TMD in Females with Menstrual Disorders

Background: Temporomandibular disorders (TMD) are a common reason for patients to present at dental offices. The majority of people with TMD are women between the age of 20 and 40 years. The purpose of this study was to assess the types and prevalence of temporomandibular disorders in female patients of reproductive age with menstrual disorders. Materials and methods: The study involved 65 females of reproductive age (18–40 years, an average of 28.00 ± 6.27 years). The women who qualified for the study were patients of the University Center for Maternal and Newborn’s Health hospitalized because of infertility or menstrual cycle disorders. Women with confirmed estrogen metabolism disorders participated in a clinical study with the use of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Results: In the studied female patients with menstrual disorders, temporomandibular disorders (92.3%) were frequent occurrences. The most common type was intra-articular joint disorders (68%). Other reported complaints included masticatory muscle pain (44.62%), and degenerative joint diseases (12.3%). Conclusions: 1. In women with menstrual disorders, TMD may exist. 2. In women with TMD symptoms, their medical history should be extended to include the diagnosis of female hormone disorders.

Comparative evaluation of soft and hard splints in treatment of clenching disorder

Introduction: The aim of this study was to compare the efficiency of soft and hard splints in treating patients with clenching. Materials and Methods: In this clinical study, 26 patients with clenching disorder random- ly divided to two equal group of treatment: hard and soft splint. The amount of masticatory muscle pain and maximum mouth opening were measured at the delivery time and 3, 6, 9, and 12 weeks later by a blind examiner. Data were analyzed by independent T and repeated measure ANOVA tests with significance level of p=0.05. Results: Hard and soft splints were resulted in significant reduction of masticatory muscle pain (hard: P<0.001, Soft: p<0.001) and increase in maximum opening (hard P<0.001, Soft p<0.003), but there was no significant difference between them in pain relieving (P=0.848) and maximum opening (P=0.622). Conclusion: This study showed that efficacy of hard and soft splints in treating patients with clenching is same.

Comparison of Transcutaneous Electric Nerve Stimulation (TENS) and Microcurrent Nerve Stimulation (MENS) in the Management of Masticatory Muscle Pain: A Comparative Study

Introduction. Temporomandibular disorders (TMDs) are a heterogeneous group of pathologies affecting the temporomandibular joint (TMJ), the jaw muscles, or both. Epidemiological studies of TMD reveal a prevalence of 82% in the general population with 48% of them presenting with clinical features of muscle tenderness and difficulty in mouth opening. TMD are considered to be the most common orofacial pain conditions of nondental origin. Methods. The patients with TMD were randomly divided into two groups, A and B, based on their VAS scale. Group A consists of two subgroups 1 and 2 each consisting of 15 patients. Group B consists of two subgroups 3 and 4 consisting of 15 patients. Patients in Group A were given TENS for twenty minutes, and the frequency is adjusted as follows: (i) subgroup 1: TENS frequency at a range of 0–5 (VAS measuring 1–5) and (ii) subgroup 2: TENS frequency at a range of 5 and above (VAS measuring 6–10). Patients in Group B were given MENS for twenty minutes, and the frequency adjusted as follows: (i) subgroup 3: MENS frequency at range of 0–5 (VAS measuring 1–5) and (ii) subgroup 4: MENS frequency at a range of 5 and above (VAS measuring 6–10). Each patient was recalled for five consecutive days for the treatment, and the same intensity and frequency were maintained throughout the treatment period. Results. The improvement in VAS is seen to be highly significant statistically in MENS subgroup 4 (moderate-to-severe pain). Subgroups 1 and 3 had improvement in VAS which was comparable in both TENS and MENS groups. Conclusion. In the present study, it was found that TENS and MENS are equally effective in improving the functional mouth opening. MENS showed better and immediate effect in relief of pain. Microcurrent also has the advantage of being subthreshold, and hence the side effects such as tingling sensation and paresthesia seen to occur in some patients following TENS are absent. TENS and MENS can be considered as the first line of treatment in patients with acute and chronic masticatory muscle pain and also as an effective treatment option in cases of functional mouth opening.