Combined prostho-orthodontic treatment of temporomandibular joint disorders: Case reports

ABSTRACT The etiology of alterations of the temporomandibular joint, such as ankylosis and bifid condyle, comprises several causes including trauma. However, otological infections cannot be overlooked as a probable cause of alterations of the temporomandibular joint, because the proximity between the external auditory canal and the temporomandibular joint facilitates the spread of infection in the region. This article presents a case-report of a patient with bifid condyle of the temporomandibular joint, in which the patient had no history of facial trauma, but had suffered recurrent otitis infections during her childhood. In parallel, a second case-report is described of temporomandibular joint ankylosis in a 12-year-old patient with a history of facial trauma during her childhood. The purpose of this study was to highlight and emphasize the importance of early diagnosis of temporomandibular joint disorders to avoid the development of facial asymmetries, restore function, esthetics, and the psychological state of the patient.

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Posisi kondilus setelah perawatan ortodontik pada maloklusi kelas II divisi 1 dengan pencabutan premolarCondylar position after orthodontic treatment in class II division 1 malocclusion with premolar extraction

Jurnal Kedokteran Gigi Universitas Padjadjaran ◽

10.24198/jkg.v33i1.30643 ◽

2021 ◽

Vol 33 (1) ◽

pp. 59

Author(s):

Dhani Ayu Andini ◽

Maria Purbiati ◽

Nia Ayu Ismaniati Suria ◽

Ira Tanti

Keyword(s):

Temporomandibular Joint ◽

Orthodontic Treatment ◽

Joint Space ◽

Class Ii ◽

Temporomandibular Joint Disorders ◽

Premolar Extraction ◽

Division 1 ◽

Before And After ◽

The Right ◽

Class Ii Division 1

Pendahuluan: Maloklusi kelas II divisi 1 dilaporkan seringkali memicu terjadinya gangguan sendi temporomandibula. Posisi kondilus mengalami perubahan pada akhir perawatan ortodontik dengan pencabutan premolar pada maloklusi kelas II divisi 1. Tujuan penelitian menganalisis posisi kondilus pada akhir perawatan ortodontik supaya dapat memberikan pelayanan yang efektif dan komprehensif kepada pasien. Metode: Jenis penelitian deskriptif observasional dengan desain kohort dilakukan pada Klinik Spesialis RSKGM FKG UI dari Maret sampai Mei 2019. Subjek sebanyak 30 orang mengalami maloklusi kelas II divisi 1 yang memiliki gejala gangguan temporomandibular yang memenuhi kriteria inklusi. Metode sampling yang digunakan adalah sampling konsekutif. Foto transkranial dibandingkan dan diukur ruang sendinya bagian anterior, posterior dan superior dan dianalisis menggunakan uji Mc Nemar. Hasil: Sebelum dan sesudah perawatan ortodontik, posisi kondilus kanan dan kiri tidak mengalami perubahan yang signifikan (p>0,05). Sebelum dan sesudah perawatan ortodontik, AJS (Anterior Joint Space), PJS (Posterior Joint Space), SS (Superior Space) kanan dan kiri tidak mengalami perubahan yang signifikan (p>0,05). Gejala gangguan sendi temporomandibula pada akhir perawatan ortodontik adalah kliking dan krepitasi dilaporkan masih ada sedangkan gejala tidak nyaman dan keterbatasan membuka mulut dilaporkan sudah hilang. Simpulan: Tidak terdapat perbedaan posisi kondilus kanan dan kiri, sebelum dan sesudah perawatan ortodontik dengan pencabutan premolar pada maloklusi kelas II divisi 1. Keluhan gangguan sendi temporomandibular tidak ditemukan lagi pada akhir perawatan ortodontik.Kata kunci: Posisi kondilus, perawatan ortodontik, maloklusi kelas II divisi 1, pencabutan premolar. ABSTRACTIntroduction: Class II division 1 malocclusion is reported to trigger temporomandibular joint disorders often. The position of the condyles changed at the end of orthodontic treatment with premolar removal in class II division 1 malocclusion. This study aimed to analyse the position of the condyles at the end of orthodontic treatment to provide effective and comprehensive services to patients. Methods: This type of descriptive observational study with a cohort design was conducted at the Specialist Clinic of University of Indonesia Dental Hospital from March to May 2019. Thirty subjects experienced class II division 1 malocclusion who had temporomandibular disorders that met the inclusion criteria. The sampling method used was consecutive sampling. Transcranial radiographs were compared, and anterior, posterior and superior joint spaces were measured and analysed using the McNemar test. Results: Before and after orthodontic treatment, the position of the right and left condyles did not change significantly (p>0.05). Before and after orthodontic treatment, AJS (Anterior Joint Space), PJS (Posterior Joint Space), SS (Superior Space) right and left did not change significantly (p>0.05). Symptoms of temporomandibular joint disorder at the end of orthodontic treatment were clicking, and crepitus was reported to be present, while the symptoms of discomfort and limited opening of the mouth were reported to have disappeared. Conclusion: There is no difference in the position of the right and left condyles before and after orthodontic treatment with premolar extraction in class II division 1 malocclusion. Complaints of temporomandibular joint disorders were not found again at the end of orthodontic treatment. Keywords: Condyle position, orthodontic treatment, class II division 1 malocclusion, premolar extraction.

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Manifestações orofaciais na síndrome de Munchausen - Revisão de literatura / Oral and maxillofacial manifestations in Munchausen Syndrome - Review of the literature

Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo ◽

10.26432/1809-3019.2020.65.040 ◽

2020 ◽

Vol 65 (1) ◽

pp. 1

Author(s):

Lorenzo Bernardi Berutti ◽

Gustavo Souza Galvão ◽

Rita de Cássia D'Ottaviano Nápole ◽

Bruna Luiza Roim Varotto ◽

Reynaldo Antequera

Keyword(s):

Health Care ◽

Temporomandibular Joint ◽

Case Reports ◽

Temporomandibular Joint Disorders ◽

Oral Manifestations ◽

Maxillofacial Injuries ◽

Review Of The Literature ◽

Munchausen Syndrome ◽

Facial Injuries ◽

Health Care Practitioners

Introdução: Pacientes com Síndrome de Munchausen (SM) simulam ou reproduzem lesões ou doenças com a intenção de assumir o papel de doente, sem o objetivo de ganho secundário. A familiarização dos profissionais da saúde com a SM e suas possíveis manifestações orofaciais pode impedir a realização de procedimentos desnecessários e tratamentos com insucessos consecutivos. Objetivo: Este estudo tem como objetivo identificar as manifestações orofaciais apresentadas por pacientes diagnosticados com a SM. Método: Foi realizada uma revisão de literatura pautada nos seguintes descritores: Síndrome de Munchausen, Boca, Face, Odontologia, Manifestações Bucais, Traumatismos Faciais e Traumatismos Maxilofaciais. Foram incluídos artigos nos idiomas inglês e português que discutem a SM e suas manifestações na região orofacial. A busca foi realizada nas bases de dados PubMed, LILACS, Embase e SciELO. Resultados e Conclusão: Foram incluídas 18 publicações que resultaram no relato de 22 casos de pacientes com manifestações orofaciais e diagnosticados com a SM. As manifestações orofaciais relatadas foram: dores orofaciais difusas ou mimetizando odontalgias; tumefação em face ou intraoral devido injeção de materiais ou ar nos tecidos; lesões ulceradas, bolhosas e sangrantes em mucosa oral; ulcerações, eritemas e equimoses em face; e disfunções da articulação temporomandibular (ATM) envolvendo múltiplas cirurgias e simulação de subluxação da ATM. Incentiva-se a publicação de relatos de caso para familiarizar o profissional da saúde com possíveis manifestações orofaciais em pacientes com a SM, contribuindo para realização de um correto diagnóstico e evitando a perpetuação do ciclo de assistência médica.Palavras Chave: Síndrome de Munchausen, Manifestações bucais, Traumatismos maxilofaciais, Traumatismos faciaisABSTRACTIntroduction: Patients with Munchausen Syndrome (MS) tend to simulate or reproduce an injury or illness with the intention of assuming a “sick role”, without the objective of a secondary gain. The habituation of health care practitioners with MS and its possible oral and maxillofacial manifestations may prevent unnecessary procedures and consecutive unsuccessful treatments. Objective: This study aimed to identify the oral and maxillofacial manifestations presented by patients diagnosed with MS. Methods: A review of the literature was carried out, based on the following descriptors: Munchausen Syndrome, Mouth, Face, Dentistry, Oral Manifestations, Facial Injuries and Maxillofacial Injuries. Publications in English and Portuguese related to MS and its oral and maxillofacial manifestations were included. The search was carried out using the following databases: PubMed, LILACS, Embase e SciELO. Results and Conclusion: 22 cases were assessed in 18 articles that reported patients presenting oral and maxillofacial manifestations and diagnosed with MS. The oral and maxillofacial presentations were: diffuse orofacial pain, occasionally similar to odontalgia; facial or intraoral swelling due to materials or pressurized air injections into the tissues; ulcerative, vesiculobullous and bleeding oral lesions; facial ulceration, erythema and ecchymosis; and temporomandibular joint disorders including multiple surgeries and simulation of subluxation of temporomandibular joint. Case reports must be performed in order to acquaint health care practitioners with possible oral and maxillofacial manifestations presented by patients diagnosed with MS, thus contributing to a correct diagnosis and preventing a cycle of repeated admissions to health care services. Keywords: Munchausen Syndrome, Oral manifestations, Maxillofacial injuries, Facial injuries

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Prevalence of temporomandibular dysfunction in children and adolescents

Revista Paulista de Pediatria ◽

10.1590/s0103-05822013000400018 ◽

2013 ◽

Vol 31 (4) ◽

pp. 538-545 ◽

Cited By ~ 38

Author(s):

Marina Fernandes de Sena ◽

Késsia Suênia F. de Mesquita ◽

Fernanda Regina R. Santos ◽

Francisco Wanderley G. P. Silva ◽

Kranya Victoria D. Serrano

Keyword(s):

Children And Adolescents ◽

Temporomandibular Joint ◽

Diagnostic Criteria ◽

Temporomandibular Disorders ◽

Selection Process ◽

Case Reports ◽

Temporomandibular Joint Disorders ◽

Sample Size Determination ◽

Cross Sectional ◽

Temporomandibular Joint Dysfunction Syndrome

OBJECTIVE: To review the prevalence of temporomandibular disorders (TMD) in children and adolescents, verifying the methodological variations. DATA SOURCES: Research conducted in Medline, PubMed, Lilacs and BBO databases, including manuscripts (except reviews and case reports) published from 1990 to 2012. The descriptors were "temporomandibular joint syndrome", "temporomandibular joint dysfunction syndrome", "temporomandibular joint disorders", "prevalence studies", and "cross-sectional studies"; the words "dysfunction", "disorder", "temporomandibular", "children", "adolescents", "prevalence", "frequency", and "transversal" were used. DATA SYNTHESIS: Seventeen articles were selected, and the TMD frequency varied from 16 to 68%. Regarding the methodological criteria, only three articles (18%) reported sample size determination, three (18%) clearly described the sample selection process by stratified selection technique, and nine studies (53%) carried out the calibration of the examiners. The diagnostic criteria used in the studies were: Helkimo index (n=2; 12%), Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (n=4; 24%), the jaw index (n=1; 6%), clinical protocols (n=10; 59%), and anamnestic questionnaires (n=6; 35%). CONCLUSIONS: The TMD prevalence in children and adolescents varies in the literature. Appropriate and standardized methods are needed to identify, with greater validity, the presence of TMD in this population, allowing a better understanding of the pathological aspects in order to address more effective preventive and therapeutic procedures.

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Patients knowledge about side effects of orthodontic treatment

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol23no2.14015 ◽

2011 ◽

Vol 23 (2) ◽

Author(s):

Mia Amalia ◽

Haru Setyo Anggani ◽

Nia Ayu Ismaniati

Keyword(s):

Side Effects ◽

Soft Tissue ◽

Temporomandibular Joint ◽

Tissue Damage ◽

Orthodontic Treatment ◽

Root Resorption ◽

Temporomandibular Joint Disorders ◽

Soft Tissue Damage ◽

Pain Experience ◽

Increased Risk

Disharmonious of dental arrangement can possibly create problems for the patient, such as the masticatory function, esthetical, psychosocial, and also the increased risk of trauma and periodontal disease. These are reasons for a patient to seek orthodontic treatment. The aim of this study was to know the patient’s knowledge about the side effects possibility that they receive during orthodontic treatment. The side effects include pain experience during orthodontic treatment, the possibility of soft tissue damage, email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders, and relapse. A cross-sectional study was conducted in patients who registered at Orthodontic Department, Faculty of Dentistry, Universitas Indonesia on March-June 2009. The participants of this study were 100 patients, consist of 86 women and 14 men respectively. Twenty-seven questions about the side-effects of orthodontic treatment were used to obtain the patient’s knowledge and the result was categorized into 3 groups, good, average and poor. The result of the study showed that patient’s knowledge about the side effect of pain experience during orthodontic treatment was average and the patient’s knowledge about the possibility of soft tissue damage due to orthodontic treatment was good. However, the patient’s knowledge about the possibility of email demineralization, loss of tooth vitality, periodontal problem, root resorption, temporomandibular joint disorders and relapse due to orthodontic treatment was low.

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Temporomandibular disorders and occlusion effect on orthodontic treatment

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20214305 ◽

2021 ◽

Vol 8 (11) ◽

pp. 5608

Author(s):

Sara Ahmed Hifny ◽

Nada Mohsen Alsaidi ◽

Eman Abdullah Al Khater ◽

Maryam Fuad Alomran ◽

Nawaf Khamis Alnufaie ◽

...

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Orthodontic Treatment ◽

Temporomandibular Joint Disorders ◽

Current Evidence ◽

Treatment Approaches ◽

Contact Points ◽

High Prevalence ◽

Occlusion Effect ◽

The Impact

Evidence in the literature indicates the significant association between temporomandibular joint disorders and orthodontic treatment. As a result of the epidemiological investigations that indicated the high prevalence of temporomandibular disorders among patients with malocclusions, it has been suggested that there might be a cause-and-effect correlation between both of these conditions. Evidence in the literature is inconsistent regarding the association between temporomandibular joint disorders and malocclusion, and orthodontic treatment. In the present literature review, we have discussed the different aspects of temporomandibular disorders and malocclusion and their relation to orthodontic treatment approaches. Among the different studies in the literature, solid evidence indicates a significant association between temporomandibular joint disorders and malocclusion, and accordingly, research aimed to study the impact of orthodontic treatment on curing and preventing the development of these disorders. The current evidence seems to be neutral regarding the impact of orthodontic treatment approaches on curing and preventing temporomandibular disorders. Therefore, it has been suggested that further investigations are still needed for adequate further evaluation. Finally, as we previously discussed, the attending orthodontist should adequately take care of certain parameters in these patients, including centric relation, maximal intercuspal position, simultaneous contact points, and evaluating the direction of forces applied on the relevant teeth.

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