increase in medial joint spaces. CLINICAL SIGNIFICANCE The TMJ characteristics of skeletal class II make it more susceptible to TMDs and any orthodontic and/or surgical interventions in a direction possibly change these characteristics are to be considered.
Collapse
Affiliation(s)
- Maged S Alhammadi
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Phone: +00966502209874, e-mail: , Orcid: https://orcid.org/0000-0002-1402-0470
| |
Collapse
|
50
|
Shinde N, Kanabar DJ, Miles LJ. Narrative review of the prevalence and distribution of acute pain in children in the self-care setting. PAEDIATRIC & NEONATAL PAIN 2022; 4:169-191. [PMID: 36618510 PMCID: PMC9798044 DOI: 10.1002/pne2.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.
Collapse
Affiliation(s)
- Nutan Shinde
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| | | | - Lisa J. Miles
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| |
Collapse
|