OBJECTIVES: This study compared temporomandibular disorders (TMD) prevalence and its association with oral behaviors and psychological factors between Chinese and U.S. university students. METHODS: A cross-sectional surv...OBJECTIVES: This study compared temporomandibular disorders (TMD) prevalence and its association with oral behaviors and psychological factors between Chinese and U.S. university students. METHODS: A cross-sectional survey of 435 students (224 China, 211 U.S.) assessed TMD (5Ts), oral behaviors (OBC-21), depression (PHQ-9), and anxiety (GAD-7). Adjusted multivariable logistic regression evaluated associations. RESULTS: Chinese students showed significantly higher TMD prevalence (OR = 3.214, 95%CI: 2.094-4.991, < .001) and more TMD symptoms (IRR = 1.951, 95%CI: 1.602-2.382, < .001) than U.S. students. Higher PHQ-9 scores (OR = 1.092, 95%CI: 1.018-1.175, = .015) and OBC-21 scores (OR = 1.025, 95%CI: 1.002-1.049, = .037) were positively associated with the odds of screen-positive TMD symptoms. Country significantly moderated the depression-TMD association: each 1-unit increase in PHQ-9 was associated with higher odds of TMD among Chinese students (OR = 1.191, 95%CI: 1.069-1.328, = .002) than U.S. students (OR = 1.047, 95%CI: 0.970-1.131, = .238), with an OR ratio of 1.138 (95% CI: 1.018-1.277, = .025). CONCLUSIONS: Chinese students exhibited higher TMD burden with a stronger depression-TMD link. These cohort differences remain hypothesis-generating and require longitudinal clinical confirmation.
BACKGROUND: Predoctoral dental education in temporomandibular disorders (TMD) remains inconsistent and highly variable despite CODA's mandate. This study examined how different TMD educational models (based on orofacial...BACKGROUND: Predoctoral dental education in temporomandibular disorders (TMD) remains inconsistent and highly variable despite CODA's mandate. This study examined how different TMD educational models (based on orofacial pain [OFP] postgraduate program affiliation, presence of OFP faculty offering TMD patient exposure, or absence of OFP faculty and clinical exposure) influence student confidence and perceived challenges. METHODS: An anonymous survey was distributed to third- and fourth-year students at U.S. CODA-accredited dental schools through the Hispanic Student Dental Association and American Student Dental Association. Students rated confidence in TMD-related skills (1-5 scale, 5="most confident") and identified educational challenges. Data were analyzed using ANOVA, chi-square tests, and correlation analyses across four educational models. RESULTS: Among 136 respondents, overall confidence was low-to-moderate (2.4 ± 0.8), with only 26.3% reaching a sufficient threshold (≥3). Confidence was highest for screening and lowest for advanced procedures. Educational model type showed no significant effect on overall confidence ( = .099), whereas prior TMD patient exposure was associated with higher confidence (2.7 ± 0.7 vs. 2.1 ± 0.7, < .001; = .384, < .001). Common challenges included limited patient availability (61.8%), insufficient faculty expertise (42.3%), and poor interdisciplinary integration (46.3%). Students without OFP faculty and clinical exposure reported significantly greater clinical challenges ( < .001). CONCLUSION: Lack of clinical exposure to TMD patients is strongly associated with low student confidence. Faculty calibration and integration of TMD screening and management into routine care are critical to improving competence and confidence in dental training.
OBJECTIVE: To investigate the efficacy and safety of platelet-rich growth factors (PRGF® Endoret®) in adults with temporomandibular joint degenerative disease (TMJ-DJD) in a real-world clinical setting. MATERIALS AND MET...OBJECTIVE: To investigate the efficacy and safety of platelet-rich growth factors (PRGF® Endoret®) in adults with temporomandibular joint degenerative disease (TMJ-DJD) in a real-world clinical setting. MATERIALS AND METHODS: This prospective study included 67 adults with TMJ-DJD treated with two intra-articular PRGF® Endoret® infiltrations per affected joint, two weeks apart. Outcomes included pain, maximum mouth opening (with and without pain), crepitus, quality of life (OHIP-TMD), and adverse events. Assessments were performed at baseline and at 1 week, 1 month, 3 months, 6 months, and 1 year after the second infiltration. RESULTS: Forty-four patients completed follow-up. Pain decreased, while pain-free mouth opening and quality of life improved at all time points (p < .001). Mouth opening with pain improved at 1 year (p < .05). Crepitus was observed in 13-25% of patients. Most adverse events were mild and transient. CONCLUSIONS: PRGF® Endoret® infiltrations were associated with improved clinical outcomes and were well tolerated in patients with TMJ-DJD.
Marchese-Ragona R, Biancoli E, Salamanca F
… +16 more, Cahali MB, Cammaroto G, Carraro S, Casale M, Capasso R, De Vito A, Guarda-Nardini L, Lugo R, Manfredini D, Moffa A, de Vries N, Piccin O, Pollis M, Vicini C, Restivo DA, Iannella G
OBJECTIVE: To review the evolution of sleep medicine and surgical management of obstructive sleep apnea (OSA), focusing on anatomy-based and individualized treatment strategies. METHODS: This narrative review was develop...OBJECTIVE: To review the evolution of sleep medicine and surgical management of obstructive sleep apnea (OSA), focusing on anatomy-based and individualized treatment strategies. METHODS: This narrative review was developed by an expert panel of otolaryngologists and sleep medicine specialists. Landmark studies, consensus statements, and clinically relevant investigations were analyzed. Surgical approaches were classified according to anatomical target and functional mechanism, with particular attention to drug-induced sleep endoscopy (DISE), patient phenotyping, and multimodal treatment strategies. RESULTS: Sleep surgery has progressed from highly invasive procedures to minimally invasive, function-preserving, and multilevel approaches. Advances in understanding upper airway anatomy and collapse mechanisms have enabled targeted interventions, including barbed pharyngoplasty, transoral robotic surgery, maxillomandibular advancement, and hypoglossal nerve stimulation. DISE has improved identification of obstruction patterns and individualized surgical planning. Current OSA management increasingly combines surgical, dental, behavioral, and medical therapies within personalized care pathways. CONCLUSION: Modern sleep surgery has evolved toward precision-based, multidisciplinary management. Individualized anatomical and functional assessment is central to treatment selection, while emerging diagnostic and therapeutic innovations may further improve outcomes.
OBJECTIVES: This study estimated the prevalence of TMD symptoms among Southeast Asian nurses, examined their associations with psychological, somatic, musculoskeletal symptoms, and identified biopsychosocial factors rela...OBJECTIVES: This study estimated the prevalence of TMD symptoms among Southeast Asian nurses, examined their associations with psychological, somatic, musculoskeletal symptoms, and identified biopsychosocial factors related to TMD and musculoskeletal symptom burden. METHODS: A cross-sectional study of 438 nurses from two hospitals collected sociodemographic and occupational data. Validated instruments assessed TMD symptoms , somatic burden, psychological distress , and musculoskeletal complaints. RESULTS: TMD symptoms were present in 22.8% of participants, with combined intra-articular and pain-related TMD (CT) having the highest burden. CT participants demonstrated significantly greater psychological distress, somatic symptom burden, and musculoskeletal complaints. spanning the cranio-cervical region, spine, upper limbs, and lower limbs. Somatic symptom burden showed moderate correlations with psychological distress, global musculoskeletal, spinal, and lower limb burden. CONCLUSION: TMD symptoms are prevalent among nurses and influenced by occupational conditions. Findings support the inclusion of TMDs in occupational health surveillance and integrated biopsychosocial care to address cumulative burdens in nursing populations.
OBJECTIVE: This study aimed to determine the prevalence of self-reported temporomandibular disorder (TMD) symptoms, bruxism-related behaviors, and non-functional oral habits among dentistry students, and to examine their...OBJECTIVE: This study aimed to determine the prevalence of self-reported temporomandibular disorder (TMD) symptoms, bruxism-related behaviors, and non-functional oral habits among dentistry students, and to examine their associations with demographic and behavioral factors. METHODS: A cross-sectional survey was conducted among 323 dentistry students at Istanbul Kent University. Data were collected using the Fonseca Anamnestic Index to assess TMD-related symptom burden and the Oral Behavior Checklist to evaluate non-functional oral behaviors. Descriptive statistics, chi-square tests, and multivariate logistic regression analyses were performed. RESULTS: Female students had significantly higher odds of reporting TMD-related symptoms than males (OR = 2.57, 95% CI: 1.50-4.38, p = 0.001). High parafunctional habit levels were independently associated with TMD-related symptoms (OR = 3.57, 95% CI: 2.08-6.12, p < 0.001). CONCLUSION: TMD symptoms and parafunctional behaviors were highly prevalent, highlighting the need for early screening and behavioral awareness in dental education programs, particularly within a high-risk student population exposed to clinical demands.
OBJECTIVE: To evaluate muscle activity during maximum voluntary clenching (MVC) in patients treated with intraoral proportional condylectomy and minimally invasive orthognathic surgery, assessing neuromuscular balance be...OBJECTIVE: To evaluate muscle activity during maximum voluntary clenching (MVC) in patients treated with intraoral proportional condylectomy and minimally invasive orthognathic surgery, assessing neuromuscular balance between operated and contralateral sides. METHODS: Thirteen patients (11 women; mean age 28.2 ± 5.23 years) were evaluated. Electromyographic activity of the masseter and anterior temporalis muscles was recorded using the Teethan® system during MVC. Asymmetry, POC, impact, and global indices were analyzed. Maximum mouth opening was measured, and sides were compared using paired t-tests (p < .05). RESULTS: Mean maximum mouth opening was 39.6 ± 4.05 mm, with a median follow-up of 2 years. No significant differences were found between sides for anterior temporalis (23.69 ± 3.01 vs 25.37 ± 2.60; p = .161) or masseter activity (25.52 ± 4.11 vs 25.26 ± 3.22; p = .887). The global index was 85.90 ± 3.43 and asymmetry index 0.17 ± 8.04. CONCLUSION: This combined approach preserved neuromuscular balance during MVC, supporting its role as a functionally conservative treatment.
OBJECTIVE: To assess and compare occlusal splints (OS) and botulinum toxin type A (BTX-A) in treating pain-related and other clinical sequelae of adult sleep bruxism (SB). METHODS: PubMed, Embase, Scopus, Web of Science,...OBJECTIVE: To assess and compare occlusal splints (OS) and botulinum toxin type A (BTX-A) in treating pain-related and other clinical sequelae of adult sleep bruxism (SB). METHODS: PubMed, Embase, Scopus, Web of Science, ScienceDirect, and Google Scholar databases were searched from 1998 to February 2025. A meta-analysis was conducted for pain outcomes. RESULTS: Thirty-six studies were included in the qualitative synthesis. Both OS and BTX-A decreased pain-related clinical sequelae. The meta-analysis did not find a statistically significant difference between the interventions regarding pain reduction at the intermediate follow-up. Faster short-term relief of symptoms was observed with BTX-A in some studies. Associations between BTX-A injections and temporary reductions in jaw muscle activity and bite force were observed. OS primarily offers mechanical protection while maintaining function. The certainty of evidence was moderate for pain reduction outcomes and lower for other reported outcomes. CONCLUSIONS: Occlusal splints and botulinum toxin type A provide similar improvements in clinical sequelae associated with adult bruxism during sleep. Occlusal splints are the preferred conservative intervention when the prevention of mechanical sequelae and maintenance of function are primary goals.
BACKGROUND: Mandibular fractures may result in important functional and quality-of-life impairments even after surgical repair. Postoperative rehabilitation has been proposed as a strategy to improve recovery, but compar...BACKGROUND: Mandibular fractures may result in important functional and quality-of-life impairments even after surgical repair. Postoperative rehabilitation has been proposed as a strategy to improve recovery, but comparative evidence remains limited. PURPOSE: Compare postoperative recovery outcomes after mandibular fracture repair between patients who underwent postoperative orofacial myofunctional therapy and those who did not. METHODS: This retrospective cohort study included 40 patients. Postoperative recovery was assessed using the QoR-15 questionnaire and an additional patient-reported question regarding time to recovery. RESULTS: Patients who underwent therapy had shorter recovery time and a higher total QoR-15 score. In Poisson regression analysis, postoperative orofacial myofunctional therapy remained significant in explaining recovery time. CONCLUSION: In this retrospective cohort, postoperative orofacial myofunctional therapy was associated with shorter recovery time and better total postoperative recovery scores after mandibular fracture repair. Additional prospective studies are needed to allow a more concrete and measurable evaluation of this association.
OBJECTIVE: Bruxism is now understood as a multidimensional masticatory muscle behavior occurring during sleep and/or wakefulness, but no formal classification system exists to organize related oral behaviors and phenotyp...OBJECTIVE: Bruxism is now understood as a multidimensional masticatory muscle behavior occurring during sleep and/or wakefulness, but no formal classification system exists to organize related oral behaviors and phenotypes. METHODS: A closed international expert workshop was held at the 2025 IADR General Assembly in Barcelona. Three regional groups prepared reports on the need, desirable features, and possible structure of an International Classification of Oral Behaviors (ICOB). Presentations and discussions were synthesized into shared principles. RESULTS: Consensus supported a classification aligned with the current bruxism definition, organized by circadian manifestation and muscle activity phenotype, with optional descriptors such as tooth contact and chronicity. Neurological movement disorders should be excluded, while other oral behaviors beyond bruxism should be included. CONCLUSIONS: The workshop established core ICOB principles and research priorities. Future steps include drafting a classification proposal, Delphi rounds, and psychometric evaluation to improve diagnostic clarity, research standardization, and clinical decision-making.
OBJECTIVE: To determine the effects of rapid maxillary expansion (RME) on hard and facial soft tissues in children with unilateral cleft lip and palate (UCLP). METHODS: TThis prospective longitudinal study comprised 34 U...OBJECTIVE: To determine the effects of rapid maxillary expansion (RME) on hard and facial soft tissues in children with unilateral cleft lip and palate (UCLP). METHODS: TThis prospective longitudinal study comprised 34 UCLP children aged 8-10 years, with maxillary transverse constriction. The effects of RME on hard tissues were assessed using cone-beam computed tomography while facial soft tissues were assessed using a three-dimensional digital stereophotogrammetry. RESULTS: Pyriform aperture width increased by 3.38 mm (P<0.001), alar base width increased by 2.91 mm (P= 0.009), and alar base root width increased by 2.45 mm (P=0.022). Anterior maxillary basal width increased by 2.80 mm (P= 0.029). Inter zygomatic maxillary distance increased by 2.66 mm (P=0.031) and the ectomolar distance increased by 3.14 mm (P = 0.015). Pyriform width had strong positive correlation with alar base width (r= 0.86, P=0.015) and anterior maxillary basal width had strong positive correlation with alar base root width (r=0.79, P=0.007). . CONCLUSION: RME produced significant increase in the nasal hard and soft tissue width with a significant positive correlation between both variables.
PURPOSE: Sleep Bruxism (SB) is recognised as repetitive masticatory muscle activity rather than a disorder, yet its musculoskeletal consequences remain clinically relevant. Cervical stabilisation exercises (CSE) may infl...PURPOSE: Sleep Bruxism (SB) is recognised as repetitive masticatory muscle activity rather than a disorder, yet its musculoskeletal consequences remain clinically relevant. Cervical stabilisation exercises (CSE) may influence masticatory neuromuscular regulation through trigeminocervical convergence. This study investigated the effects of a six-week CSE programme on masticatory and cervical area in individuals with SB. METHODS: Twenty-eight female participants (aged 18-30) were randomised to experimental or control groups, with assessments at baseline, post-intervention and at six-week follow-up. Surface electromyography recorded resting and working activity of the masseter, temporalis and trapezius muscles. Tongue pressure, maximum mouth opening, tongue range of motion ratio, head posture and sleep quality were secondary outcomes. RESULTS: Significant reductions in masticatory and cervical resting muscle activity were observed, alongside improvements in tongue performance and head posture. Sleep quality remained unchanged. CONCLUSIONS: These findings suggest CSE may contribute to the neuromuscular regulation of the stomatognathic system as a complementary musculoskeletal approach in SB management.
OBJECTIVE: To apply a visual psychosocial profiling method based on standardized DC/TMD Axis II T-scores in women with chronic painful temporomandibular disorders (TMD). METHODS: A cross-sectional study was conducted wit...OBJECTIVE: To apply a visual psychosocial profiling method based on standardized DC/TMD Axis II T-scores in women with chronic painful temporomandibular disorders (TMD). METHODS: A cross-sectional study was conducted with 40 adult women (20 with chronic painful TMD and 20 pain-free controls). Psychosocial variables were assessed using DC/TMD Axis II instruments, and T-scores were calculated to enable standardized comparisons. A visual approach was used to integrate and represent psychosocial profiles across domains. RESULTS: Women with TMD exhibited significantly elevated psychosocial scores across domains compared to controls. Clinically elevated values ( ≥ 60) were observed in 95% of the TMD group. Pain catastrophizing correlated strongly with pain intensity and pain-related interference. No significant differences were found between groups for salivary biomarkers. CONCLUSION: The visual integration of DC/TMD Axis II measures may support rapid identification of psychosocial vulnerability and improve clinical decision-making in women with chronic TMD.
OBJECTIVE: Temporomandibular joint internal derangement with reduction commonly causes pain, joint clicking, and limited jaw movement. Injectable platelet-rich fibrin (I-PRF), an autologous concentrate containing growth...OBJECTIVE: Temporomandibular joint internal derangement with reduction commonly causes pain, joint clicking, and limited jaw movement. Injectable platelet-rich fibrin (I-PRF), an autologous concentrate containing growth factors, has emerged as a potential regenerative treatment. METHODS: This systematic review assessed the effectiveness of intra-articular I-PRF as a sole therapy for temporomandibular disorders (TMD). A literature search of PubMed, Scopus, Embase, and Web of Science (2015-2025) identified five eligible studies following PRISMA guidelines. RESULTS AND DISCUSSION: Included studies reported reduced pain, improved mouth opening, and decreased joint sounds after I-PRF therapy, without significant adverse effects. However, variations in study design and treatment protocols were noted. CONCLUSION: Overall, current evidence indicates that I-PRF may improve symptoms and jaw function as a minimally invasive conservative treatment for TMD. Nonetheless, the evidence remains limited due to methodological heterogeneity and the predominance of non-randomized studies, highlighting the need for further high-quality randomized controlled trials.
OBJECTIVE: This study aims to evaluate the accuracy and quality of responses generated by large language model-based chatbots to frequently asked questions related to temporomandibular disorders (TMD). METHODS: Ten quest...OBJECTIVE: This study aims to evaluate the accuracy and quality of responses generated by large language model-based chatbots to frequently asked questions related to temporomandibular disorders (TMD). METHODS: Ten questions were selected based on the most common inquiries made by patients with TMD to artificial intelligence (AI) chatbots. The responses of four widely used AI chatbots (ChatGPT Pro, ChatGPT 3.5, Deepseek, Grok3.0) were collected. Three expert evaluators assessed each chatbot's response using a modified Global Quality Scale (GQS). RESULTS: A statistically significant difference was observed among the four AI chatbots ( = 0.0097; η² = 0.09). ChatGPT Pro and Grok achieved significantly higher GQS scores than DeepSeek ( = 0.037*). CONCLUSION: While some AI chatbots show potential in answering TMD-related patient questions, variability in accuracy and reliability currently limits their use in clinical settings. Further training and validation are needed before integration into patient education or clinical decision-support systems.
OBJECTIVE: To evaluate postoperative adaptive changes in the mandibular condyle after bimaxillary orthognathic surgery in skeletal Class III patients and compare these changes according to mandibular fixation type. METHO...OBJECTIVE: To evaluate postoperative adaptive changes in the mandibular condyle after bimaxillary orthognathic surgery in skeletal Class III patients and compare these changes according to mandibular fixation type. METHODS: Twenty-six patients treated with Le Fort I osteotomy and bilateral sagittal split ramus osteotomy were divided into semirigid and rigid fixation groups. Preoperative and 1-year postoperative CBCT images were analyzed. Condylar trabecular microstructure was assessed by three-dimensional fractal analysis, and cortical bone thickness was measured in five regions. RESULTS: Baseline cephalometric variables, cortical thickness, and fractal dimension values were similar between groups. The semirigid group showed increased medial and decreased superior cortical thickness, while the rigid group showed no significant cortical changes. Fractal dimension values remained stable in both groups. Intergroup comparison showed a significant difference only in superior cortical thickness change. CONCLUSION: Fixation type did not markedly affect condylar trabecular microstructure, although superior cortical remodeling may differ by fixation method.
OBJECTIVES: This study aimed to evaluate changes in masseter muscle morphology and elasticity after monoblock functional appliance therapy in skeletal Class II patients using ultrasonography and elastography, with elasti...OBJECTIVES: This study aimed to evaluate changes in masseter muscle morphology and elasticity after monoblock functional appliance therapy in skeletal Class II patients using ultrasonography and elastography, with elasticity as the primary outcome. METHODS: 30 skeletal Class II and 30 skeletal Class I individuals received monoblock therapy and bilateral ultrasonographic and elastographic assessments were performed at T0 and T1; masseter elasticity (kPa) was the primary outcome, with thickness, length, and area as secondary outcomes, analyzed using mixed-design ANOVA with Bonferroni correction. RESULTS: Elasticity was higher during clenching than at rest ( < 0.001). Greater stiffness was observed on the left side ( = 0.001). A significant Time × Condition interaction was found ( = 0.026), indicating decreased resting and slightly increased clenching values over time. CONCLUSION: Masseter elasticity was mainly influenced by functional condition, being higher during clenching. Left-side stiffness was greater. Muscle response remained stable and mainly depended on functional activity rather than treatment-related differences.
BACKGROUND: Temporomandibular disorders (TMD) are multifactorial conditions associated with psychological and behavioral factors. This study examined pathways linking smartphone addiction to TMD using structural equation...BACKGROUND: Temporomandibular disorders (TMD) are multifactorial conditions associated with psychological and behavioral factors. This study examined pathways linking smartphone addiction to TMD using structural equation modeling (SEM). METHODS: A cross-sectional online survey was conducted among 856 university students. TMD was assessed using the Fonseca Anamnestic Index, and smartphone addiction using the Smartphone Addiction Scale-Short Version. Oral behaviors and psychological factors were also evaluated. Exploratory and confirmatory factor analyses were performed before SEM analysis. RESULTS: TMD prevalence was 56.4% and was higher among females ( < 0.001). Smartphone addiction scores were significantly higher in the TMD group (28.03±7.74 vs. 23.80±8.42, < 0.001). SEM showed that psychological distress (β = 0.31), oral parafunction (β = 0.26), and oral habits (β = 0.15) were directly associated with TMD. Smartphone addiction had significant indirect effects through psychological distress (β = 0.19) and oral habits (β = 0.11) ( < 0.001). CONCLUSION: Smartphone addiction was indirectly associated with TMD through psychological distress and maladaptive oral behaviors.