Journal of Clinical Medicine

Research

Jump to: Review

19 pages, 865 KiB

Open AccessArticle

Temporomandibular Joint Disorders in Females with Adolescent Idiopathic Scoliosis: Long-Term Effects of Milwaukee Brace Treatment

by Jakub Glowacki, Joanna Latuszewska, Adam Okret, Natalia Skowron, Ewa Misterska and Justyna Opydo-Szymaczek

J. Clin. Med. 2022, 11(6), 1721; https://doi.org/10.3390/jcm11061721 - 20 Mar 2022

Cited by 4 | Viewed by 2852

Abstract

Patients with adolescent idiopathic scoliosis (AIS) more frequently suffer dysfunctions of dento-skeletal complex. To our knowledge, no study has ever evaluated the temporomandibular joint disorders (TMD) of AIS patients at least 23 years after the completion of Milwaukee brace treatment. We aimed to [...] Read more.

Patients with adolescent idiopathic scoliosis (AIS) more frequently suffer dysfunctions of dento-skeletal complex. To our knowledge, no study has ever evaluated the temporomandibular joint disorders (TMD) of AIS patients at least 23 years after the completion of Milwaukee brace treatment. We aimed to provide a complex assessment of TMD and AIS patients treated with a Milwaukee brace, in a minimum 23-year follow-up, using radiological, clinical, and socio-demographical data, and to adapt the TMD Disability Index Questionnaire (TMDQ) and Fonseca’s questionnaire (FQ) to Polish conditions. In total, 42 healthy females and 30 AIS patients with a minimum of 23 years after a completed Milwaukee brace treatment were asked to complete the Polish version of (TMDQ-PL) and (FQ-PL). AIS patients present higher TMD levels than healthy controls. Significant differences exist between TMDQ-PL and FQ-PL (both in total scores and particular sub-sections), and AIS patients. Clinical and radiological factors affected the TMDQ-PL and FQ-PL results. Adult patients with scoliosis treated conservatively present limitations in everyday activities connected with the temporomandibular joint (TMJ). The variety of curve-related factors in a long-term follow-up of wearing the Milwaukee brace influence TMJ. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Figure 1

10 pages, 2968 KiB

Open AccessArticle

Temporomandibular Disk Dislocation Impacts the Stomatognathic System: Comparative Study Based on Biexponential Quantitative T2 Maps

by Piotr A. Regulski, Jakub Zielinski and Kazimierz T. Szopinski

J. Clin. Med. 2022, 11(6), 1621; https://doi.org/10.3390/jcm11061621 - 15 Mar 2022

Cited by 3 | Viewed by 2061

Abstract

In this study, we aimed to assess the potential impact of temporomandibular disk displacement on anatomical structures of the stomatognathic system using biexponential T2 magnetic resonance imaging (MRI) maps. Fifty separate MRI scans of the temporomandibular joints (TMJ) of 25 patients were acquired [...] Read more.

In this study, we aimed to assess the potential impact of temporomandibular disk displacement on anatomical structures of the stomatognathic system using biexponential T2 magnetic resonance imaging (MRI) maps. Fifty separate MRI scans of the temporomandibular joints (TMJ) of 25 patients were acquired with eight echo times. Biexponential T2 maps were created by weighted reconstruction based on Powell’s conjugate direction method and divided into two groups: the TMJ without (32 images) and with (18 images) disk displacement. The disk, retrodiscal tissue, condylar bone marrow, masseter muscle, lateral and medial pterygoid muscles and dental pulp of the first and second molars were manually segmented twice. The intrarater reliability was assessed. The averages and standard deviations of the T2 times and fractions of each segmented region for each group were calculated and analysed with multiple Student’s t-tests. Significant differences between groups were observed in the retrodiscal tissue, medial pterygoid muscle and bone marrow. The pulp short T2 component showed a trend toward statistical significance. The segmentation reliability was excellent (93.6%). The relationship between disk displacement and quantitative MRI features of stomatognathic structures can be useful in the combined treatment of articular disk displacement, pterygoid muscle tension and occlusive reconstruction. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Graphical abstract

11 pages, 717 KiB

Open AccessArticle

Signs, Symptoms, and Morphological Features of Idiopathic Condylar Resorption in Orthodontic Patients: A Survey-Based Study

by Akihiko Iwasa and Eiji Tanaka

J. Clin. Med. 2022, 11(6), 1552; https://doi.org/10.3390/jcm11061552 - 11 Mar 2022

Cited by 5 | Viewed by 5384

Abstract

Background: Idiopathic condylar resorption (ICR) is an aggressive degenerative disease of the temporomandibular joint that is most frequently observed in teenage girls. However, no specific cause of ICR has been identified. To explore the specific causes of the onset and progression of ICR, [...] Read more.

Background: Idiopathic condylar resorption (ICR) is an aggressive degenerative disease of the temporomandibular joint that is most frequently observed in teenage girls. However, no specific cause of ICR has been identified. To explore the specific causes of the onset and progression of ICR, we performed a survey-based study on ICR in orthodontic patients and described its subjective symptoms, clinical signs, and condylar morphological features. Methods: A total of 1735 participants were recruited from 2193 orthodontic patients. For each participant, subjective symptoms and clinical signs of temporomandibular disorders (TMDs) were evaluated through clinical examination and a questionnaire. Furthermore, three-dimensional computed tomography (CT) was performed to diagnose ICR. Results: Among the 1735 patients evaluated, ICR was present in two male and ten female patients. All 12 patients had maxillary protrusion and an anterior open bite. Four patients with ICR underwent orthodontic treatment. Based on CT findings, patients with ICR had significantly different condylar sizes and shapes from patients with TMDs alone. Conclusions: The coexistence of intrinsic and extrinsic factors, such as sex-hormone imbalance and a history of orthodontic treatment, might lead to the onset of ICR. We suggest that growing patients suspected of having ICR should undergo CT evaluation because CT findings may precede clinical symptoms and signs. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Figure 1

12 pages, 520 KiB

Open AccessArticle

Characteristics of the Maxillofacial Morphology in Patients with Idiopathic Mandibular Condylar Resorption

by Kotaro Tanimoto, Tetsuya Awada, Azusa Onishi, Naoki Kubo, Yuki Asakawa, Ryo Kunimatsu and Naoto Hirose

J. Clin. Med. 2022, 11(4), 952; https://doi.org/10.3390/jcm11040952 - 11 Feb 2022

Cited by 3 | Viewed by 1877

Abstract

Idiopathic mandibular condylar resorption (ICR) is a pathological condition characterized by idiopathic resorption of the mandibular condyle, resulting in a decrease in the size and height of the mandibular condyle. The purpose of this study was to characterize the maxillofacial morphology of ICR [...] Read more.

Idiopathic mandibular condylar resorption (ICR) is a pathological condition characterized by idiopathic resorption of the mandibular condyle, resulting in a decrease in the size and height of the mandibular condyle. The purpose of this study was to characterize the maxillofacial morphology of ICR patients. Subjects were selected from patients that attended our orthodontic clinic between 1991 and 2019. Twenty-five patients were diagnosed with ICR by magnetic resonance imaging; however, growing patients were excluded. In total, 18 patients were finally selected. The control group comprised 18 healthy volunteers. Lateral and frontal cephalograms were also used. The ICR group had significantly more severe skeletal class II malocclusions than the control group, mainly due to retrusion of the mandible. In the ICR group, there was a tendency for a skeletal open bite due to a significantly larger clockwise rotation of the mandible than in the control group. There was no significant difference between the two groups in the inclination of the upper and lower central incisors or protrusion of the upper and lower central incisors and first molars. ICR patients have been suggested to exhibit skeletal open bite and maxillary protrusion with changes in maxillofacial morphology due to abnormal resorption of the mandibular condyle. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Figure 1

12 pages, 1187 KiB

Open AccessArticle

The Short Form of the Fonseca Anamnestic Index for the Screening of Temporomandibular Disorders: Validity and Reliability in a Spanish-Speaking Population

by Noelia Zagalaz-Anula, Carmen María Sánchez-Torrelo, Faustino Acebal-Blanco, Roger Alonso-Royo, Alfonso Javier Ibáñez-Vera, Esteban Obrero-Gaitán, Daniel Rodríguez-Almagro and Rafael Lomas-Vega

J. Clin. Med. 2021, 10(24), 5858; https://doi.org/10.3390/jcm10245858 - 14 Dec 2021

Cited by 3 | Viewed by 2566

Abstract

The Short Form of the Fonseca Anamnestic Index (SFAI) is a simple and quick questionnaire used for screening temporomandibular disorders (TMDs). The present study aimed to validate the Spanish version of the SFAI in patients with TMDs. The study sample comprised 112 subjects [...] Read more.

The Short Form of the Fonseca Anamnestic Index (SFAI) is a simple and quick questionnaire used for screening temporomandibular disorders (TMDs). The present study aimed to validate the Spanish version of the SFAI in patients with TMDs. The study sample comprised 112 subjects (50 TMDs and 52 controls). Test–retest reliability, factorial validity, internal consistency, concurrent validity, and the SFAI’s ability to discriminate between TMDs subjects and healthy controls were analyzed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD protocol) as the reference. Factor analysis showed a single factor that explained 63% of the total variance. Cronbach’s alpha was 0.849. The reliability of the items measured with the Kappa index showed values from 0.767 to 0.888. Test–retest reliability was substantial (intraclass correlation coefficient = 0.837). The total SFAI score showed a significant correlation with orofacial pain, vertigo, and neck disability measurements. For a cut-off point of >10 points, the SFAI showed a sensitivity of 78% and specificity of 78.85% at differentiating between TMDs patients and healthy subjects, with an area under the curve (AUC) of 0.852. The Spanish version of the SFAI is a valid and reliable instrument for diagnosing people with TMDs and shows generally good psychometric properties. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Figure 1

10 pages, 264 KiB

Open AccessArticle

The Relationship between Stress and Masticatory Muscle Activity in Female Students

by Grzegorz Zieliński, Michał Ginszt, Magdalena Zawadka, Katarzyna Rutkowska, Zuzanna Podstawka, Jacek Szkutnik, Piotr Majcher and Piotr Gawda

J. Clin. Med. 2021, 10(16), 3459; https://doi.org/10.3390/jcm10163459 - 4 Aug 2021

Cited by 17 | Viewed by 2787

Abstract

The aim of the study was to analyze the relationship between stress measured by the perceived stress scale (PSS-10) questionnaire and masticatory muscle activity. Experimental design assumed the study of healthy young women without temporomandibular disorders, dividing them into three groups depending on [...] Read more.

The aim of the study was to analyze the relationship between stress measured by the perceived stress scale (PSS-10) questionnaire and masticatory muscle activity. Experimental design assumed the study of healthy young women without temporomandibular disorders, dividing them into three groups depending on the result of the stress level and then comparing these groups in terms of bioelectrical activity of the masticatory muscles. After the exclusion criteria were applied, 63 female students (mean age: 22.3 ± 2.4 years) from Medical University of Lublin were included in the study. The subjects were then divided into 3 groups: with low (n = 18), medium (n = 18) and high stress level (n = 27), according to PSS-10 results. Resting and functional activity of temporalis anterior (TA) and masseter (MM) muscles were measured by electromyograph BioEMG III. There were statistically significant effects of group on the absolute value of asymmetry index (AsI) of TA and MM during maximum voluntary clenching on dental cotton rollers (both p = 0.02). Post hoc analysis shows that there were statistically significant differences between medium and high stress groups in AsI TA (p = 0.01) and between low and high stress groups in AsI MM (p = 0.02). Perceived stress measured by PSS-10 questionnaire seems to be associated with changes in muscular asymmetry in functional clenching activity. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

7 pages, 448 KiB

Open AccessArticle

Monitoring of Changes in Masticatory Muscle Stiffness after Gum Chewing Using Shear Wave Elastography

by Cyprian Olchowy, Kinga Grzech-Leśniak, Jakub Hadzik, Anna Olchowy and Mateusz Łasecki

J. Clin. Med. 2021, 10(11), 2480; https://doi.org/10.3390/jcm10112480 - 3 Jun 2021

Cited by 9 | Viewed by 2319

Abstract

This study aimed to investigate if intensive exercise affects the stiffness of the masticatory muscles measured with shear-wave elastography. The study included a cohort of healthy adults (n = 40) aged 40 ± 11 years. In each individual, the stiffness of both [...] Read more.

This study aimed to investigate if intensive exercise affects the stiffness of the masticatory muscles measured with shear-wave elastography. The study included a cohort of healthy adults (n = 40) aged 40 ± 11 years. In each individual, the stiffness of both the masseter and temporalis muscle was examined three times: at baseline, after 10 min of intensive exercise (chewing gum), and after 10 min of relaxation. Stiffness values (median (IQR)) of both the masseter and temporalis muscle were the lowest at the baseline (11.35 (9.7–12.65) and 10.1 (9.1–10.95)), increased significantly after the exercise (12.5 (11.1–13.25) and 10.3 (10.2–10.52)) and then dropped significantly after 10 min of relaxing (11.75 (9.95–12.6) and 10.2 (9.65–11.9)). The stiffness of the temporalis muscle was significantly lower than that of the masseter muscle. The values of the stiffness of the masseters correlated significantly with the values of the stiffness of the temporalis muscles. Shear wave elastography proved to be a sensitive method for showing changes in the stiffness of the muscles involved in the mastication occurring as a response to the effort, which increased the muscle stiffness. Further research is needed to broaden knowledge on the impact of eating habits and the occurrence of parafunctions on the development of temporomandibular disorders and the condition of masticatory muscles. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures

Figure 1

Review

Jump to: Research

19 pages, 1428 KiB

Open AccessEditor’s ChoiceReview

The Administration of Hyaluronic Acid into the Temporomandibular Joints’ Cavities Increases the Mandible’s Mobility: A Systematic Review and Meta-Analysis

by Maciej Chęciński, Maciej Sikora, Kamila Chęcińska, Zuzanna Nowak and Dariusz Chlubek

J. Clin. Med. 2022, 11(7), 1901; https://doi.org/10.3390/jcm11071901 - 29 Mar 2022

Cited by 14 | Viewed by 2243

Abstract

Objectives: The purpose of this systematic review with meta-analysis is to identify clinical studies concerning the impact of intra-articular administration of hyaluronic acid (HA) on mandibular mobility and to make an attempt at determining the efficacy of HA in this indication. Methods: The [...] Read more.

Objectives: The purpose of this systematic review with meta-analysis is to identify clinical studies concerning the impact of intra-articular administration of hyaluronic acid (HA) on mandibular mobility and to make an attempt at determining the efficacy of HA in this indication. Methods: The review included primary studies involving groups of at least 10 patients who were diagnosed with pain in the temporomandibular joint and who were injected with hyaluronic acid as the only intervention. The outcomes pursued were changes in mandibular mobility and pain intensity. Four databases of medical articles were searched, including PubMed and BASE. The risk of bias was assessed using the Cochrane methodology tools. The therapy‘s efficacy was calculated in the domains of mandibular abduction, protrusive movement, lateral mobility, and pain relief. For these values, the regression and correlation with variables characterizing the interventions were analyzed. Results: In total, 16 reports on 20 study groups with a total of 1007 patients qualified for the review. The mean effectiveness in the domain of mandibular abduction over the 6-month follow-up period was 122% of the initial value, and the linear regression model can be expressed as 0.5x + 36. The level of pain in the same time frame decreased to an average of 29%. The severity of pain 6 months after the beginning of treatment positively correlates with the number of injections per joint (0.63), the total amount of drug administered in milliliters (0.62), and the volume of drug administered monthly per joint (0.50). Limitations: In some studies, the patient groups were heterogeneous in terms of diagnosis. The studies varied depending on the joint into which the HA was administered. The synthesized studies differed with regard to the method of measuring the mandible abduction amplitude. Conclusions: The increase in the amplitude of mandibular abduction was expressed as the quotient of the mean values during the observation periods, and the initial value was achieved in all study groups, and in the linear regression model, it was 0.5 mm on average per month. Multiple administrations of the drug may reduce the analgesic effectiveness of the treatment. Full article

(This article belongs to the Special Issue Temporomandibular Joint Disorders Update: Etiology, Diagnosis and Treatment)

► Show Figures