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Objectives: This cross-sectional observational study examines the relationship between chronic cervico-cranio-mandibular pain, a significant health concern associated with temporomandibular disorders, and adverse childhood experiences (ACEs). Given the high prevalence of cervical pain and the gap in adequate treatment for temporomandibular disorders, this research highlights the interplay between psychological, social factors, and musculoskeletal health. Methods: The study, conducted from January to June 2023, included 114 participants (mean age = 31 ± 12 years, 69.3% female) experiencing chronic cervico-cranio-mandibular pain. Pain severity and dysfunction were assessed, and exposure to ACEs was measured using validated questionnaires. Statistical analysis, performed using Jamovi (v 2.23.28) software. Results: Data revealed a significant correlation between the number of ACEs and both pain intensity (r = 0.254, p = 0.006, η2 = 0.062) and disability (r = 0.262, p = 0.005, η2 = 0.068). However, no significant association was found between ACEs and mandibular functional limitation (p = 0.222). These findings suggest that while early life stressors impact overall health, their specific influence on cervico-cranio-mandibular pain is limited. Conclusion: The study emphasizes the importance of integrated early intervention strategies to mitigate the long-term musculoskeletal repercussions of adverse events, advocating for comprehensive mental health support and preventive measures. This research contributes valuable insights into the necessity of a multifaceted approach to understanding, diagnosing, and treating musculoskeletal disorders, highlighting the complexity of their causes and effects. [ABSTRACT FROM AUTHOR]

BACKGROUND: Proprioceptive neuromuscular facilitation (PNF) stretching exercises have been widely advocated for the management of patients with different musculoskeletal conditions. However, its effect on the treatment of temporomandibular dysfunction (TMD) in patients with forward head posture (FHP) has not been fully investigated. OBJECTIVE: To investigate the effect of PNF stretching exercises on the treatment of TMD in patients with FHP. METHODS: A prospective, randomized, double-blinded clinical trial. Twenty-four patients with TMD and FHP aged from 18–40 years were randomly assigned to PNF or control group. The PNF group composed of 12 patients received PNF stretching exercises of masticatory muscles in addition to routine physical therapy treatment (FHP correction exercises and ultrasound for the temporomandibular joint); the control group composed of 12 patients received routine physical therapy treatment only. Interventions were conducted twice a week for six weeks. Craniovertebral angle, pain threshold, pain intensity, temporomandibular joint ROM, and temporomandibular joint function were assessed for all participants before and after the intervention. The outcomes were analyzed using Two-way mixed MANOVA. For further multiple comparisons, post-hoc tests with the Bonferroni correction were performed. RESULTS: There was no significant difference between both groups pre-treatment (p > 0.05). Comparison between groups post-treatment revealed statistically significant differences in all outcome measures (p < 0.05) in favor of the PNF group. CONCLUSION: Adding PNF stretching exercises of masticatory muscles to routine physical therapy programs is an effective method for management of TMD in patients with FHP more than routine physical therapy programs alone. [ABSTRACT FROM AUTHOR]

Aim of the study: Screening for the prevalence and severity of TMDs in individuals. Materials and methods . This cross-sectional study included a cohort of 109 consecutive volunteer patients (28 male and 81 female), with average age 38.31 ± 12.625 years, who attended a private praxis in Iasi at least once within ten months (February 2023 – October 2023). Before the clinical evaluation, the patients were invited to fill out the TMD-Pain Screener completed by Fonseca Anamnestic Index, consisting of 10 closed-ended questions. Results Proportion of 43.1% had mild craniomandibular dysfunction, moderate and severe dysfunctions were less common, occurring in 12.8% and 2.8% of patients. Our study observed a higher prevalence of TMD among female patients. Conclusions It can be concluded that the prevalence of TMD is a significant concern (58,7 %) that should be deemed a matter of significant importance in dental medicine and addressed accordingly.

Objective: Temporomandibular disorders (TMD) are common. They affect abilities for carrying out daily tasks and influence different psychological aspects. In addition to standard treatment, psychological treatments have been suggested. The aim was to investigate the effects of psychological treatments on patients with painful TMD in a short‐ and long‐term perspective. Materials and Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL), and Web of Science for randomized clinical trials (RCTs) reporting psychological interventions for TMD. Registered beforehand in PROSPERO (CRD42022320106). In total, 18 RCTs were included; six RCTs that could be used in the meta‐analysis, and all 18 RCTs were used in the narrative synthesis. Risk of bias was assessed by the Cochrane's tool for assessing risk of bias and certainty of evidence by GRADE. Results: The narrative synthesis indicates that psychological treatment options seem equivalent to standard treatment for painful TMD. The meta‐analysis showed that a combination of psychological treatment and standard treatment and manual treatment (very low‐quality evidence) are significantly better in pain reduction than just counselling and standard treatments of TMD. Conclusion: This study indicates that psychological treatments seem to reduce pain intensity in individuals with painful TMD, and that the effect seems to be equally good as standard treatment. However, a combination of psychological treatments and standard treatments seems to have an even better effect. This indicates that psychological treatments are promising as an additional treatment approach for painful TMDs. [ABSTRACT FROM AUTHOR]

Purpose: To describe the characteristics of and the associations between health-related quality of life, pain, craniomandibular function, and psychosocial factors related to pain and fear of movement in patients with head and neck cancer. Methods: Seventy-eight patients diagnosed with HNC were recruited. Measurements of the maximum mouth opening range and pressure pain thresholds on the masseter muscle and the distal phalanx of the thumb were conducted, as well as a battery of self-report questionnaires were administrated, including the QoL Questionnaire (EORT QLQ-H&N35), Numeric Rating Scale (NRS), Pain Catastrophizing Scale (PCS), the Spanish translation of the Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD), and the short version of the Craniofacial Pain and Disability Inventory (CF-PDI-11). Results: The study sample (66.7% men, mean age 60.12 [11.95] years) experienced a moderate impact on their QoL levels (57.68 [18.25] EORT QLQ-H&N35) and high kinesiophobia values (20.49 [9.11] TSK-TMD). Pain was present in 41% of the patients, but only 3.8% reported severe pain. 26.4% had a restricted mouth opening range, and 34.62% showed significant catastrophism levels. There were strong positive correlations between EORT QLQ-H&N35 and CF-PDI-11 (r = 0.81), between NRS and CF-PDI-11 (r = 0.74), and between PCS and CF-PDI-11 (r = 0.66). Conclusion: Patients with HNC experience negative effects in their QoL, related to their impairment in craniomandibular function. Fear of movement, pain intensity, and catastrophism are associated with poorer functionality; relationships that should be considered when attempting to improve health care. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to assess the efficacy of arthroscopy compared to arthrocentesis and to conservative treatments for temporomandibular joint disorders. Thirteen controlled studies on various patient outcomes were included after a systematic search in seven electronic databases. Meta-analyses were conducted separately for arthroscopic surgery (AS) and arthroscopic lysis and lavage (ALL), and short-term (<6 months), intermediate-term (6 months to 5 years), and long-term (≥5 years) follow-up periods were considered. No significant differences in pain reduction and complication rates were found between AS or ALL and arthrocentesis. Regarding improvement in maximum mouth opening (MMO), both AS at intermediate-term and ALL at short-term follow-up were equally efficient when compared to arthrocentesis. However, at intermediate-term follow-up, ALL was superior to arthrocentesis for MMO improvement (mean difference 4.9 mm, 95% confidence interval 2.7–7.1 mm). Trial sequential analysis supported the conclusion of the meta-analysis for MMO improvement for ALL versus arthrocentesis studies at intermediate-term follow-up, but not for the other meta-analyses. Insufficient evidence exists to draw conclusions regarding other patient outcomes or about comparisons between arthroscopy and conservative treatments. Due to the low quality of the primary studies, further research is warranted before final conclusions can be drawn regarding the management of temporomandibular joint disorders. [ABSTRACT FROM AUTHOR]

Abstract Background Temporomandibular disorders (TMDs) encompass pain and dysfunction in the jaw, muscles, and adjacent structures. This study aimed to explore the quantitative (condylar position, morphology) and qualitative (bone mineral density (BMD)) therapeutic outcomes following a stabilization splint (S.S.) therapy in adult patients diagnosed with TMD (Arthralgia) with/without lateral mandibular asymmetry (MA) using cone beam computed tomography (CBCT). Methods In this retrospective clinical study, 60 adult TMD patients who received S.S. therapy were enrolled and allocated into the TMD group (TMDG) and TMD with MA group (TMD + MAG). The diagnosis was made according to the Diagnostic Criteria for TMD (DC/TMD) AXIS I. MA was measured from the mid-sagittal plane to the Menton point. CBCT was used to scan the temporomandibular joints pre- (T0) and post- (T1)-treatment for three-dimensional analysis. Intra- and intergroup statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal‒Wallis test. Results For quantitative comparisons, there was a statistically significant difference between T0 and T1 in the joint spaces of TMD + MAG (anterior, superior, posterior, and coronal lateral on the deviated side as well as in the superior, coronal medial joint space of the contralateral side). Morphologically, the deviated side had a narrower condylar width, reduced condylar height, and a steeper eminence angle. In contrast, the contralateral side tended to have a greater condylar length. For qualitative measurements, BMD also showed statistical significance between T0 and T1 in the majority of the condyle slopes (AS, SS, PS, and LS on the deviated side and in AS and MS on the contralateral side) of TMD + MAG. Additionally, only the AS and PS showed significance in TMDG. Conclusion Multiple joint space widening (AJS and CMS) and narrowing (SJS, PJS, and CLS) could characterize the deviated side in TMD + MA. Factors like narrower condylar width, reduced condylar height, and steeper eminence angle on the deviated side can worsen TMD + MA. Proper alignment of the condyle-disc position is essential for optimal function and load distribution, potentially affecting bone mineral density (BMD). MA plays a prominent role in disturbing bone densities. S.S. therapy shows more evident outcomes in TMD + MAG (on the deviated side compared to the contralateral side) than the TMDG.

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This article discusses a study on temporomandibular disorders (TMDs) in individuals, finding that 43.1% of patients had mild craniomandibular dysfunction. The study also observed a higher prevalence of TMD among female patients. The authors emphasize the importance of early diagnosis and treatment of TMDs. Another document provides a list of references and citations related to TMD, including studies on prevalence, diagnostic criteria, treatment options, and the relationship between TMD and other factors. These resources can be used by library patrons conducting research on TMD. [Extracted from the article]

Background: Temporomandibular disorders (TMDs) encompass pain and dysfunction in the jaw, muscles, and adjacent structures. This study aimed to explore the quantitative (condylar position, morphology) and qualitative (bone mineral density (BMD)) therapeutic outcomes following a stabilization splint (S.S.) therapy in adult patients diagnosed with TMD (Arthralgia) with/without lateral mandibular asymmetry (MA) using cone beam computed tomography (CBCT). Methods: In this retrospective clinical study, 60 adult TMD patients who received S.S. therapy were enrolled and allocated into the TMD group (TMDG) and TMD with MA group (TMD + MAG). The diagnosis was made according to the Diagnostic Criteria for TMD (DC/TMD) AXIS I. MA was measured from the mid-sagittal plane to the Menton point. CBCT was used to scan the temporomandibular joints pre- (T0) and post- (T1)-treatment for three-dimensional analysis. Intra- and intergroup statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal‒Wallis test. Results: For quantitative comparisons, there was a statistically significant difference between T0 and T1 in the joint spaces of TMD + MAG (anterior, superior, posterior, and coronal lateral on the deviated side as well as in the superior, coronal medial joint space of the contralateral side). Morphologically, the deviated side had a narrower condylar width, reduced condylar height, and a steeper eminence angle. In contrast, the contralateral side tended to have a greater condylar length. For qualitative measurements, BMD also showed statistical significance between T0 and T1 in the majority of the condyle slopes (AS, SS, PS, and LS on the deviated side and in AS and MS on the contralateral side) of TMD + MAG. Additionally, only the AS and PS showed significance in TMDG. Conclusion: Multiple joint space widening (AJS and CMS) and narrowing (SJS, PJS, and CLS) could characterize the deviated side in TMD + MA. Factors like narrower condylar width, reduced condylar height, and steeper eminence angle on the deviated side can worsen TMD + MA. Proper alignment of the condyle-disc position is essential for optimal function and load distribution, potentially affecting bone mineral density (BMD). MA plays a prominent role in disturbing bone densities. S.S. therapy shows more evident outcomes in TMD + MAG (on the deviated side compared to the contralateral side) than the TMDG. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the association between low back pain (LBP) and painful temporomandibular disorders (TMDs). Methods: Systematic review of observational studies. Searches were conducted using OVID MEDLINE, CINHAL, Web of Science and PUBMED databases up to 21 October 2022. Qualitative and quantitative analyses were performed. Risk of bias (RoB) was assessed using the Quality in Prognosis Studies tool (QUIPS). Results: Eight studies were included in the present review with meta‐analysis. The first onset of TMDs was more likely in patients with previous chronic LBP (hazard ratio (HR) 1.53 [95% confidence interval (CI): 1.28; 1.83, p <.00001]). In addition, patients with chronic LBP had 3.25 times the odds (OR) [95% CI: 1.94; 5.43, p <.00001] of having chronic TMDs than those who did not have chronic LBP. In addition, the higher the exposure to chronic LBP, the higher the risk of developing a first onset of TMDs. Conclusions: Chronic LBP can be considered a risk/contributing factor for painful TMDs. Although there is a high certainty in the evidence linking chronic LBP with the risk of a first onset of TMDs, there are insufficient studies to draw definitive conclusions. Furthermore, while an association between chronic LBP and chronic TMDs and a dose–effect was observed between these two conditions, a limited number of studies and evidence exist to support these findings. Future studies are needed to increase the body of evidence. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study were to compare the cervical ROM data obtained from accelerometer exams between patients suffering from TMDs (study group) and healthy patients (control group). Material and Methods: A sample of 43 young adult subjects (23 control subjects and 20 TMD patients) were included in this study and analyzed with the accelerometer (Baiobit™, BTS, Garbagnate Milanese, Milan, Italy) to assess cervical ROM using a standardized protocol, including the following occlusal conditions: mandibular rest position, clenching, clenching with cotton rolls, maximal intercuspation, and mandibular position with cotton rolls. The cervical ROM was measured in degrees and expressed as the mean and standard deviation. Results: TMD patients showed a reduced cervical extension compared to control subjects in all the conditions, with statistically significant relevance. Regarding the other movements, the differences were not statistically or clinically significant. Conclusions: Based on the results of the present study, it can be observed that temporomandibular disorders are associated with a decreased cervical extension range, while the remaining components of ROM do not seem to be significantly associated. The use of accelerometers in ROM analysis could be helpful in improving interdisciplinary communication between dentists and physiotherapists. [ABSTRACT FROM AUTHOR]

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Copyright of Quintessenz der Zahntechnik is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study intends to investigate the relationship between otologic symptoms, in particular, tinnitus, and temporomandibular disorders (TMD). The literature studies during the previous 20 years had focused on the treatment and alleviation of the otologic symptoms and were limited to randomized clinical trials, case reports, and prospective studies. The following Boolean keywords, (tinnitus) AND (temporomandibular disorders OR temporomandibular therapy), were used in the databases of PubMed, Scopus, and Web of Science between 2003 and 9 May 2023 with an English language restriction. Results: The computerized search turned up 693 articles in total, and after eliminating duplicates, reviewing them, and determining their eligibility, 20 papers were included. Conclusion: The connections between temporomandibular TMD and tinnitus are numerous and intricate. It is unclear whether TMD could be the source of tinnitus or only its symptoms. Tinnitus may not always occur in persons with TMD, indicating that additional causes may potentially be involved in its occurrence. The precise mechanisms behind the link between TMD and tinnitus need to be clarified by additional study. [ABSTRACT FROM AUTHOR]

Abstract Background Practitioners, including physical therapists, are not proficiently trained to evaluate and treat individuals with temporomandibular disorders. The purpose of this study is to evaluate the knowledge and awareness of examining and treating temporomandibular disorders among physical therapists in Saudi Arabia. Methods An online questionnaire was distributed to physical therapists on different social media platforms. The survey covered demographics characteristics and knowledge of examining and treating temporomandibular disorders. Descriptive statistics were used for data analysis. Results A total of 143 participants with a mean of age of 30 (± 6.6) years participated in this study. The majority of participants (n = 109; 76.2%) did not take educational courses on temporomandibular disorders; more than half (n = 84; 58.7%) had never evaluated or treated individuals with temporomandibular disorders. Most physical therapists were aware that they could treat individuals with temporomandibular disorders (n = 121, 84.6%). The most common evaluation methods were temporomandibular joint palpation, jaw movement during opening and closing, and palpation of the masticatory muscles (n = 56, 95%); (n = 49, 83%); (n = 48, 81%), respectively. The common methods used for treatment were therapeutic exercise strengthening, manual therapy, and patient education (n = 49; 83%; n = 46; 78%; n = 33; 56%), respectively. Thirty-one participants (53%) referred patients to other practitioners. Conclusion This preliminary study indicates there is a fair level of knowledge, low confidence, low education, and low clinical experience for physical therapists in the evaluation and treatment of temporomandibular disorders in Saudi Arabia. More attention is needed on physical therapy education programs and post-graduate education courses on temporomandibular disorders.

Objective: This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). Materials and methods: In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35 years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal–Wallis test, respectively. Results: The course of treatment was 6–12 months, with an average of 9.1 months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. Conclusion: In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. Clinical relevance: This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective. [ABSTRACT FROM AUTHOR]

Arthrocentesis for arthralgia of the temporomandibular joint (TMJ) is often only indicated when conservative, non-surgical interventions have failed. However, performing arthrocentesis as initial therapy may facilitate earlier and better recuperation of the joint. The aim of this study was to assess the efficacy of this therapy with a long-term follow-up. Eighty-four patients were randomly allocated to receive either arthrocentesis as initial treatment (n = 41) or non-surgical intervention (n = 43). Pain (100-mm visual analogue scale, VAS) and mandibular function impairment questionnaire scores (MFIQ, 0–100) were recorded at 3, 12, and 26 weeks, and ≥ 5 years (median 6.2, interquartile range 5.6–7.4 years). Univariable analyses were performed and linear mixed-effect models were constructed. Patients in the arthrocentesis group experienced significantly lower TMJ arthralgia compared to those treated non-surgically (pain during movement: −10.23 mm (95% confidence interval −17.86; −2.60); pain at rest: − 8.39 mm (95% confidence interval −13.70; −3.08)), while mandibular function remained similar in the two groups (MFIQ −2.41 (95% confidence interval −8.61; 3.78)). Of the final sample, 10 patients (10/39, 26%) in the non-surgical intervention group and two patients (2/34, 6%) in the arthrocentesis group received additional treatment during follow-up. Thus, initial treatment with arthrocentesis reduced TMJ arthralgia more efficaciously than non-surgical intervention in the long term, while maintaining similar mandibular function. [ABSTRACT FROM AUTHOR]

Background and Objectives: The aim of this study were to compare the cervical ROM data obtained from accelerometer exams between patients suffering from TMDs (study group) and healthy patients (control group). Material and Methods: A sample of 43 young adult subjects (23 control subjects and 20 TMD patients) were included in this study and analyzed with the accelerometer (Baiobit™, BTS, Garbagnate Milanese, Milan, Italy) to assess cervical ROM using a standardized protocol, including the following occlusal conditions: mandibular rest position, clenching, clenching with cotton rolls, maximal intercuspation, and mandibular position with cotton rolls. The cervical ROM was measured in degrees and expressed as the mean and standard deviation. Results: TMD patients showed a reduced cervical extension compared to control subjects in all the conditions, with statistically significant relevance. Regarding the other movements, the differences were not statistically or clinically significant. Conclusions: Based on the results of the present study, it can be observed that temporomandibular disorders are associated with a decreased cervical extension range, while the remaining components of ROM do not seem to be significantly associated. The use of accelerometers in ROM analysis could be helpful in improving interdisciplinary communication between dentists and physiotherapists.

Copyright of Manuelle Medizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Craniomandibular disorders are a significant cause of maxillofacial pain, resulting in alterations in the masticatory muscles and internal derangement of the temporomandibular joint (TMJ). Purpose: This study aims to comprehensively review the existing literature on morphological changes associated with craniomandibular disorders using cone-beam computed tomography (CBCT). Material and methods: The research was conducted in Medline and PubMed and focused on reviews regarding CBCT evaluation of morphological changes in craniomandibular disorders. Results and discussions: Sixteen full-text articles were assessed for eligibility, including 2 reviews and 14 systematic reviews, which provided consistent data on mandibular condyle, glenoid fossa and articular eminence. Conclusion: Temporomandibular components and associated structures showed statistically significant differences between the patients with craniomandibular disorders and healthy individuals. [ABSTRACT FROM AUTHOR]

The aim of this literature review is to study the prevalence and incidence of craniomandibular disorders and to correlate them with risk factors such as systemic diseases and comorbid symptoms, so that prevention, early diagnosis and effective determination of treatment and prognosis takes place in clinical practice. The PubMed database was used for the literature search, with inclusion criteria: 1) articles in the English language, 2) publication date 1970 - 2022, 3) clinical studies. Initially, the articles were evaluated based on their title. Duplicates and articles unrelated to the topic were discarded and finally 170 articles were included in the study. The results show that many factors related to general health and systemic diseases are correlated with TMD. Mental strain and stress have a negative effect on the prognosis, while several authors highlight that they are the most important cause of TMD. [ABSTRACT FROM AUTHOR]

The aim of this literature review is to study the prevalence and incidence of craniomandibular disorders and to correlate them with risk factors such as ethnicity, gender, age, so that in prevention, early diagnosis and effective determination of treatment and prognosis takes place in clinical practice. The PubMed database was used for the literature search, with inclusion criteria: 1) articles in the English language, 2) publication date 1970 - 2021, 3) clinical studies. Initially, the articles were evaluated based on their title. Duplicates and articles unrelated to the topic were discarded and finally 172 articles were included in the study. The results show prevalence rates from 2.1-80.9%, with the genetic variations of people significantly influencing health and disease. The most frequently and heavily affected sex is women, with ratios reaching up to 8:1 compared to men. Researchers who find differences in prevalence in relation to age, define the age group 18-45 years as the high-risk age group, while several factors related to general health, as well as comorbidities, are associated with the disorders. Mental strain and stress have a negative effect on the prognosis, while several authors highlight that they are the most important cause of TMD. Unlike prevalence, incidence has been studied less and is estimated between 1.8% and 5.3%. [ABSTRACT FROM AUTHOR]

This study intends to investigate the relationship between otologic symptoms, in particular, tinnitus, and temporomandibular disorders (TMD). The literature studies during the previous 20 years had focused on the treatment and alleviation of the otologic symptoms and were limited to randomized clinical trials, case reports, and prospective studies. The following Boolean keywords, (tinnitus) AND (temporomandibular disorders OR temporomandibular therapy), were used in the databases of PubMed, Scopus, and Web of Science between 2003 and 9 May 2023 with an English language restriction. Results: The computerized search turned up 693 articles in total, and after eliminating duplicates, reviewing them, and determining their eligibility, 20 papers were included. Conclusion: The connections between temporomandibular TMD and tinnitus are numerous and intricate. It is unclear whether TMD could be the source of tinnitus or only its symptoms. Tinnitus may not always occur in persons with TMD, indicating that additional causes may potentially be involved in its occurrence. The precise mechanisms behind the link between TMD and tinnitus need to be clarified by additional study.

Objective. To investigate the effect of adenoid hypertrophy on malocclusion and maxillofacial development in children. Methods. Total of 102 children with malocclusion or maxillofacial dysplasia admitted to our hospital from March 2017 to June 2020 were selected as the research subjects. All children were divided into a control group (50 cases with adenoid hypertrophy) and an observation group (52 cases without adenoid hypertrophy) according to the presence or absence of adenoid hypertrophy. The incidence of malocclusion was compared between the two groups, and lateral cranial radiographs were taken in both groups to measure and compare the malocclusion angle, jaw angle, and jaw length indexes between the two groups. Results. The incidence of malocclusion in the observation group (71.15%) was higher than that in the control group (42.00%), and the difference was statistically significant (P < 0.05). The angle between the long axis of the upper central incisor and the nasal root point and the upper alveolar base point (U1-NA), the angle between the long axis of the lower central incisor and the nasal root point and the lower alveolar base point (L1-NB), the angle between mandibular plane and anterior cranial base plane (MP-SN), the angle between the long axis of upper central incisor and anterior cranial base plane (U1-SN), the angle between the long axis of lower central incisor and mandibular plane (L1-MP), the angle of Y axis, the overall height (N-Me), lower height (ANS-Me), overall height/back height (N-Me/S-Go), and lower height/overall height (ANS-Me/N-Me) values in the observation group were higher than those in the control group, while the mandibular length (Go-Gn) values in the observation group were lower than those in the control group (P < 0.05). Conclusion. Adenoid hypertrophy can increase the incidence of malocclusion in children and can also increase the steepness and overall height and lower height of the mandible, resulting in the lengthening of the facial shape and the development of the maxillofacial deformity. [ABSTRACT FROM AUTHOR]

Abstract: Purpose of this study was to examine the discriminative properties of the 3-item Pain (P), Enjoyment (E), and General activity (G) (PEG) questionnaire for grading impact of nondental orofacial pain. Two hundred eighty-six consecutive patients with orofacial pain of nondental origin filled out the PEG questionnaire and Graded Chronic Pain Scale (GCPS, version 2). Correlation between the PEG and GCPS scores, internal consistency of the PEG, and differences between groups were examined statistically (level of significance: P ≤ 0.05). The mean (±SD) age of the 213 patients (158 female) who were included in the analysis was 43.1 (±16.7) years. Of the sample, 48.8% (n = 104) had some degree of orofacial pain-related disability (mean overall characteristic pain intensity: 51.2 ± 23.2, average overall PEG score: 4.3 ± 2.7, and average PHQ-9 score: 8.2 ± 6.5). No significant differences were found between the sexes for any score. The number of disability points (GCPS) and overall PEG score showed a strong and positive correlation (Spearman ρ = 0.77, P < 0.001). The internal consistency of the PEG questionnaire was high (Cronbach α = 0.86). Assuming 3 different levels of orofacial pain-related disability (mild, moderate, and severe), we obtained overall accuracy of 69.01%, with high specificity for mild and severe cases. The 3 PEG groups (mild, moderate, or severe) differed from each other significantly regarding their clinical grading according to the GCPS (Kruskal-Wallis, P < 0.001). Analysis of the receiver operating characteristic curve showed that a single cutoff value of 3.8 points in the PEG score yields adequate validity (sensitivity = 0.91 and specificity = 0.78). The proposed 2 cutoff points (upper = 7 and lower = 4) yield low sensitivity for the upper threshold. The 3-item PEG questionnaire is suitable for grading impact of nondental orofacial pain. [ABSTRACT FROM AUTHOR]

The aim of this review work was to identify the most effective therapeutic intervention to increase the range of motion of the mandible in the temporomandibular joint (MMO - maximal mouth opening) in patients with its myogenic disorder. The databases Scopus, PubMed, Web of Science and PEDro were used for the study and sources from 2011-2021 were included. A total of 390 articles were found based on the keywords, however, 12 studies met the defined criteria and were subjected to analysis. The results suggest that the most effective physiotherapeutic intervention to increase MMO in patients with myogenic temporomandibular disorder is the use of a low-power laser. Electrotherapy, combination therapy - exercise plus manual techniques, exercise alone and partly also soft tissue techniques were evaluated as other effective procedures. [ABSTRACT FROM AUTHOR]

Background: Within physical therapy, manual therapy is known to be effective for managing temporomandibular disorders (TMDs). However, manual therapy is a broad term including different approaches applied to different body regions. Aims: This is the first systematic review that aims to evaluate the effectiveness of manual therapy applied specifically to the craniomandibular structures (Cranio‐Mandibular Manual Therapy [CMMT]) on pain and maximum mouth opening in people with TMD. Material and methods: This systematic review was developed based on a pre‐determined published protocol which was prospectively registered with PROSPERO (CRD42019160213). A search of MEDLINE, Embase, CINAHL, ZETOC, Web of Science, SCOPUS, PEDro, PubMed, Cochrane Library and Best Evidence, EBM reviews–Cochrane Central Register of Controlled Trials, Index to Chiropractic Literature ChiroAccess and Google Scholar databases was conducted from inception until October 2020. Randomised controlled trials comparing the effect of CMMT on pain and maximum mouth opening versus other types of treatment in TMDs were included. Two reviewers independently screened articles for inclusion, extracted data, assessed risk of bias with the revised Cochrane risk of bias tool for randomised trials and evaluated the overall quality of evidence with the Grading of Recommendations, Assessment, Development and Evaluations. Results: A total of 2720 records were screened, of which only 6 (293 participants) satisfied the inclusion criteria. All studies showed some concerns in risk of bias, except for one, which was high risk of bias. The overall quality of evidence was very low for all outcomes because of high heterogeneity and small sample sizes. All studies showed a significant improvement in pain and maximum mouth opening for CMMT from baseline in the mid‐term, but only two showed superiority compared to other interventions. Given the high heterogeneity and small sample sizes of the included studies, a quantitative synthesis was not performed. Discussion and conclusion: There is the need for future high methodology research investigating different manual therapy techniques applied to different regions and different populations (e.g., chronic versus acute TMD) to determine what is most effective for pain and maximum mouth opening in patients with TMDs. [ABSTRACT FROM AUTHOR]

Abstract Background The etiology of temporomandibular disorders (TMD) can be explained on the basis of a biopsychosocial model. However, psychosocial assessment is challenging in daily dental practice. The purpose of the current study was to field-test the practicability of a novel psychosocial assessment scoring form regarding the reliability of scoring procedures and the opinion of examiners. The working hypotheses were that the scoring results of inexperienced undergraduate students were similar to the results collected by a gold standard and that the scoring form was easy to use. Methods A psychosocial assessment scoring form was developed in accordance with guidelines of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), including results of the Graded Chronic Pain Scale (GCPS), Patient Health Questionnaires (PHQ), and Generalized Anxiety Disorders (GAD). Inexperienced operators (undergraduate students) examined patients with TMD-associated complaints and rated the practicability of the scoring form. The scoring results were recalculated by two experienced operators and a consensus was defined as a gold standard. Reliability coefficients were determined comparing results of the gold standard and the inexperienced operators. Results Sixty-five examiners used the scoring form to obtain results for patients with TMD-associated complaints. Of the patients, 78.8% received a diagnosis according to DC/TMD decision trees. Two-thirds of the operators (62.9%) stated that the form was easy to complete, and 83.0% would use it in their dental practice. The reliability coefficients ranged between 0.81–1.00. Conclusions Within the limitations of the present study, the psychosocial assessment scoring form seems to be an easy-to-use and practicable tool. The vast majority of the inexperienced examiners recommended the application.

The temporomandibular joint (TMJ) represents a biomechanically and morphologically complex structure, tightly connected with the development and growth of mandible and craniofacial complex. The aim of this article is to comprehensively present contemporary diagnostic modalities and clinical implications for imaging of the TMJ. Contemporary imaging modalities, if used properly and according to adequate clinical implications and criteria, are able to depict different pathological processes and play a crucial role in establishing the right diagnosis and monitoring therapeutic effect. The key to right diagnosis, however, still lies in good knowledge of the TMJ developmental and functional anatomy, as well as the TMJ dysfunction related to the jaws, surrounding muscles, teeth, and cranial base.

Objectives: The objective was to describe the physical and psychosocial features of patients attending a specialized consultation hour for temporomandibular disorders (TMD). This investigation focused on those patients who did not receive a diagnosis according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Materials and methods: From 2004 to 2017, patients seeking care during a TMD-specialized consultation hour were consecutively recruited. Each patient completed a TMD-related questionnaire, psychosocial questionnaires (Graded Chronic Pain Scale, Hospital Anxiety and Depression Scale, Beschwerden-Liste), and the Oral Health Impact Profile-49. The clinical examination was performed according to the RDC/TMD. Results: The mean age of the 1020 patients was 43.3 years (75.3% female). According to the RDC/TMD decision trees, 351 patients were categorized without a TMD diagnosis (NoTMDdx). The most frequent reasons for seeking care were orofacial pain/TMJ pain or headaches revealing an OR of 1.89 (for TMDdx group). A relevant proportion of patients was categorized as positive for anxiety (NoTMDdx/TMDdx 30.8/41.2%; p = 0.072), depression (20.8/23.9%; p = 0.433), non-specific physical symptoms (31.4/44.1%; p < 0.001), or dysfunctional chronic pain (11.5/18.2%; p < 0.001). In both patient groups, the oral health-related quality of life was impaired (42.9/52.7 points; p < 0.001), and the frequency of therapy measures prior to the consultation hour was high. Conclusions: Patients seeking care from TMD specialists were usually referred with TMD-associated symptoms. Of those, a relevant proportion did not receive a diagnosis according to RDC/TMD decision trees. Clinical relevance: Psychosocial screening and the avoidance of overtreatment are recommended for patients with TMD-related symptoms. [ABSTRACT FROM AUTHOR]

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The aim of this study was to assess the best timing to perform arthrocentesis in the management of temporomandibular disorders with regard to conservative treatment. A systematic search based on PRISMA guidelines, including a computer search with specific keywords, reference list search, and manual search was performed. Relevant articles were selected after three search rounds for final review based on six predefined inclusion criteria, followed by a round of critical appraisal. Eleven publications, including eight randomized controlled trials and three prospective clinical studies, were included in the review. The studies were divided into three groups based on the timing of arthrocentesis: (1) arthrocentesis as the initial treatment; (2) early arthrocentesis; and (3) late arthrocentesis. Meta-analysis was carried out to compare the efficacy of improvement in mouth opening and pain reduction in the three groups. All three groups showed improvement in mouth opening and pain reduction, with forest plots suggesting that arthrocentesis performed within 3 months of conservative treatment might produce beneficial results. We conclude that there is a knowledge gap in the current literature regarding the preferable timing to perform arthrocentesis in the management of temporomandibular disorders, and more high-quality randomized controlled trials are required to shed light on this subject. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the association of oral parafunctions with the presence of signs and symptoms of craniomandibular disorder in children with cleft lip and palate (CLP). A cross-sectional study was performed in which one hundred and eighty-eight children with CLP and absence of associated syndromes or malformations were investigated. During clinical examination, the presence of wear facets and dental occlusion were observed and palpation was performed in the temporomandibular joint region (TMJ) and orofacial musculature. The children and their guardians were interviewed regarding the presence of oral parafunctional habits (bruxism, the act of biting the lips and/or cheeks, nail biting, sucking of fingers and pacifiers) and signs and symptoms of craniomandibular dysfunction (headache, ear and/or neckache, tiredness or crack in the TMJ during mouth opening and chewing movements). The data were analyzed by means of absolute and relative frequency measurements, and bivariate analysis using Pearson's chi-square test and likelihood ratio test were performed, considering the significance level of 5%. A higher prevalence of cleft lip and palate type (76.0%) and the presence of malocclusion (61.7%) was observed, highlighting the anterior crossbite (58.7%) and midline deviation (48.9%). There was a higher occurrence of teeth grinding (40.4%), onychophagy (28.7%) and biting lips and/or cheeks (28.7%). Onychophagia was associated with headache (p <0.05) and with pain or cracking during mouth opening (p <0.05). It was concluded that parafunctional oral habits may be associated with signs and symptoms of craniomandibular disorder in children with cleft lip and palate. [ABSTRACT FROM AUTHOR]

Objective: Nonrestorative sleep and sleep disorders are commonly reported in patients suffering from craniomandibular (CMD) and craniocervical dysfunctions (CCD). This study aimed to investigate polysomnographic characteristics and the reduction of pain before and after treatment in these patients.Methods: Seventy-four patients with sleep disorders and evident CMD and CCD were included. Manual therapy and an Aqualizer® were used in the therapeutic group. Polysomnographic measurements were conducted pre- and post-therapy.Results: The number of sleep stage alterations and the sleep stage index differed significantly between pre- and post-therapeutic measurements. Between both groups, these parameters were significantly different, as well (p = .001 and p = .012). The subjective perception of sleep quality improved in 81.6% post-therapy (p < .001).Discussion: Manual therapy and the application of an Aqualizer® may improve sleep quality in patients suffering from CMD and CCD. Pain may not be the main cause for the sleep disorders in CMD and CCD. [ABSTRACT FROM AUTHOR]

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Introduction: the incidence of temporomandibular disorders (TMD) is up to 50 % in the adult population and headache can be extremely disabling in severe cases. In addition, both pathologies can appear simultaneously. Therefore, it is necessary to know the scientific evidence on the relationship of both pathologies in the adult population. Objective: the aim of this study is to review the scientific evidence regarding the relationship between temporomandibular disorders and headaches among the adult population. Material and method: a search for observational articles in English and Spanish was performed in the Medline Complete, Cinhal Complete and Academic Search Complete databases. Articles that analyzed in adults the relationship between TMD and headaches in adults from different variables were included. A critical reading of each article was made through the Newcastle-Ottawa Quality Assessment Scale. Results: eight articles met the eligibility criteria and were part of the present review. Six of them assessed how the presence of temporomandibular disorder could influence headaches, while 3 studies studied headache as a risk factor to verify its relationship with temporomandibular disorders. All studies fulfill STROBE criteria for observational studies. Conclusion: there is a relationship between TMD and headaches, both pathologies appearing simultaneously, despite the need for a muscular component in TMD to produce a headache.The greater the pain or the severity of the TMD, the more likely you are to have a headache. Migraine is the type of headache most closely related to TMDs. [ABSTRACT FROM AUTHOR]

Background and Objective: Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among schoolchildren aged 8‐12 years. Methods: This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8‐12 years, with and without TMD symptoms, selected randomly from the Rhein‐Neckar district. Self‐reporting of non‐dental facial pain was used as the reference standard, against which we calculated the following for the pain‐related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver‐operating characteristic (AUROC) curve displaying sensitivity and specificity. Results: Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs). Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jaw‐opening limitations, as they occurred too rarely in our sample. Conclusion: In this study, the diagnostic accuracy of the DC/TMD for TMD‐related pain in children was lower than that recorded for adults in previous studies. [ABSTRACT FROM AUTHOR]

Background: The clinical care of chronic pain requires personalised understanding of the mechanisms involved. Temporomandibular disorders (TMD) are the most common chronic orofacial pain conditions, and oxidative stress has been proposed to be implicated in their pathophysiology, especially in arthrogenous TMD. However, few studies have explored oxidative stress in myogenous TMD (TMDM). Objective: The aims of this study were to compare the salivary oxidative stress profiles between individuals with TMDM and healthy controls, and to explore associations of these markers with clinical characteristics. Methodology: Saliva samples were collected from 39 individuals with TMDM and 37 age and sex‐matched healthy volunteers. Psychological stress levels and clinical characteristics were assessed in all participants. The samples were analysed for total oxidant status (TOS), total antioxidative capacity (TAC) and superoxide dismutase activity (SODa). Comparisons between groups were performed using parametric and non‐parametric tests depending on data distribution. Results: Psychological stress was higher in TMDM compared to controls (P <.001). TAC levels were significantly higher (P <.05) whereas TOS levels were significantly lower (P <.05) in TMDM compared to controls. There were no differences in SODa levels between groups and no correlations were found between clinical characteristics and oxidative stress markers. Conclusion: Individuals with TMDM showed higher levels of antioxidative markers, but lower levels of oxidative markers. These results can be explained in part by chronicity and adaptation to the disease and other factors, such as psychological stress. Longitudinal studies must be conducted to clarify the role of oxidative stress in TMDM. [ABSTRACT FROM AUTHOR]

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Objectives: Proteus syndrome (PS) is an extremely rare disorder with asymmetric and disproportionate bone overgrowth. Craniofacial abnormalities in PS are less frequent than skeletal abnormalities. Although there are recognized oral and maxillofacial manifestations of PS, few case reports describing these manifestations are available. Thus, the objective of this systematic review and case report is to describe oral and maxillofacial manifestations of PS and to report a PS case. Methods: A 31-year-old male presented with restricted mouth opening and pain during mastication. A panoramic radiograph and an occlusal radiograph were obtained. Reports with relevant keywords were assessed. Data were summarized and demonstrated using a critical appraisal checklist for case reports. Results: The panoramic radiograph demonstrated unilateral overgrowth of the mandible, impacted teeth, and deciduous prolonged retention. Thirteen PS case reports were identified. Conclusions: Proteus syndrome oral and maxillofacial manifestations may include dental agenesis, impacted teeth, malocclusion, asymmetric dental growth and maturation, frontal line displacement, asymmetric tongue enlargement, mandibular hemihypertrophy and asymmetry, presence of exostoses/hyperostosis, degenerative changes in the temporomandibular joint, alterations of maxillary and mandibular vertical and/or horizontal growth, and enlargement of mandibular canal and foramen. The PROSPERO systematic review registration number is CRD42019140942. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB)., Materials and Methods: A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes., Results: A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment (P > 0.05)., Conclusions: Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

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Copyright of Kieferorthopädie: die Zeitschrift für die Praxis is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)