Development and Application of Reflexodent in the Quantitative Functional Evaluation of Chewing Control in Patients with Temporomandibular Joint Dysfunction and a Control Group

OBJECTIVE: It has been shown that the temporomandibular joint is frequently affected by juvenile idiopathic arthritis, and this degenerative disease, which may occur during facial growth, results in severe mandibular dysfunction. However, there are no studies that correlate oral health (tooth decay and gingival diseases) and temporomandibular joint dysfunction in patients with juvenile idiopathic arthritis. The aim of this study is to evaluate the oral and facial characteristics of the patients with juvenile idiopathic arthritis treated in a large teaching hospital. METHOD: Thirty-six patients with juvenile idiopathic arthritis (26 female and 10 male) underwent a systematic clinical evaluation of their dental, oral, and facial structures (DMFT index, plaque and gingival bleeding index, dental relationship, facial profile, and Helkimo's index). The control group was composed of 13 healthy children. RESULTS: The mean age of the patients with juvenile idiopathic arthritis was 10.8 years; convex facial profile was present in 12 juvenile idiopathic arthritis patients, and class II molar relation was present in 12 (P = .032). The indexes of plaque and gingival bleeding were significant in juvenile idiopathic arthritis patients with a higher number of superior limbs joints involved (P = .055). Anterior open bite (5) and temporomandibular joint noise (8) were present in the juvenile idiopathic arthritis group. Of the group in this sample, 94% (P = .017) had temporomandibular joint dysfunction, 80% had decreased mandibular opening (P = 0.0002), and mandibular mobility was severely impaired in 33% (P = .015). CONCLUSION: This study confirms that patients with juvenile idiopathic arthritis a) have a high incidence of mandibular dysfunction that can be attributed to the direct effect of the disease in the temporomandibular joint and b) have a higher incidence of gingival disease that can be considered a secondary effect of juvenile idiopathic arthritis on oral health.

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Possibilities of osteopathic correction in complex therapy of temporomandibular joint dysfunction

Russian Osteopathic Journal ◽

10.32885/2220-0975-2019-1-2-43-50 ◽

2019 ◽

pp. 43-50 ◽

Cited By ~ 1

Author(s):

Yu. A. Milutka ◽

I. G. Yushmanov ◽

A. N. Badmaeva

Keyword(s):

Temporomandibular Joint ◽

Orthodontic Treatment ◽

Control Group ◽

Temporomandibular Joint Dysfunction ◽

Mandibular Joint ◽

The Status ◽

Osteopathic Treatment ◽

The Mean ◽

And Control ◽

Methods Of Treatment

Introduction. Dysfunction of the temporo-mandibular joint is a frequent, complex, multifactorial disease that is traditionally treated by orthodontic methods, but not always with a positive result.Goal of research — to assess the effect of osteopathic treatment combined with orthodontic treatment on the temporo-mandibular joint dysfunction and osteopathic status of patients with TMJ disfunction.Materials and methods. The study included 40 patients with the temporo- mandibular joint dysfunction receiving orthodontic treatment (hard and soft splints, brace system, exercises). All patients were women without severe somatic pathology divided into 2 groups: treatment group and control group. The mean (±SD) age of participants was 27,5±5,3 and 29,2±5,7 years, respectively. In both groups, osteopathic, orthodontic status have been evaluated, patients completed a questionnaire on the status of the temporo-mandibular joint. In the main group, the described orthodontic methods of treatment were supplemented by osteopathic correction.Results. The study showed a decrease in the number of somatic dysfunctions, objective symptoms and subjective sensations arising from dysfunction of the temporo-mandibular joint. The analysis showed a greater effi cacy of combined osteopathic and orthodontic treatment in comparison with exclusively orthodontic treatment.Conclusion. The obtained results provide possibility of further research of the effectiveness of osteopathic correction in combination with orthodontic treatment of the temporomandibular joint dysfunction.

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Evaluation of C-Reactive Protein Level in Patients with Pain Form of Temporomandibular Joint Dysfunction

Pain Research and Management ◽

10.1155/2018/7958034 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Malgorzata Pihut ◽

Piotr Ceranowicz ◽

Andrzej Gala

Keyword(s):

Temporomandibular Joint ◽

Soft Tissues ◽

Temporomandibular Joint Disorders ◽

Control Group ◽

Study Group ◽

C Reactive Protein ◽

Level Of Evidence ◽

Temporomandibular Joint Dysfunction ◽

Mean Values ◽

Reactive Protein

Temporomandibular joint dysfunction is a functional disorder concerned with the abnormal functioning of the muscles of the stomatognathic system and temporomandibular joints involved in the dynamic movements of the jaw and surrounding structures. The aim of the study was to compare the level of C-reactive protein in patients with pain and painless forms of temporomandibular joint dysfunction. Materials and methods. The study group consisted of 72 patients who reported to the prosthetic treatment because of temporomandibular joint dysfunction. The study group included 36 patients with pain form of dysfunction, and the control group included 36 patients with painless form of disorder. Each patient underwent specialized examination of functional disorders in order to diagnose the type of dysfunction and was commissioned to carry out a study of the blood test concerned with evaluation of the C-reactive protein (CRP) level in the same analytical laboratory. The results of the investigation were subjected to statistical analysis. The research obtained approval from the Ethics Committee of the Jagiellonian University (KBET/125/L/2013). Level of Evidence for primary research was established as type V. Results. The mean values of C-reactive protein levels in both groups were in the normal range and did not differ statistically significantly, which indicates the fact that the pain form of the temporomandibular joint disorders is not associated with inflammation of the soft tissues of the joint. Conclusion. Painful form of the temporomandibular joint dysfunctions is not connected with the inflammation of joints.

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MMP-7 and MMP-9 are overexpressed in the synovial tissue from severe temporomandibular joint dysfunction

European Journal of Histochemistry ◽

10.4081/ejh.2020.3113 ◽

2020 ◽

Vol 64 (2) ◽

Cited By ~ 5

Author(s):

Carla Loreto ◽

Vera Filetti ◽

Luis Eduardo Almeida ◽

Giusy Rita Maria La Rosa ◽

Rosalia Leonardi ◽

...

Keyword(s):

Extracellular Matrix ◽

Matrix Metalloproteinases ◽

Temporomandibular Joint ◽

Synovial Tissue ◽

Inflammatory Diseases ◽

Test Group ◽

Control Group ◽

Temporomandibular Joint Dysfunction ◽

Disk Displacement ◽

Significant Difference

Matrix metalloproteinases (MMPs) are tissue-enzymes that play a key role during the remodeling process, such as in inflammatory diseases. MMP-7 and MMP-9 have been shown to be implicated in extracellular matrix homeostasis and in joint disc remodeling. The objective of this study was to determine the relation of MMP-7 and MMP-9 expression with severe temporomandibular joint dysfunction, in particular with anterior disk displacement without reduction (ADDwoR), using an immunohistochemical approach. Therefore, twenty human temporomandibular synovia in the test group and ten in the control group were collected. The results showed there was a statistically significant difference (P<0.001) for morphometric and densitometric analysis of both detected MMPs in control and test groups. In conclusion, MMP-7 and MMP-9 were overexpressed in the synovial tissue of patients with ADDwoR.

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EVALUATION OF THE EFFECTIVENESS OF TREATMENT OF PATIENTS WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION AFTER MANDIBULAR FRACTURES ACCORDING TO X-RAY EXAMINATION

Wiadomości Lekarskie ◽

10.36740/wlek202109110 ◽

2021 ◽

Vol 74 (9) ◽

pp. 2082-2086

Author(s):

Olga L. Skrypa

Keyword(s):

Temporomandibular Joint ◽

Statistical Processing ◽

Treatment Method ◽

Joint Space ◽

Main Group ◽

Control Group ◽

Mandibular Fractures ◽

Temporomandibular Joint Dysfunction ◽

Radiological Data ◽

Post Traumatic

The aim: On the basis of radiological data to evaluate the effectiveness of our developed treatment complex of patients with temporomandibular joint dysfunction after mandibular fractures. Materials and methods: To achieve this goal, 92 patients hospitalized in the department of surgical dentistry of the Chernivtsi Regional Clinical Hospital were examined for traumatic fractures of the mandible with functional disorders of the TMJ. 46 patients (main group) were treated according to the treatment method developed by us, and 46 patients (control group) were treated with the traditional method. Patients underwent orthopanthography and radiography of the temporomandibular joint according to Schuller. Statistical processing of research results was carried out using commonly used methods of variation statistics. Results: After 12 months of studies in patients of the main group, unilateral narrowing of the joint space was determined in 6,52 ± 1,83% of persons p, p1 0.05.The number of persons with unilateral expansion of the joint space according to Rtg, in the main group decreased by 2,3 times relative to the data before treatment. Conclusions: Timely treatment of musculoskeletal disorders with the help of pharmacological and physiotherapeutic methods proposed by us, allowed, to a large extent, to eliminate clinical, radiological and ultrasound symptoms of temporomandibular joint dysfunction in patients with post-traumatic lesions of mandibule. This was confirmed by the improvement of the data of the conducted functional researches.

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EVALUATION OF CEPHALOMETRIC ANALYSIS IN PATIENTS WITH BILATERAL CONDYLAR RETROPOSITION IN TEMPOROMANDIBULAR DYSFUNCTION

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.20.3.41 ◽

2020 ◽

Vol 20 (3) ◽

pp. 41-46

Author(s):

V.V. Vovk ◽

V.P. Nespriadko

Keyword(s):

Temporomandibular Joint ◽

Test Group ◽

Masticatory Muscles ◽

Control Group ◽

Cephalometric Analysis ◽

Temporomandibular Joint Dysfunction ◽

Mandibular Growth ◽

Facial Skull ◽

Condylar Position ◽

Canine Guidance

Relevance. During the dentoalveolar growth and development, the direction and growth type of facial skull play a very important role. Development of esthetical symmetry, functional relationship, and clinical disharmony depends on skull parameters. Temporomandibular joint dysfunction is one of the most common diseases nowadays. That is why early identification of risk factors is among the priorities. This study aimed at evaluating occlusional and skeletal specific characteristics in patients with temporomandibular joint dysfunction, comparing different cephalometric findings and CT findings relating to condylar position. Materials and methods. The study included 45 individuals. The study group consisted of 26 patients with bilateral condylar retroposition. Control group was made up of 19 patients. The participants underwent clinical examination, functional testing, palpation of masticatory muscles, occlusion diagnosis by applying Baush articulating film 200,100,8 microns, cephalometric analysis: Tweed, Kim, Jarabak, Ricketts, computed tomography of temporomandibular joint. Statistical analysis was carried out by the program IBM SPSS Statistic Base v.22. Results. There were no pathological contacts during evaluation of static and dynamic occlusion, laterotrusion as «canine guidance». The patients of the test group had bilateral posterior joint fissure reduced right-median 1,96, left-median 1,81. In control group the position was right-average 2,75 and left-median 2,67 The patients in the control and test groups the indices Tweed <FMA average were 19,6°/ median 21,7°; <IMPA average 97,9°/ median 97,8°; Kim ODI median was 68,9°/73,74°; Ricketts Overbite median 2.1 mm /1,9 mm, Overjet median was 2,9 mm /2,85 mm, PM-Xi-ANS median was 44,1°/43,75°, <NPog-FH median was 91°/86,85°,<NBa-PtGn median was 91,1°/90,1°, <MeGo-FH median was 18,7°/22,4°; Jarabak <N-S-Ar average was 127,2°/125,6 °. Conclusions. In the patients with bilateral condylar retropositionm the joint fissure is reduced. Cephalometric analysis demonstrated the following: Tweed <FMA, <IMPA; Kim ODI; Ricketts Overbite, Overjet, PM-Xi-ANS, <MeGo-FH; Jarabak <N-S-Ar can not be used as diagnostic criteria of bilateral condylar retroposition. Ricketts <NPog-FH in the test group showed the mandibular retroposition, but with normal type of mandibular growth <NBa-PtGn. It can be used as one of the primary cephalometric diagnostic indicator of bilateral condylar retroposition.

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Morphological changes in temporomandibular joint dysfunction and effectiveness of different treatment methods

Anatomy (International Journal of Experimental and Clinical Anatomy) ◽

10.2399/ana.20.037 ◽

2020 ◽

Vol 14 (2) ◽

pp. 102-110

Author(s):

Fatma Duman ◽

Aynur Emine Çiçekçibaşı ◽

Nesrin Atçı ◽

Fatma Öztürk ◽

Bircan Yücekaya ◽

...

Keyword(s):

Temporomandibular Joint ◽

Morphological Changes ◽

Masticatory Muscles ◽

Control Group ◽

Dry Needling ◽

Temporomandibular Joint Dysfunction ◽

Anatomical Structures ◽

Treatment Methods ◽

Mandibular Fossa ◽

Group B

Objectives: Temporomandibular joint dysfunction (TMD) results in changes in anatomical structures. The aim of this study was to examine the morphological changes using magnetic resonance imaging (MRI) and evaluate the effectiveness of different treatment methods in patients with TMD. Methods: 34 TMD patients (18–62 years of age) were randomly divided into two treatment groups. Group A (n=18) was subjected to dry needling (DN) and mobilization for 10 sessions, Group B (n=16) was instructed to use occlusal splint with home exercises for one month. The control group included MRIs of 17 healthy adults that were randomly selected from the archives of Radiology Department of Mustafa Kemal University. The length and width of the masseter, lateral and medial pterygoid muscles and the depth of the mandibular fossa were measured and mandibular condyle types were recorded. Range of motion of each temporomandibular joint was evaluated in pre- and post-treatment periods to test the effectiveness of the treatment methods. Results: The size of the masticatory muscles in TMD group was significantly smaller than the control group (p<0.05). The depth of the mandibular fossa was significantly shallower in the TMD group (p<0.05). The most commonly encountered condylar shape was convex in the TMD group (63.6%), but flat (58.8%) in the control group. No statistically significant relationship was observed between condyle type and fossa depth (p>0.05). However, the fossa depth showed a significant correlation with muscle size (p<0.05) and this correlation decreased with dysfunction. Dry needling and mobilization significantly decreased pain and increased mandibular movements (p<0.05); however, there was no significant change for Group B. Conclusion: The anatomical structures associated with the temporomandibular joint seems to be affected in patients with TMD. We suggest that the limited movement of the temporomandibular joint may cause atrophy of the masticatory muscles, affecting the range of motion of the joint. Dry needling and mobilization techniques might be a more effective alternative than occlusal splint in the treatment of TMD.

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