scholarly journals Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 459
Author(s):  
Dion Tik Shun Li ◽  
Yiu Yan Leung

Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.


Author(s):  
Dion Tik Shun LI ◽  
Yiu Yan LEUNG

Temporomandibular disorders (TMD) is a group of orofacial pain conditions which is the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology and often cyclical nature of the disease, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.



Author(s):  
Satheesh Simha Reddy Panga ◽  
Ravi Sekhar ◽  
Raja Sekhar

ABSTRACT Temporomandibular disorder (TMD) is not just one disorder, but a group of conditions, often painful, that affect the temporomandibular joint, and the muscles that control chewing. Many psychological and physical factors cause myofascial pain, internal derangement of the joint, degenerative joint diseases which ultimately leads to temporomandibular disorder. Scientists are exploring how behavioral, psychological and physical factors may combine to cause temporomandibular disorders and researchers are working to clarify temporomandibular disorders symptoms, with the goal of developing easier and better methods of diagnosis and improved treatment. In part 1 of this 2-part series on temporomandibular disorders, emphasis will be placed on the history and classification of temporomandibular disorders, structure and function of the temporomandibular joint (TMJ), and patient evaluation techniques.



1999 ◽  
Vol 15 (1) ◽  
pp. 10-17
Author(s):  
Molina Omar Franklin ◽  
Tavares Gimenes Pablo ◽  
Aquilino Raphael ◽  
Rank Rise ◽  
Coelho Santos Zeila ◽  
...  

Objective: To assess the level of depression, severity of pain and pain in single/multiple sites in patients with different severity of bruxing behavior and Temporomandibular Disorders (TMDs). Methods: We evaluated 131 patients with bruxism and TMDs: 20 patients with mild bruxism, 42 patients with moderate bruxism, 45 patients with severe bruxism and 24 patients with extreme bruxism. We used the Beck Depression Inventory (BDI), clinical examination, a questionnaire of clinical epidemiological data, criteria for TMDs and bruxism, palpation of muscles and joints, the Visual Analogue Scale for pain, classification of the occlusion and biomechanical tests to assess for internal joint derangements. Results: The level of depression increased from the mild, to the moderate, severe and extreme bruxing behavior groups, but the difference was significant only from the mild to the extreme group (p<0.001). Pain levels increased from the mild and moderate to the severe and extreme subgroups, but were not statistically significant. Mean number of pain sites increased from the mild, to the moderate, severe and extreme subgroup and the difference was extremely significant (p<0.0001). Conclusion: Levels of depression, severity of pain and pain sites increased with severity of bruxing behavior. A higher number of pain sites with more severe bruxism indicates somatization in bruxers, but a further study using the same protocol and a psychological test for somatization would be indicated to further substantiate these findings.





2021 ◽  
Vol 16 (1) ◽  
Author(s):  
F. Haubner ◽  
A. Schneider ◽  
H. Schinke ◽  
M. Bertlich ◽  
B. G. Weiss ◽  
...  

Abstract Background Recurrent spontaneous epistaxis is the most common clinical manifestation and the most debilitating symptom in hereditary haemorrhagic telangiectasia (HHT) patients. To this date, there exist only a classification of HHT patients by different genetic mutations. There is no standard classification for the mucocutaneous endonasal manifestations of HHT. The aim of the present study was to document the variety of endonasal HHT lesions using digital microscopy and to propose a clinical classification. Methods We recorded the endonasal HHT lesions of 28 patients using a digital microscope. We reconstructed the 3D images und videos recorded by digital microscope afterwards and classified the endonasal lesions of HHT in two classes: Grade A, presence of only flat telangiectasias in the mucosa level and Grade B, (additional) presence of raised berry or wart-like telangiectasia spots. We investigated also Haemoglobin level by routine laboratory procedures, plasma VEGF level by ELISA, Severity of epistaxis by epistaxis severity score (ESS) and quality of life by a linear visual analogue scale (VAS). Results We found a higher quality of life and a lower severity of epistaxis in Grade A patients in comparison to Grade B patients. No difference in plasma VEGF level and in Haemoglobin between Grad A patients and Grade B patients could be detected. Plasma VEGF levels showed no gender specific differences. It could also not be correlated to the extranasal manifestation. Conclusion The classification for endonasal manifestation of HHT proposed in this study indicates severity of epistaxis und quality of life. Digital microscopy with the ability of 3D reconstruction of images presents a useful tool for such classifications. The classification of endonasal HHT lesions using digital microscopy allows to evaluate the dynamic of HHT lesions in the course of time independent of examiner. This allows also to evaluate the efficacy of the different treatment modalities by dynamic of HHT lesions. Moreover digital microscopy is very beneficial in academic teaching of rare diseases.



2002 ◽  
Vol 5 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Monique E. De Paepe ◽  
Sarah Burke ◽  
Francois I. Luks ◽  
Halit Pinar ◽  
Don B. Singer

Invasive treatment modalities for severe chronic twin-to-twin transfusion syndrome (TTTS), such as fetoscopic laser coagulation of communicating vessels, have revived the need for detailed studies of placental angioar-chitecture. We describe a practical placental vascular injection technique using alcohol-resistant tissue-staining dyes. Injection of color-coded gelatin-dye mixtures effectively delineated the intertwin vasculature, and allowed unequivocal macroscopic classification of vascular communications as artery-to-artery, vein-to-vein, or deep artery–to-vein anastomoses. The existence of deep artery–to-vein anastomoses was further confirmed by light microscopic demonstration of venous dye of one twin and arterial dye of the opposite twin within the same stem villus. Furthermore, the injection technique allowed determination of the caliber of the anastomoses, the direction of the artery-to-vein anastomoses, and the relative vascular territory of each twin. Documenting the vascular communications in monochorionic twin placentas with and without TTTS may enhance our understanding of the pathogenesis of chronic TTTS. Correlating the anastomotic patterns and location of the laser coagulation scars with post-ablation outcome will aid in the design of rational therapeutic methods for this often lethal condition.



Author(s):  
Kirsanov S.I.

Despite nearly a century of research on diseases affecting the temporomandibular joint (TMJ), masticatory muscles and associated structures, this problem still remains open. Pain syndrome caused by TMJ diseases ranks first in terms of prevalence among non-odontogenic pain syn-dromes in the maxillofacial region and leads to a signifi-cant deterioration in the quality of life of patients. The high prevalence of these diseases in female patients and the presence of a number of factors of a somatic, psycho-logical and social nature, contributing to such a high prevalence, indicate the need for more close attention of researchers to these aspects, which can become a way to develop new effective methods for the diagnosis and treatment of TMJ diseases in this category of patients. A review of scientific literature was carried out in order to identify topical scientific issues related to the study, di-agnosis and treatment of TMJ diseases.



2020 ◽  
pp. 28-29
Author(s):  
Paulo Cesar Rodrigues Conti ◽  
Juliana Stuginski Barbosa ◽  
Leonardo R Bonjardim ◽  
Daniela Aparecida de Godoi Gonçalves

Editorial



2021 ◽  
Vol 14 (2) ◽  
pp. 98-104
Author(s):  
Andrea Cunningham ◽  
Dipali Patel ◽  
Zahra Sheriteh

This case series describes a number of different treatment modalities used in the management of impacted mandibular second molars (MM2s). A variety of cases is used to illustrate a number of ways in which these teeth can be managed, and to demonstrate that each case should be managed on an individual basis, taking into account the overall malocclusion. The importance of early diagnosis and management is highlighted throughout. CPD/Clinical Relevance: This case series highlights the difficulties and challenges in managing patients who present with impacted lower second molars (MM2s), and the importance of early diagnosis and treatment.



2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Mahdi Khoshchehreh ◽  
Omalbanin Paknejad ◽  
Mehrdad Bakhshayesh-Karam ◽  
Marzieh Pazoki

The thorax is the rarest place among all forms of renal ectopia. We report a rare case of an unacquired thoracic kidney. Only about 200 cases of the thoracic kidney have ever been reported in medical literature worldwide. In this paper we present the rarest form of nontraumatic nonhernia associated, truly ectopic thoracic kidney. The differential diagnosis and management options and classification of this rare form of aberrant kidney are discussed.



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