Diagnosis and management of temporomandibular joint dysfunction before surgery: a case report

We present a case of colorectal cancer with temporomandibular joint dysfunction and discuss the management of the case. Type IIIb temporomandibular disorder involves anterior dislocation of the articular disk, trismus and difficult intubation. A 68-year-old woman was scheduled for colectomy. The day before surgery, the patient had temporomandibular pain. On examination, the mouth opening was 13 mm. We diagnosed type IIIb temporomandibular disorder. A simple splint was fabricated with gauze and she bit it. The mouth opening was 55 mm on the day of surgery. The pain disappeared, and intubation was uneventful. Temporomandibular disorders are generally treated by dentists. It is beneficial for general hospitals without a dentistry department to employ a dental anaesthesiologist to assist in potentially difficult intubations in patients with temporomandibular disorders.

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Importance of stability and retention of double total prostheses: factors related to its use in the etiology of temporomandibular disorders

Brazilian Dental Science ◽

10.14295/bds.2016.v19i1.1153 ◽

2016 ◽

Vol 19 (1) ◽

pp. 55 ◽

Cited By ~ 1

Author(s):

Letícia De Souza Renhe ◽

Jean Soares Miranda ◽

Natália Veloso Malta ◽

Isabel Cristina Gonçalves Leite ◽

Fabiola Pêssoa Pereira Leite

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Facial Pain ◽

Temporomandibular Disorder ◽

Statistical Significance ◽

Disc Displacement ◽

Temporomandibular Joint Dysfunction ◽

Temporomandibular Joint Dysfunction Syndrome ◽

Axis I ◽

School Of Dentistry

Objective: Evaluate the prevalence of Temporomandibular Disorder in patients with full double prosthesis. Material and Methods: The sample was composed of 40 volunteer patients, aged between 34 and 92 years, with upper and lower dentures, assisted at the Total Prosthodontics Clinic of the School of Dentistry at the Federal University of Juiz de Fora. Patients were evaluated by a single trained examiner and the diagnosis of TMD was established from the axis I of the RDC/TMD. Results: The prevalence of TMD in the sample was 42.5%, and most patients were female. Although there was no statistical significance between the time of use of the prosthesis and the presence of TMD was found, there was a correlation between time without use of prosthesis and the presence of disc displacement. Conclusion: According to the methodology applied and the results of this study, it can be concluded that there was a considerable prevalence of TMD in patients with double dentures, but there was no correlation between the use of full and DTM prosthesis.Keywords: Facial Pain; Temporomandibular Joint Dysfunction Syndrome; Complete Denture.

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Asociación entre hábitos parafuncionales de la cavidad bucal y los transtornos temporomandibulares en adolescentes

REVISTA ODONTOLOGÍA PEDIÁTRICA ◽

10.33738/spo.v10i2.167 ◽

2018 ◽

Vol 10 (2) ◽

Author(s):

Gabriel Muñoz Quintana

Keyword(s):

Oral Cavity ◽

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Neuromuscular System ◽

Jaw Movements ◽

Nail Biting ◽

Palabras Clave ◽

Masticatory System ◽

Objective Being

La musculatura del sistema masticatorio y la articulación temporomandibular (ATM) están protegidos por reflejos nerviosos básicos y sistema neuromuscular a través de la coordinación de fuerzas musculares, todo lo que produce sobrecarga muscular repetitiva como los hábitos parafuncionales (HPF) pueden ocasionar trastornos temporomandibulares (TTM)1. Los HPF se caracterizan por movimientos anormales a la función mandibular normal sin objetivo funcional, al estar alterados constituyen una fuente productora de fuerzas traumáticas caracterizadas por dirección anormal, intensidad excesiva y repetición frecuente y duradera (Rolando Castillo Hernández, 2001)4. El objetivo del estudio fue identificar la asociación entre la presencia de hábitos parafuncionales de la cavidad bucal y los TTM en adolescentes de la ciudad de Puebla. Estudio observacional descriptivo. Se incluyeron 258 adolescentes, 132 (51.2%) mujeres y 126 (48.8%) hombres, con una edad promedio de 12.5±.73 y quienes fueron diagnosticados con los CDI/TTM y los HPF fueron auto-reportados por los pacientes. Se encontró una prevalencia de los TTM del 39.9% y una prevalencia de HPF del 86%. Los HPF más frecuentemente reportados fueron la succión labial y la onicofagia. Se encontró una asociación significativa (x2=7.31, p=0.007) entre los hábitos parafuncionales y los TTM en adolescentes. Palabras clave: Trastornos temporomandibulares, hábitos parafuncionales, adolescentes, articulación temporomandibular. Abstract The muscles of the masticatory system and temporomandibular joint (TMJ) are protected by basic nerve reflex and neuromuscular system through the coordination of muscle forces, all that repetitive muscle overload occurs as habit parafunctional (HPF) can cause temporomandibular disorder TMD)1. The characteristics of HPF are abnormal jaw movements without a functional objective. Being the jaw movements altered, they constitute a source of traumatic forces with an abnormal direction, excessive intensity and long-lasting and frequent duration. (Rolando Hernandez Castillo 2001)4. Objective: was to identify the association between the presences of parafunctional habits of the oral cavity and TMD in adolescents in the Puebla city in Mexico. Material and methods: Is a observational study, we included 258 adolescents 132 (51%) females and 126 (48.8%) were men, mean age 12.5±.73 and who were diagnosed with CDI/TTM and HPF were self- reported by patients. Results: The prevalence of TMD was 39.9% and a prevalence of 86% HPF. The most frequently reported HPF were lip sucking and nail biting. We found a significant association (x2= 7.31, p = 0,007) between HPF and TMD in adolescents. Key words: Parafunctional habits of oral cavity, temporomandibular disorders, temporomandibular joint. (Odontol Pediatr 2011;10(2): 90-94).

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Temporomandibular Disorders and Bruxism Prevalence in a Portuguese Sample

Medical Sciences Forum ◽

10.3390/msf2021005037 ◽

2021 ◽

Vol 5 (1) ◽

pp. 37

Author(s):

João Belo ◽

André Almeida ◽

Paula Moleirinho-Alves ◽

Catarina Godinho

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Diagnostic Aspects ◽

Relevant Role

Temporomandibular disorder (TMD) encompasses a set of disorders involving the masticatory muscles, the temporomandibular joint and associated structures. It is a complex biopsychosocial disorder with several triggering, predisposing and perpetuating factors. In the etiology of TMD, oral parafunctions, namely bruxism, play a relevant role. The study of bruxism is complicated by some taxonomic and diagnostic aspects that have prevented achieving an acceptable standardization of diagnosis. The aim of this study was to analyze the prevalence of temporomandibular disorders and bruxism in a Portuguese sample.

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Effectiveness of Combining Manual Therapy and Acupuncture on Temporomandibular Joint Dysfunction: A Retrospective Study

The American Journal of Chinese Medicine ◽

10.1142/s0192415x07004746 ◽

2007 ◽

Vol 35 (02) ◽

pp. 203-208 ◽

Cited By ~ 11

Author(s):

Byung-Cheul Shin ◽

Chung-Hyo Ha ◽

Yung-Sun Song ◽

Myeong Soo Lee

Keyword(s):

Retrospective Study ◽

Temporomandibular Joint ◽

Manual Therapy ◽

Randomized Clinical Trials ◽

Combined Treatment ◽

Mouth Opening ◽

Temporomandibular Joint Dysfunction ◽

Future Studies ◽

Before And After ◽

Maximal Mouth Opening

This retrospective study investigated the effects of combining manual therapy and acupuncture on the pain and maximal mouth opening (MMO), which were associated with temporomandibular joint dysfunction (TMD). The 49 TMD patients (15 men, 34 women; mean age = 30.47 years, SD = 13.52 years) were treated with a combination of acupuncture and manual therapy two or three times a week at the hospital. The pain and maximal mouth opening were assessed before and after 1 and 4 weeks of treatment. The combination therapy produced significant changes in pain levels ( p < 0.001) and mouth opening ( p < 0.001). All pairwise non-parametric comparison showed a significant improvement in pain ( p < 0.05 for all pairs) and MMO ( p < 0.05 for all pairs). These findings suggest that combining manual therapy and acupuncture decreases the pain level and increases the MMO of TMD patients. However, future studies should further investigate the efficacy of combined treatment on TMD with more rigorous randomized clinical trials.

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Temporomandibular joint dysfunction in Parkinson's Disease: an integrative literature review

Revista CEFAC ◽

10.1590/1982-0216201719516416 ◽

2017 ◽

Vol 19 (5) ◽

pp. 702-711 ◽

Cited By ~ 1

Author(s):

Taysa Vannoska de Almeida Silva ◽

Maria das Graças Wanderley de Sales Coriolano ◽

Carla Cabral dos Santos Accioly Lins

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Temporomandibular Joint ◽

Myofascial Pain ◽

Mouth Opening ◽

Signs And Symptoms ◽

Masticatory Muscles ◽

Therapeutic Interventions ◽

Temporomandibular Joint Dysfunction ◽

Language Restriction

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.

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Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

Pacific Medical Journal ◽

10.34215/1609-1175-2021-4-98-100 ◽

2022 ◽

pp. 98-100

Author(s):

A. A. Sultanov ◽

Y. Y. Pervov ◽

A. K. Yatsenko ◽

M. A. Sultanova ◽

D. O. Drozdova

Keyword(s):

Physical Examination ◽

Temporomandibular Joint ◽

Orthodontic Treatment ◽

Clinical Case ◽

Mouth Opening ◽

Integrated Approach ◽

Masticatory Muscles ◽

Temporomandibular Joint Dysfunction ◽

The Right ◽

Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

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Dental malocclusion is not related to temporomandibular joint clicking: a logistic regression analysis in a patient population

The Angle Orthodontist ◽

10.2319/041613-295.1 ◽

2013 ◽

Vol 84 (2) ◽

pp. 310-315 ◽

Cited By ~ 31

Author(s):

Daniele Manfredini ◽

Giuseppe Perinetti ◽

Luca Guarda-Nardini

Keyword(s):

Logistic Regression ◽

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Open Bite ◽

Final Model ◽

Posterior Crossbite ◽

The Difference ◽

Contact Position ◽

Dental Malocclusion

ABSTRACT Objectives: To assess the association of several dental malocclusion features with temporomandibular joint (TMJ) click sounds in a population of temporomandibular disorder (TMD) patients. Materials and Methods: Four hundred forty-two TMD patients (72% female; 32.2 ± 5.7 years, range 25–44 years) were divided into a TMJ clicking and a no-TMJ clicking group, based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) assessment. Seven occlusal features were recorded for each patient: (1) posterior crossbite, (2) overbite, (3) open bite, (4) overjet, (5) mediotrusive and (6) laterotrusive interferences and (7) retruded contact position to maximum intercuspation (RCP-MI) slide length. A logistic regression model was created to estimate the association of occlusal features with TMJ clicking. Results: The difference between the groups as for the prevalence of the various occlusal features was generally not statistically significant, with minor exceptions. Mediotrusive interferences (P = .015) and RCP-MI slide ≥2 mm (P = .001) were the two occlusal features that were associated with the probability of having TMJ clicking, even if the adjusted odds ratios for TMJ clicking were low for both variables (1.63 and 1.89, respectively). Moreover, the amount of variance in the prevalence of TMJ clicking that was predicted by the final model was as low as 4.5% (R2 = 0.045). Conclusions: Findings from the present investigation suggested that in a population of TMD patients, the contribution of dental malocclusion features to predict TMJ click sounds is minimal with no clinical relevance.

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Ultrasonography: A step forward in temporomandibular joint imaging. A preliminary descriptive study

Clinics and Practice ◽

10.4081/cp.2019.1134 ◽

2019 ◽

Vol 9 (2) ◽

Author(s):

Surej Kumar L.K. ◽

Georgie P. Zachariah ◽

Sumesh Chandran

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Imaging Modality ◽

Mouth Opening ◽

Diagnostic Technique ◽

High Specificity ◽

Cost Effective ◽

Joint Space ◽

Dynamic Relationship ◽

Disc Position

Ultrasonography (USG) is a cost-effective and noninvasive imaging modality commonly employed for imaging the abdominal region and extremities. Currently, with the availability of higher frequency probes and higher resolution devices, USG imaging of the temporomandibular joint (TMJ) looks promising. The aim is to evaluate and demonstrate the role of USG as an imaging modality of TMJ by visualizing the static and dynamic relationship of the joint, assessment of joint space and eliciting reproducibility at both open and closed mouth positions. 30 volunteers were selected based on the inclusion criteria in line with the research diagnostic criteria/temporomandibular disorders guidelines. High-resolution USG (≥12 MHz) of the right TMJ (chosen for uniformity) was done in the left decubitus position on (n=30) volunteers. The joint disc movement was directly visualized during opening and closing motions. The vertical joint space was assessed using the firmware and accurate reproducibility was checked. At the closed mouth position, the measured values ranged from 0.2 mm to 0.7 mm with a median of 0.05 cm and a mean of 0.4±0.15 mm. At the position of maximal mouth opening, the measured values ranged from 0.9 mm to 1.5 mm with a median of 1.1 mm and a mean of 1.1±0.17 mm. USG enables visualization of the dynamic relationship between joint structures, with particular importance to the condyle and disc position. The articular disc appears on the USG as a thin layer of hyperechogenicity surrounded by a hypoechoic halo, located between 2 hyperechoic lines viz, the condyle and the articular eminence. We recommend ultrasonographic imaging as a noninvasive diagnostic technique with relatively high specificity for patients with temporomandibular disorders.

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Interpositional Arthroplasty for Treatment of ATM Ankylosis

Journal of Surgery Open Access ◽

10.16966/2470-0991.226 ◽

2020 ◽

Vol 6 (6) ◽

Author(s):

Dos Santos FDB ◽

Braz E ◽

Matos MR ◽

Schmitz MO ◽

Tomazi FHS ◽

...

Keyword(s):

Literature Review ◽

Temporomandibular Joint ◽

Temporal Bone ◽

Mouth Opening ◽

Functional Disorders ◽

Condylar Fracture ◽

Temporomandibular Joint Ankylosis ◽

Articular Disk ◽

Image Test ◽

Joint Ankylosis

Introduction: The temporomandibular joint ankylosis is the union between the surface of the temporal bone in its articular portion and the complex made out of articular disk and the condyle. Its etiology is multifactorial being the trauma with condylar fracture most cited. This alteration causes several functional disorders to the patient, among them the main one is the limitation of mouth opening, which causes difficulty eating, speaking, hygiene, speech and others. The diagnosis is made through a clinic image test. The goal is to show a report of case of ankylosis as well as a literature review.

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Automated segmentation of articular disc of the temporomandibular joint on magnetic resonance images using deep learning

Scientific Reports ◽

10.1038/s41598-021-04354-w ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Shota Ito ◽

Yuichi Mine ◽

Yuki Yoshimi ◽

Saori Takeda ◽

Akari Tanaka ◽

...

Keyword(s):

Neural Network ◽

Deep Learning ◽

Magnetic Resonance ◽

Convolutional Neural Network ◽

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Semantic Segmentation ◽

Magnetic Resonance Images ◽

Articular Disc

AbstractTemporomandibular disorders are typically accompanied by a number of clinical manifestations that involve pain and dysfunction of the masticatory muscles and temporomandibular joint. The most important subgroup of articular abnormalities in patients with temporomandibular disorders includes patients with different forms of articular disc displacement and deformation. Here, we propose a fully automated articular disc detection and segmentation system to support the diagnosis of temporomandibular disorder on magnetic resonance imaging. This system uses deep learning-based semantic segmentation approaches. The study included a total of 217 magnetic resonance images from 10 patients with anterior displacement of the articular disc and 10 healthy control subjects with normal articular discs. These images were used to evaluate three deep learning-based semantic segmentation approaches: our proposed convolutional neural network encoder-decoder named 3DiscNet (Detection for Displaced articular DISC using convolutional neural NETwork), U-Net, and SegNet-Basic. Of the three algorithms, 3DiscNet and SegNet-Basic showed comparably good metrics (Dice coefficient, sensitivity, and positive predictive value). This study provides a proof-of-concept for a fully automated deep learning-based segmentation methodology for articular discs on magnetic resonance images, and obtained promising initial results, indicating that the method could potentially be used in clinical practice for the assessment of temporomandibular disorders.

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