Diagnostic of Temporomandibular Disorders and Other Facial Pain Conditions—Narrative Review and Personal Experience

Temporomandibular disorders are complex dysfunctions of masticatory muscles and temporomandibular joints. Their symptoms affect more than 40% of the population and their prevalence is rising. It is important to establish a unified protocol for this specialistic examination. This review describes the authors’ own longstanding experiences and the discrepancies in the current literature regarding this topic as well as a detailed procedure of diagnosing temporomandibular disorders including the leading but often underrated role of a medical interview. We presented optimal physical examination methods as well as specific situations in which additional diagnostic and imaging tools may be useful. The emphasis was put on the importance of differential diagnosis between temporomandibular disorders and other diseases presenting with similar symptoms.

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Vitamin D and Temporomandibular Disorders: What Do We Know So Far?

Nutrients ◽

10.3390/nu13041286 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1286

Author(s):

Andreea Kui ◽

Smaranda Buduru ◽

Anca Labunet ◽

Silvia Balhuc ◽

Marius Negucioiu

Keyword(s):

Vitamin D ◽

Temporomandibular Disorders ◽

Potential Role ◽

Current Knowledge ◽

Masticatory Muscles ◽

The Body ◽

Ultraviolet B ◽

Pathological Conditions ◽

Temporomandibular Joints

Background and aims. Vitamin D is synthesized in the skin with the aid of ultraviolet-B radiation, playing a variety of roles in the body. Temporomandibular disorders (TMDs) are a group of pathological conditions involving the temporomandibular joints as well as the masticatory muscles and othersurrounding tissues. In the present narrative review, we investigated the potential role of vitamin D in the etiology of temporomandibular disorders in order todetermine whether the current knowledge supports 25-hidroxyvitamin D (25-OHD) supplementation in temporomandibular disorders associated with insufficient or deficient levels of vitamin D. Methods. A literature research was performed in PubMed, Scopus, Science Direct, and Google Scholar databases, and a total of 10 articles were included for analysis. Results.Among the observational studies published to date, investigating the role for vitamin D in the etiology of TMDs, six of them suggest that there is a connection between the two aspects. In this context, patients suffering from TMD, with deficient levels of vitamin D (<30 ng/mL), are most likely to benefit from supplementation, whereas individuals with vitamin D level >50ng/mL probably have little benefit from supplementation.Conclusion.Vitamin D might be a safe, simple, and potentially beneficial way to prevent TMDs or to reduce pain; however, more randomized and placebo-controlled trials are required before any firm conclusions can be drawn.

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Associação entre a sintomatologia dolorosa e a disfunção temporomandibular

ARCHIVES OF HEALTH INVESTIGATION ◽

10.21270/archi.v9i1.4667 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Wyllka Cyntya Galvão da Silva ◽

Karolinne Domingos Medeiros ◽

Eloisa Cesário Fernandes ◽

Sandja Gabriela Oliveira ◽

Caio Rodrigues Maia ◽

...

Keyword(s):

Diagnostic Criteria ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Epidemiologic Study ◽

Masticatory Muscles ◽

Degenerative Disorders ◽

International Conference On Bioinformatics ◽

Research Diagnostic Criteria

Introdução: A Disfunção Temporomandibular (DTM) é um quadro patológico que afeta o sistema estomatognático e, frequentemente, acompanhada de dor. Objetivos: Aferir o nível de dor dos pacientes portadores de DTM e a prevalência de sintomatologia articular e muscular. Percebeu-se que a relação entre a origem da DTM e a sintomatologia dolorosa é pouco relatada na literatura. Materiais e Métodos: Trata-se de um estudo descritivo, observacional de corte transversal, desenvolvido com 30 pacientes com DTM, diagnosticado pelo Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). A amostra foi determinada pelas estimativas de atendimento. A associação entre a sintomatologia e a origem da DTM foram verificadas através do teste qui-quadrado, com intervalos de confiança (95%). Foi usada uma ficha clínica para a coleta de dados com idade, gênero e nível da dor, que foi aferido através da Escala Visual Analógica de dor. Resultados: Constatou-se que 26 pacientes eram do sexo feminino e 4 do sexo masculino. Quinze apresentaram idade inferior a 36,5 anos, e os outros uma idade superior a esta. Quanto a origem da DTM, 19 tinham desordem articular e 11 muscular. A categoria moderada foi o nível mais prevalente, seguida do intenso. Determinou-se que não houve associação estatisticamente significante entre as variáveis deste estudo com a DTM. Conclusão: Constatou-se que, os fatores etiológicos analisados isoladamente não influenciam de forma única no desenvolvimento da DTM, mas poderão atuar em conjunto com outros fatores, já que a sua causa é multifatorial.Descritores: Dimensão Vertical; Boca Edêntula; Dor Facial; Síndrome da Disfunção da Articulação Temporomandibular.ReferênciasDworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6(4):301-55.Gonçalves DAG, Bigal ME, Jales LCF, Camparis CM, Speciali JG. Headache and symptoms of temporomandibular disorders: an epidemiologic study. Headache. 2010;50(2):231-41.Piccin CF, Pozzebon D, Chiodelli L, Boufleus J, Pasinato F, Corrêa ECR. Aspectos clínicos e psicossociais avaliados por critérios de diagnóstico para disfunção temporomandibular. Revista Cefac. 2016;18(1):113-19.Winocur E, Emodi-Perlman A. Occlusion, orthodontic treatment and temporomandibular disorders: myths and scientific evidences. in: Orthodonthics-basis aspects and clinical considerations. In Tech. 2012.Jorge JMS, Dini C, Santos L, Camara de Bem SH, Custodio W. Associação entre dimensão vertical de oclusão e transtornos temporomandibulares. ClipeOdonto – UNITAU. 2016;8(1):44- 50.Bayma PTC, Feltrin PP, Dias CAS, Costa JF, Laganá DC, Inoue RT. Temporomandibular disorders in otolaryngology patients. RGO (Porto Alegre). 2010;58(3):313-17.Martinez JE, Grassi DC, Marques LG. Análise da aplicabilidade de três instrumentos de avaliação de dor em distintas unidades de atendimento: ambulatório, enfermaria e urgência. Rev Bras Reumatol. 2011;51(4):299-308.Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE et al. Painful temporomandibular disorder: decade of discovery from OPPERA studies. J Dental Res. 2016; 95(10):1084-92.Rauhala K., Oikarinen KS, Raustia AM. Role of temporomandibular disorders (TMD) in facial pain: occlusion, muscle and TMJ pain. Cranio. 1999;17(4):254-61.Manfredini D, Favero L, Gregorini G, Cocilovo F, Guarda-Nardini L. Natural course of temporomandibular disorders with low painrelated impairment: a 2-to-3-year follow-up study. J Oral Rehabil. 2013;40(6):436-42.Freitas LS. Associação da disfunção Temporomandibular com o polimorfismo 102T-C do gene receptor da serotonina HTR2A [tese]. São José do Rio Preto: Faculdade de Medicina do São José do Rio Preto – FAMERP; 2011.Tanaka E, Detamore MS, Mercuri LG. Degenerative disorders of the temporomandibular joint: etiology, diagnosis, and treatment. J Dent Res. 2008;87(4):296-307.Lopes PRR, Campos PSF, Nascimento RJM. Dor e inflamação nas disfunções temporomandibulares: revisão de literatura dos últimos quatro anos. R Ci med biol. 2011;10(3):317-25.Wang X, Guo H, Wang Y, Yi X. The effects of estrogen on cytoplasmic ca2+ concentration of masticatory muscles myoblast in acid condition. 5th International Conference on Bioinformatics and Biomedical Engineering (iCBBE); 10-12 May 2011; Wuhan, China. Anais. Disponível em http://www.icbbe.org/2011/Proceeding2010.aspx.Cairns BE. Pathophysiology of TMD Pain—Basic Mechanisms and Their Implications for pharmacotherapy. J Oral Rehabil. 2010; 37(6):391-410.Portinho CP, Razera MV, Splitt BI, Gorgen ARH, Faller GJ, Collares MVM. Apresentação clínica inicial em pacientes com disfunção Temporomandibular. Rev Bras Cir Craniomaxilofac. 2012;15(3):109-12.

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The use of occlusal splints in temporomandibular disorders - an overview.

Acta Stomatologica Marisiensis Journal ◽

10.2478/asmj-2020-0008 ◽

2020 ◽

Vol 3 (2) ◽

pp. 3-8

Author(s):

Andreea Kui ◽

Silvia Pop ◽

Smaranda Buduru ◽

Marius Negucioiu

Keyword(s):

Temporomandibular Disorders ◽

Mouth Opening ◽

Clinical Situation ◽

Masticatory Muscles ◽

The State ◽

Common Symptom ◽

Occlusal Splints ◽

Temporomandibular Joints ◽

Closed Lock ◽

State Of Art

AbstractTemporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.

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Neurophysiological conception of pain in craniomandibular disfunction

Medicinski pregled ◽

10.2298/mpns0810478s ◽

2008 ◽

Vol 61 (9-10) ◽

pp. 478-482

Author(s):

Sasa Stankovic ◽

Mirjana Boskovic ◽

Zorica Ajdukovic ◽

Ljiljana Kesic ◽

Ljiljana Aleksov ◽

...

Keyword(s):

Clinical Signs ◽

Masticatory Muscles ◽

Point Of View ◽

Main Role ◽

Craniomandibular Dysfunction ◽

Emotional Factors ◽

Morphological Aspects ◽

Temporomandibular Joints ◽

Neurophysiological Data

Introduction. Ethiopathogenesis of dysfunction and pain in temporomandibular joints has been the subject of passionate discussions between supporters of purely mechanical conception and the ones who are supporters of psyhosomatic conception. The aim of the study: Relying on neurophysiological data, the authors are trying to reveal the main role of reticular mesencephalical formation in mechanisms which provoke craniomandibular dysfunctions and confront the influence of emotional factors from neocortex and painful stimuli from oral structures. Discussion. From dynamical point of view, not only the morphological aspects of teeth and arcades, but also sensitive-sensorial mechanisms connected to masticatory muscles, periodontal structures and oral structures, should be considered. The ideal bite and perfect morphology of tooth arcades are not enough for reconstitution of correct occlusion, if there are no neuromuscular system, temporomandibular joint, and especially central nervous system. Conclusion. The presence of pain is just one of the craniomandibular dysfunction symptoms, but if it is added to the other clinical signs and emotional or affect - provoking factor, it will provoke dysfunctional syndrome.

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The prevalence of Jaw and temporomandibular disorders and its relationship with malocclusions in children

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v1i2.34 ◽

2017 ◽

Vol 1 (2) ◽

Author(s):

Amirhosein Pakravan ◽

Tahmine Bamdadian ◽

Zohreh Taqavi ◽

Faeze Valipour ◽

Mahdi Babaei Hatkehloui

Keyword(s):

Temporomandibular Disorders ◽

Masticatory Muscles ◽

Second Phase ◽

Temporomandibular Joints ◽

Number Of Patients ◽

The Common ◽

Two Phases ◽

Masticatory Muscle Pain ◽

Subclinical Symptoms ◽

Clinical Problems

In recent years the number of patients with temporomandibular disorders (TMDs) is on the rise, given this, this paper aimed to investigate the prevalence of jaw and TMDs and its relationship with malocclusions in children. This study was conducted as a review article. The study was a descriptive – library type in which by referring to all the resources and literature of the existing studies, their results have been summed up. The TMDs is referred to clinical problems that involve masticatory muscles, temporomandibular joints or both of them. Its prevalence is 12 to 20%, and including subclinical symptoms, it reaches to 65 %. The common age is reported to be between 20 and 40 years, and its prevalence is higher in women. The most common symptoms are masticatory muscle pain, and the most common cause of it is premature contacts. Its treatment includes two phases; the first phase includes reducing anxiety, medication, and physiotherapy. The second phase involves orthodontic treatment.

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Internal Derangement of the Temporomandibular Joints

Musculoskeletal Imaging Volume 2 ◽

10.1093/med/9780190938178.003.0111 ◽

2019 ◽

pp. 285-288

Author(s):

Josephina A. Vossen

Keyword(s):

Temporomandibular Disorders ◽

Facial Pain ◽

Imaging Techniques ◽

Treatment Options ◽

Degenerative Joint Disease ◽

Internal Derangement ◽

Joint Disease ◽

Multiple Risk Factors ◽

Temporomandibular Joints ◽

Pain Symptoms

Chapter 110 provides a systematic approach to the imaging techniques and interpretation of the temporomandibular joint (TMJ). The most common TMJ conditions and treatment options are discussed. The TMJ plays a crucial role in mastication, jaw mobility, and verbal and emotional expression. Temporomandibular disorders (TMDs) include several entities that can lead to orofacial pain symptoms. Common symptoms include jaw pain, jaw dysfunction, earache, headache, and facial pain. Multiple risk factors have been implicated, including trauma, anatomical factors, pathophysiological factors, and psychosocial factors. TMJ dysfunction is best evaluated with MRI. Internal derangement is the most common TMJ disorder, followed by degenerative joint disease.

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Biomarkers of Temporomandibular Disorders

SONDE (Sound of Dentistry) ◽

10.28932/sod.v3i1.1782 ◽

2019 ◽

Vol 3 (1) ◽

pp. 41-47

Author(s):

Dian Dominica ◽

Silvia Naliani ◽

Shelly Lelyana ◽

Ferry Sandra

Keyword(s):

Early Detection ◽

Temporomandibular Disorders ◽

Daily Activity ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Joint Function ◽

Monocyte Chemoattractant ◽

Temporomandibular Joints ◽

Myofacial Pain ◽

Potential Biomarkers

Temporomandibular disorder is a disorder that includes masticatory muscles or temporomandibular joints, unbalanced joint function or both. The disorders can disturb daily activity, cause by pain. The therapy consuming time and cost. Early detection of temporomandibular disorder is needed, as a prevention of more severe disorders. Increased cortisol can be found in myofacial pain and is not found in internal dearagement or osteoarthritis. Biomarkers of interleukin and monocyte chemoattractant proteins are only found in osteoarthritis. The use of biomarkers can be useful in detecting temporomandibular disorders. Biomarkers can be measured from blood, serum and saliva. Cortisol, dopamine and TAC are potential biomarkers in the temporomandibular disorder.

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