OBJECTIVE: This systematic review aims to assess the quality, reliability, and content of TMD-related social media posts across multiple platforms. METHODS: A comprehensive search of three databases were conducted. TMD r...OBJECTIVE: This systematic review aims to assess the quality, reliability, and content of TMD-related social media posts across multiple platforms. METHODS: A comprehensive search of three databases were conducted. TMD related content on social media sites were considered eligible. The extracted data was narratively synthesized. RESULTS: Out of 254 studies, seven were included. YouTube was the most commonly assessed social media platform (n=5). Information created by amateurs encourages greater interaction than that of experts or news outlets. A majority videos and threads cover treatment choices. However, there is a noticeable absence of discussion on complications and prevention methods. Health professionals' videos scored better in quality and reliability than -professionals' videos. CONCLUSION: There is a need for creating evidence-based, accessible, and engaging content on TMD on social media and consideration of implementing rigorous information verification methods to ensure that high-quality, expert-validated content is prioritized in search results.
OBJECTIVE: This study evaluated telerehabilitation-supported exercises' effects on pain, neck disability, anxiety, oral behaviors, and sleep quality in patients with Temporomandibular Disorders associated with probable s...OBJECTIVE: This study evaluated telerehabilitation-supported exercises' effects on pain, neck disability, anxiety, oral behaviors, and sleep quality in patients with Temporomandibular Disorders associated with probable sleep bruxism (TMDs-SB). METHODS: During the COVID-19 pandemic (March 2021-May 2022), 40 patients aged 18-65 with TMDs-SB were randomized to a telerehabilitation ( = 20) or home exercise ( = 20) groups. Both received education and exercises; the telerehabilitation group supervised 30-minute weekly WhatsApp video sessions for eight weeks. Outcomes were assessed at baseline and eight weeks. RESULTS: Both groups improved significantly in all outcomes from baseline to eight-week follow-up ( < .05). Telerehabilitation showed greater reductions in morning jaw pain ( = .012), neck disability ( = .032), trait anxiety ( = .028), and oral behaviors ( = .001) versus home exercises. Sleep quality improved similarly in both groups ( = .154). CONCLUSIONS: Telerehabilitation effectively reduced TMDs-SB symptoms, offering a promising alternative to unsupervised exercises during the pandemic. Given this unique context, conducting studies outside the pandemic's conditions would enhance generalizability and clarify telerehabilitation's potential. Further studies are needed to confirm its efficacy beyond pandemic conditions.
OBJECTIVE: Following recognition of orofacial pain as specialty in 2020, US dental schools are now mandated to incorporate temporomandibular disorder (TMD) education into their predoctoral curricula. However, the percept...OBJECTIVE: Following recognition of orofacial pain as specialty in 2020, US dental schools are now mandated to incorporate temporomandibular disorder (TMD) education into their predoctoral curricula. However, the perception of dental students regarding their TMD knowledge is unclear. This study assessed confidence in diagnosing and treating TMD among dental students at a predoctoral dental school where TMD instruction has been integrated across the dental curriculum. METHODS: A 10-item REDCap-survey was distributed to all dental students and faculty, assessing self-perceived confidence in TMD (0-100, 100="Extremely confident"). Between-group differences were analyzed with independent t-tests and within-group differences across academic years and grade-point average (GPA) with ANOVA. RESULTS: Among the 145 participants (108 = dental students), overall confidence in TMD was 52.7 ± 25.8 (49.3 ± 24.5 among students, 63.5 ± 26.8 among faculty). All participants reported the highest confidence in distinguishing between TMD/dental pain (59.5 ± 23.9) and the least confidence in adjusting occlusal appliances (43.8 ± 32.4). Students felt less confident than faculty in differentiating between TMD/dental pain ( = .005), establishing TMD diagnoses ( = .003), explaining TMD to patients ( = .010), understanding necessity for treatment ( = .003), adjusting occlusal appliances ( < .0001), and communicating with other providers ( < .001). Fourth-year students exhibited significantly higher confidence in establishing TMD diagnoses ( = .023), adjusting appliances ( < .001), and communicating with other providers than students in other academic years ( = .033). Students with higher GPA were more confident in differentiating between TMD/dental pain than those with lower GPA ( = .015). CONCLUSION: TMD-perceived confidence can improve with training. The current TMD curricula may be lacking in specific areas, emphasizing the importance of structured TMD education within all dental curricula.
INTRODUCTION: Discussions related to the diagnosis and management of temporomandibular joint (TMJ) disorders (TMDs) have always been interesting, and at times controversial, since they involve combinations of dental, med...INTRODUCTION: Discussions related to the diagnosis and management of temporomandibular joint (TMJ) disorders (TMDs) have always been interesting, and at times controversial, since they involve combinations of dental, medical, and surgical etiological theories and management strategies. Amongst the various recommendations that emerged over the years was that any dental and surgical procedures that are primarily focused on mandible repositioning and irreversible changes to dental occlusion should be avoided. This statement has important implications for appraising the validity of physiopathology concepts and treatment proposals centered around the evaluation of TMJ disc position, since they also generally lead to performing irreversible procedures. METHODS: A review of the pertinent TMJ literature related to the articular disc position and its association with TMD symptoms was carried out by the authors. RESULTS: For many practitioners, the position of the TMJ disc has been regarded as a primary cause of TMJ pain and dysfunction. For decades, incoordination between the TMJ disc, the condylar head and the articular eminence was indeed considered the main factor for the etiology of intracapsular TMD symptoms and consequently an important target for therapy. However, research has shown that synovitis is the more important variable in dealing with those conditions. CONCLUSION: In this commentary, the biological rationale to consider synovitis, rather than disc position, as the linchpin for clinical symptoms is presented in detail. Hopefully, this might contribute to putting the elusive butterfly characteristics of this topic finally to rest.
OBJECTIVE: Temporomandibular disorders (TMDs) have been historically linked to symptoms such as tinnitus, hearing loss, and vertigo. The aim of this systematic review is to investigate the association between TMDs and au...OBJECTIVE: Temporomandibular disorders (TMDs) have been historically linked to symptoms such as tinnitus, hearing loss, and vertigo. The aim of this systematic review is to investigate the association between TMDs and audiological symptoms. METHODS: Adhering to the PRISMA guidelines, a comprehensive literature search in three databases was performed searching for studies utilizing imaging and audiometric assessments to diagnose TMDs and audiological symptoms. Of the 1153 studies retrived, a total number of 6 studies were included. RESULTS: Although tinnitus was commonly reported among patients with TMDs, objective audiological deficits were not consistently confirmed. The majority of existing studies lack standardized diagnostic methods and the heterogeneity of methodologies and limited sample sizes restricted the feasibility of a meta-analysis. CONCLUSIONS: The lack of appropriate instrumental diagnostic tests makes it difficult to draw conclusions about the causal relationship between TMDs and audiological symptoms. Future trials are needed to clarify this clinical association.
OBJECTIVE: To review the clinical success of the various prosthodontic materials (e.g., lithium disilicate, zirconia, resin composite) in patients with different frequencies of bruxism. METHODS: A systematic search in th...OBJECTIVE: To review the clinical success of the various prosthodontic materials (e.g., lithium disilicate, zirconia, resin composite) in patients with different frequencies of bruxism. METHODS: A systematic search in the most relevant databases to find any randomized clinical trial that assesses the outcome of prosthodontic restorations performed in subjects where an assessment of sleep bruxism (SB) and awake bruxism (AB) was Conducted. RESULTS: No article present in the literature met the inclusion and exclusion criteria. CONCLUSION: The present systematic review unveils an important gap in the field of prosthodontics: no clinical trial in the literature has ever investigated the long-term success rate of different prosthodontic materials in patients with different frequencies of AB and SB.
OBJECTIVE: Brief behavioral interventions targeting pain (Physical Self-Regulation, PSR) or sleep (Brief Behavioral Intervention for Insomnia, BBTI) show promise for interdisciplinary management of chronic pain, though t...OBJECTIVE: Brief behavioral interventions targeting pain (Physical Self-Regulation, PSR) or sleep (Brief Behavioral Intervention for Insomnia, BBTI) show promise for interdisciplinary management of chronic pain, though their feasibility with chronic musculoskeletal orofacial pain (MSK-OFP) populations remains underexplored. This pilot study assessed the feasibility of a randomized clinical trial (RCT) of these interventions in a university-affiliated tertiary OFP clinic and explored clinical changes in pain, sleep, and other secondary outcomes. METHODS: Treatment-seeking participants (=19) with chronic MSK-OFP and insomnia were randomized to three-session PSR or BBTI. At pre- and post-intervention, participants completed questionnaires (assessing pain intensity, insomnia symptomatology, sleep quality, headache disability, fatigue, jaw-movement limitations, and quality of life), 8 consecutive days of actigraphy and morning/evening diaries. Feasibility outcomes were recruitment, retention, and adherence rates. Clinical outcomes included clinically-meaningful reductions in insomnia symptoms (Insomnia Severity Index [ISI]<15) and pain intensity (>2.5 point on 0-10 Numerical Rating Scale). RESULTS: Over a 17-month period, of 19 consenting participants (88.9% females, 38.4±12.2y/o, recruitment rate: 1.1/month),12 (92% females, 38.5±11.5y/o) completed the study (retention rate: 63.2%) with high completion rate (questionnaires: 95.8%, daily diaries: 95%, actigraphy: 100%). Despite no significant changes in pain, ISI scores decreased by 6.0 and 4.8-points among BBTI and PSR groups. Improvements in sleep quality, headache disability, fatigue, jaw-movement limitations, and quality of life wereobserved. CONCLUSION: RCTs of brief behavioral interventions are feasible in tertiary-OFP clinics.
OBJECTIVE: This study aimed to clarify differences in assessment of sleep bruxism (SB) using electromyography (EMG) among analysis periods with/without excluding time zones after going to bed (GB) and before getting up (...OBJECTIVE: This study aimed to clarify differences in assessment of sleep bruxism (SB) using electromyography (EMG) among analysis periods with/without excluding time zones after going to bed (GB) and before getting up (GU). METHODS: Masseteric EMG of 22 outpatients clinically diagnosed as SB was measured. Sleep onset (SO) and waking up (WU) were determined using a wearable motion monitor. Numbers of EMG episodes for nine periods were scored: GB-GU, SO-WU and other seven periods with exclusion of 15 min or more. RESULTS: Number of episodes/h for SO-WU highly correlated with those for the other eight analysis periods. The number for GB-GU was significantly larger than that for SO-WU, whereas those for other seven analysis periods were not significantly different from that for SO-WU. CONCLUSION: The results suggest efficacy of excluding some adequate time zones after GB and before GU with a possibility of wakefulness in SB assessment.
OBJECTIVES: To explore the role of autonomic dysregulation in otologic symptoms among individuals with temporomandibular disorders (TMDs). METHODS: Data from 79,731 individuals were analyzed, categorized by the presence...OBJECTIVES: To explore the role of autonomic dysregulation in otologic symptoms among individuals with temporomandibular disorders (TMDs). METHODS: Data from 79,731 individuals were analyzed, categorized by the presence of TMD-related or otologic symptoms. Self-administered questionnaires screened TMD and otologic discomfort. Heart rate variability (HRV) and hearing impairment was measured. RESULTS: Fully-adjusted regression models showed no significant relationship between HRV and otologic discomfort, However, subgroup analyses indicated significant interactions between HRV metrics and otologic symptoms in participants with TMD-related symptoms. CONCLUSIONS: Autonomic dysregulation may contribute to otologic discomfort in individuals with TMD, emphasizing its role in symptoms development.
OBJECTIVE: Bruxism is repetitive masticatory muscle activity occurring during sleep or wakefulness. Once considered purely harmful, it is now recognized as having both risk (e.g., tooth wear, TMD) and protective roles (e...OBJECTIVE: Bruxism is repetitive masticatory muscle activity occurring during sleep or wakefulness. Once considered purely harmful, it is now recognized as having both risk (e.g., tooth wear, TMD) and protective roles (e.g., against sleep apnea, reflux). This study evaluated Finnish dental students' understanding of modern bruxism concepts and management. METHODS: A 17-question survey was sent to all Finnish dental students (n = 1000), with 220 responses analyzed using SPSS (version 28) via chi-square and Spearman correlation tests. RESULTS: Knowledge improved with study progression (p < .001), and students with formal bruxism education answered more accurately (p < .001). However, misconceptions about occlusion as a cause increased with study progression (p = .009) and instruction hours (p = .018). CONCLUSION: While Finnish dental students demonstrate growing bruxism knowledge, outdated beliefs persist. Universities should update curricula with evidence-based content and promote critical evaluation of bruxism-related information.
OBJECTIVE: Between 5-12% of the population suffers from Temporomandibular disorders (TMDs). TMDs are known for their multifactorial aetiology and one of the proposed associated factors is orofacial trauma. This study inv...OBJECTIVE: Between 5-12% of the population suffers from Temporomandibular disorders (TMDs). TMDs are known for their multifactorial aetiology and one of the proposed associated factors is orofacial trauma. This study investigated the possible association between orofacial trauma and TMD in a tertiary referral clinic. METHODS: Patients were diagnosed with one or more TMD diagnoses; myalgia, arthralgia, headache associated with TMD and/or a TMD function diagnosis. 659 consenting patients were included. The majority were female. Ages ranged between 18 and 86 years. All patients were included in a logistic regression analysis, and 236 were included in a network analysis. RESULTS: Neither analysis yielded a statistically significant association between orofacial trauma and TMD. Results showed associations between psychosocial variables and TMD diagnoses. DISCUSSION: These results are contradictory to a recent review, where an association between orofacial trauma and TMD was found. The results on psychosocial variables and TMD diagnoses are corroborated by literature. CONCLUSION: In conclusion, in this tertiary referral clinic, no association between orofacial trauma and TMD was found.
OBJECTIVE: To evaluate the position and orientation of the mandibular proximal segment and the volume of condylar and coronoid processes in class II and III patients submitted to bimaxillary orthognathic surgery, using c...OBJECTIVE: To evaluate the position and orientation of the mandibular proximal segment and the volume of condylar and coronoid processes in class II and III patients submitted to bimaxillary orthognathic surgery, using cone beam computed tomography scans. METHODS: Class II and III patients who underwent bimaxillary orthognathic surgery were evaluated by fusing their preoperative virtual planning and postoperative outcomes. The CBCT scans were import into Dolphin Imaging Software and the images were superimposed. The superimposition of the planned and postoperative CBCT images was performed with the voxel-based method. Results: Differences were found in condylar resorption between class II and III. CONCLUSION: The displacement of the mandibular proximal segment after orthognathic surgery was negligible and supported by the condyle and coronoid process, which demonstrated with a clinically non-relevant resorption and postoperative stability.
OBJECTIVES: To evaluate the efficacy, compliance, and side effects of the NOA® device compared to other mandibular advancement devices (MADs) in managing obstructive sleep apnea (OSA). METHODS: Thirty-three participants...OBJECTIVES: To evaluate the efficacy, compliance, and side effects of the NOA® device compared to other mandibular advancement devices (MADs) in managing obstructive sleep apnea (OSA). METHODS: Thirty-three participants using the NOA® device were evaluated based on apnea-hypopnea index (AHI) reduction (criterion I: >50% reduction of AHI or criterion II: residual AHI < 5 events/hour), compliance, temporomandibular disorders (TMDs), and patient-reported side effects. These data were compared to retrospective data of 59 patients receiving a different MAD. RESULTS: Results showed that the NOA® device was effective in 78.8% (criterion 1) and 90.9% (criterion 2) of cases, requiring less mandibular advancement than other MADs. Participants used the device for an average of 6.94 ± 0.97 hours per night. Significant improvements were noted in morning headaches, sleep bruxism, and nocturnal urination. CONCLUSIONS: The NOA® device demonstrated high efficacy, improved patient-reported outcomes, and caused no significant side effects or issues. It required less mandibular advancement than other devices and had high patient compliance.
OBJECTIVE: Perform a clinimetric analysis of the visual analogue scale (VAS) and active pain-free mouth opening (PFMO) in patients with muscular temporomandibular disorder (mTMD). METHODS: Reliability (intraclass correl...OBJECTIVE: Perform a clinimetric analysis of the visual analogue scale (VAS) and active pain-free mouth opening (PFMO) in patients with muscular temporomandibular disorder (mTMD). METHODS: Reliability (intraclass correlation coefficient=ICC), construct validity, responsiveness (area under the curve=AUC), minimal detectable change (MDC), and minimal clinically important difference (MCID) values were calculated. RESULTS: The VAS-24hr (ICC=0.59), VAS-7day (ICC= 0.54), and PFMO (ICC=0.86) exhibited acceptable reliability. Both the VAS (AUC=0.96) and PFMO (AUC=0.87) exhibited a high level of responsiveness. The MCID was 15.5mm (VAS-24 and VAS-7day) and 3.5mm (PFMO) in the improved group; and 27.5mm (VAS-24), 21mm (VAS-7day), and 6.6mm (PFMO) in the much-improved group. The MDC was 9.6mm (VAS-24), 9.5mm (VAS-7day), and 6.1mm (PFMO). All outcomes demonstrated strong construct validity (Pearson's r; p<0.001) . CONCLUSIONS: All three outcome measures demonstrated acceptable clinimetric properties in patients with mTMD at the 3-month follow-up. The MCID lies outside measurement error in all outcomes in the much-improved group. .
OBJECTIVE: The maxillary canines have long been considered critical for dental function and aesthetics, with traditional practice prioritizing their preservation and alignment. However, this view often stems from outdate...OBJECTIVE: The maxillary canines have long been considered critical for dental function and aesthetics, with traditional practice prioritizing their preservation and alignment. However, this view often stems from outdated teachings rather than evidence-based principles, since there is no scientific support for the concept of canine-protected occlusion. Therefore, this commentary paper provides justification for extraction of severely impacted maxillary canines with first premolar substitution. RESULTS: In cases of severely impacted maxillary canines, orthodontic alignment may be associated with higher morbidity, unpredictable outcomes, prolonged treatment times, and increased patient burden. As an alternative, extracting the impacted canines and substituting the first premolars offers a viable, efficient solution that can achieve functional and aesthetic outcomes with fewer complications. CONCLUSION: This paper challenges traditional perspectives on the management of impacted canines, advocating for an evidence-based approach that prioritizes patient-centered care.
OBJECTIVE: To investigate several postural parameters and upper cervical functions in patients with temporomandibular disorders (TMD). METHODS: Patients diagnosed with different subtypes of TMD and healthy individuals wi...OBJECTIVE: To investigate several postural parameters and upper cervical functions in patients with temporomandibular disorders (TMD). METHODS: Patients diagnosed with different subtypes of TMD and healthy individuals without complaints of TMD were evaluated for pain, functional limitation, and anxiety by validated instruments. For evaluating upper cervical functions and postural parameters, cervical joint range of motion, cervical performance test, tragus wall distance, hamstring flexibility measurement, and measurement of the sacrum angle were recorded. RESULTS: Pain and jaw functional limitation scores were statistically higher in all groups with TMD. Patients with internal derangement and myofascial pain were significantly linked to a severe limiting of functions, higher anxiety, and depression scores. Postural parameters and cervical functions were similar between groups. CONCLUSION: Although postural parameters and cervical functions remained unaffected, parameters such as pain, anxiety, and functional limitation that may affect the quality of life were related to unfavorable values in the TMD groups.
OBJECTIVE: This cross-sectional study evaluated associations between sleep disorders, pain, bruxism, and chronotypes in patients with trigeminal neuralgia (TN) or post-herpetic neuralgia (PHN) in orofacial area. METHODS:...OBJECTIVE: This cross-sectional study evaluated associations between sleep disorders, pain, bruxism, and chronotypes in patients with trigeminal neuralgia (TN) or post-herpetic neuralgia (PHN) in orofacial area. METHODS: Ninety-four subjects (25 TN, 14 PHN, 55 controls) were evaluated for pain, sleep, chronotype, anxiety, depression, oral behaviors, and lifestyle by validated instruments. Bruxism was assessed by self-report. Between-group comparisons and associations using correlation and regression analysis were made. RESULTS: TN patients had more sleep disorders and depressive symptoms and poorer lifestyles. Morningness was more common in PHN. Pain and anxiety were correlated with lower sleep quality and oral risk behaviors, mainly in TN. Worse lifestyle in both groups was correlated to anxiety and depression, and morningness was correlated to better lifestyle in TN. No association was observed of sleep or awake bruxism with lifestyle, anxiety, or depression. CONCLUSION: TN patients are more vulnerable to sleep disorders and psychosocial impacts of pain.