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Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal...
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Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 8861

Special Issue Editors

Prof. Dr. Cosmin Sinescu

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Guest Editor
Department of Prostheses Technology and Dental Materials, Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
Interests: dental medicine; biomaterials; prosthodontics; dental treatments; biomedical imaging; optical coherence tomography (OCT)
Dr. Elena Amaricai

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Guest Editor
Department of Rehabilitation, Physical Medicine and Rheumatology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
Interests: rehabilitation medicine; musculoskeletal disorders; clinical rheumatology; physical therapy; pediatric rehabilitation; quality of life research; kinesiology
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Virgil-Florin Duma

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Guest Editor
1. 3OM Optomechatronics Group, Faculty of Engineering, “Aurel Vlaicu” University of Arad, Arad, Romania
2. Department of Measurements and Optical Electronics, Faculty of Electronics, Telecommunications, and Information Technology, Polytechnic University of Timisoara, Timișoara, Romania
3. Center of Research and Development for Mechatronics, National University of Science and Technology POLITEHNICA, Bucharest, Romania
Interests: biomaterials; biomedical imaging; optical coherence tomography (OCT); biomechanics; dental medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Recent studies have extensively addressed the implications of many general conditions on the oral cavity complex. Normal or abnormal posture affects both the mandibular reference positions and its movements. 

The association between musculoskeletal disorders and bruxism has been investigated, as it is still a subject of debate. A poor body posture (i.e., a misalignment of the cervical and thoracolumbar spine), as well as an imbalance in the muscle tone of the shoulder girdle and cervical region can be a predisposing factor for bruxism. Aspects such as the excessive use of smartphones or laptops in the modern world has led to new medical conditions, i.e., adverse postural phenomena such as the text neck and the forward head posture, respectively, with influence on the static occlusion.

The benefits of exercise and of increasing physical activity for patients diagnosed with bruxism is essential. This is especially important for pediatric rehabilitation, as well as for therapeutic approaches for adolescents of young people. An interdisciplinary approach with medical and biomechanical assessments and therapeutic measures can be an answer to the bruxism condition, leading to the correlated, medical, and biomechanical studies of this Special Issue. Other state-of-the-art or emerging investigation methods, including optical (for example augmented reality) methods, are also of interest.

All these subjects of research, implying the regarding analyses and measures to tackle bruxism, are of interest for this Special Issue. Its aim is to provide a forum for contributions regarding the topics above, as well as other relevant and timely aspects concerning both diagnosis and treatment techniques for bruxism and their assessments.

While this forum is opened to all researchers in the fields above, it also provides a topical selection of papers presented at the Conferences and Workshops, organized by the Guest Editors and their institutions, including the Medical Sections of the 3rd International Conference ‘Advances in 3OM: Opto-Mechatronics, Opto-Mechanics, and Optical Metrology’ (December 2025, Timisoara, Romania).

All types of contributions, i.e., research papers and reviews, are welcome.

Prof. Dr. Cosmin Sinescu
Dr. Elena Amaricai
Prof. Dr. Virgil-Florin Duma
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rehabilitation medicine
  • biomechanics
  • bruxism assessment
  • general medicine
  • dental medicine
  • biomedical imaging
  • musculoskeletal disorders
  • shoulder girdle
  • cervical region
  • physical therapy
  • therapeutic exercise
  • postural correction
  • dynamic balance
  • pediatric rehabilitation
  • sports medicine
  • quality of life research
  • general conditions with resonance in the oro-maxillo-facial sphere

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Published Papers (5 papers)

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17 pages, 4836 KiB  
Article
Condylar Parameters and Mandibular Movement Patterns in Bruxers Using an Optical Jaw Tracking System
by Manuela Tăut, Solene Chanteux, Andreea Kui, Rareș Buduru, Marius Negucioiu, Manuela Manziuc, Ioana Gheorghiu, Mihaela Hedeșiu, Smaranda Buduru and Aranka Ilea
J. Clin. Med. 2024, 13(24), 7761; https://doi.org/10.3390/jcm13247761 - 19 Dec 2024
Viewed by 846
Abstract
Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during [...] Read more.
Background/Objectives: Eccentric bruxism is a complex parafunctional activity that involves grinding of teeth and occurs more frequently during sleep. This study aimed to assess differences in condylar parameters (sagittal condylar inclination -SCI and Bennett angle -BA) and mandibular and condylar kinematics during functional and parafunctional movements in bruxers and non-bruxers and to assess a digital method for quantifying eccentric bruxism using an optical jaw tracking system (Modjaw®). Methods: The study group included subjects diagnosed with eccentric bruxism according to validated clinical diagnostic criteria. A control group of non-bruxer subjects with demographic characteristics similar to the study group was considered. Each participant underwent Modjaw® examination twice to assess the recordings’ repeatability. The anterior guidance, mastication, and simulated eccentric bruxism were recorded. The SCI and BA were computed. The trajectories of interincisal inferior point (IIP), left condyle (LC), and right condyle (RC) in the frontal (F), sagittal (S), and horizontal (H) planes were outlined in rectangles to calculate areas of mastication and areas of eccentric bruxism (mm2). Intraclass correlation coefficient (ICC) was used to assess the recordings’ repeatability. Comparisons between groups were performed using Student’s t- and Mann–Whitney tests. The receiver–operator characteristic (ROC) curve was used to assess the diagnostic quality of the digital method. Results: Twenty bruxers (10 F and 10 M) and 20 non-bruxers (10 F and 10 M) were included. The ICC had values higher than 0.85. SCI, BA, and area of mastication for IIP, LC, and RC were similar between the groups (p > 0.05). The area of eccentric bruxism was significantly wider in the bruxers (p < 0.001). According to the ROC curve, the following cut-off areas (mm2) for eccentric bruxism were found in F, S, and H planes: IIP (18.05, 13.43, 16.28); LC (3.74, 10.83, 3.35); and RC (4.21, 10.63, 2.9), corresponding to sensitivity > 0.8, specificity > 0.75 and area under the curve (AUC) > 0.85. Conclusions: Mandibular and condylar kinematics during functional movements were similar in bruxers and non-bruxers. A novel digital method for quantifying eccentric bruxism was found using Modjaw®, which could serve as a tool for early detection of eccentric bruxism before the onset of clinical consequences. Full article
(This article belongs to the Special Issue Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions)
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25 pages, 4524 KiB  
Article
The Role of Occlusal Appliances in Reducing Masseter Electromyographic Activity in Bruxism
by Adrian Marcel Popescu, Diana Elena Vlăduțu, Mihaela Ionescu, Daniel Adrian Târtea, Sanda Mihaela Popescu and Veronica Mercuț
J. Clin. Med. 2024, 13(23), 7218; https://doi.org/10.3390/jcm13237218 - 27 Nov 2024
Cited by 2 | Viewed by 1002
Abstract
Background/Objectives: Bruxism is a masticatory muscle activity, phasic or tonic, with/without teeth contact, that appears in sleep or an awake state. An instrumental technique used to measure the surface electromyographic (sEMG) activity of the masseter muscle is used to diagnose bruxism activity [...] Read more.
Background/Objectives: Bruxism is a masticatory muscle activity, phasic or tonic, with/without teeth contact, that appears in sleep or an awake state. An instrumental technique used to measure the surface electromyographic (sEMG) activity of the masseter muscle is used to diagnose bruxism activity during sleep and while awake. The objective of this study was to compare the variation in bruxism (sleep and awake) indices and masseter activity indices in low sleep bruxism and moderate sleep bruxism before and after wearing an occlusal appliance (OA) for 3 months each night. Methods: A clinical interventional study was designed in which subjects diagnosed with sleep bruxism were randomly selected to be included in the study. After the first sEMG recording, two groups were formed: a low sleep-bruxism group (number of sleep-bruxism events/h between 2 and 4) and a moderate sleep-bruxism group (number of sleep-bruxism events/h equal or higher than 4). All subjects received treatment with a 3D-printed occlusal appliance and wore it each night for 3 months, at which point the second sEMG recording was performed. For each participant of this study, a chart was created that included anamnestic data, clinical data, and sEMG data. The data were statistically analyzed with SPSS, using the Mann–Whitney U and Wilcoxon signed-rank tests. Results: A total of 21 participants were included in the final analysis, 18 women and 3 men, with a mean age of 24.5 ± 2.7 years. The OA lowered all bruxism indices in the whole group, but clusters analysis showed a significant reduction in sleep-bruxism indices in the moderate sleep-bruxism group, while in the low-bruxism group, the sleep and awake indices varied insignificantly, and the number of sleep-bruxism events/h remained constant. Conclusions: The 3D-printed occlusal appliances significantly lowered the sleep-bruxism indices and sleep masseter activity indices recorded with a portable sEMG device in the moderate sleep-bruxism group. The OA lowered the awake-bruxism indices and awake masseter activity indices in the moderate sleep-bruxism group. Full article
(This article belongs to the Special Issue Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions)
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22 pages, 10678 KiB  
Article
Condylar Remodeling and Skeletal Changes Following Occlusal Splint and Manual Therapy: A Cone Beam Computed Tomography Study in Temporomandibular Disorders
by Manuela Tăut, Ioan Barbur, Mihaela Hedeșiu, Alina Ban, Daniel Leucuța, Marius Negucioiu, Smaranda Dana Buduru and Aranka Ilea
J. Clin. Med. 2024, 13(18), 5567; https://doi.org/10.3390/jcm13185567 - 19 Sep 2024
Cited by 1 | Viewed by 2313
Abstract
Background: Temporomandibular disorders (TMD) may be associated with degenerative disease of temporomandibular joint (TMJ), such as condyle erosion and subchondral cysts. Occlusal splint and cranio-mandibular manual therapy, or combined therapy, is recommended as a conservative treatment to alleviate pain-related signs and symptoms [...] Read more.
Background: Temporomandibular disorders (TMD) may be associated with degenerative disease of temporomandibular joint (TMJ), such as condyle erosion and subchondral cysts. Occlusal splint and cranio-mandibular manual therapy, or combined therapy, is recommended as a conservative treatment to alleviate pain-related signs and symptoms in TMD. This study aimed to assess osseous condylar changes and skeletal changes following occlusal splint and cranio-mandibular manual therapy in TMD using cone beam computed tomography (CBCT). Methods: A retrospective cohort study included 24 patients diagnosed with TMD. Combined therapy was performed until pain-related signs and symptoms disappeared. CBCT scans were performed before and after therapy. Osseous structure of condyles and their subsequent modifications were analyzed on CBCT images: flattening, erosion, and subchondral cyst. Sella-Nasion-A point (SNA), Sella-Nasion-B point (SNB), A point-Nasion-B point (ANB), Sella-Articulare-Gonion (Condylar angle), and anterior and posterior facial height (AFH, PFH) were measured on CBCT-generated lateral cephalograms. A paired t-test, Wilcoxon rank-sum test, McNemar test, and Stuart–Maxwell test were used for the statistical analyses. Results: The treatment period with combined therapy was 7.42 ± 3.27 months, and 21 out of 33 TMJ presenting degenerative disease (63.6%) had significant complete remodeling (p < 0.05). Following therapy, SNB significantly decreased from 75.61 ±3.47° to 74.82 ± 3.41° (p = 0.02), ANB significantly increased from 4.05° (3.35–4.9°) to 4.8° (3.3–6.12°) (p < 0.001), AFH significantly increased from 112.85 mm (109.28–118.72) to 115.3 mm (112.58–118.88) (p < 0.001), PFH/AFH significantly decreased from 64.17 (61.39–66.1) to 63 (59.68–64.51) (p = 0.012), and condylar angle significantly increased from 140.84 ± 8.18° to 144.42 ± 8.87° (p = 0.007). Conclusion: Combined therapy promoted significant condylar remodeling in TMJ degenerative disease, along with skeletal changes (mandibular retrusion and increase in facial height). Therapeutic strategies should consider condylar remodeling in TMD. Skeletal and dental parameters should be evaluated prior to occlusal splint therapy. Full article
(This article belongs to the Special Issue Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions)
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12 pages, 666 KiB  
Systematic Review
Effectiveness of Laser Therapy in Treatment of Temporomandibular Joint and Muscle Pain
by Smaranda Buduru, Denisa Maria Oprea, Manuela-Maria Manziuc, Daniel-Corneliu Leucuța and Oana Almășan
J. Clin. Med. 2024, 13(17), 5327; https://doi.org/10.3390/jcm13175327 - 9 Sep 2024
Cited by 2 | Viewed by 2495
Abstract
Background/Objectives: Temporomandibular joint disorders (TMDs) express a condition derived from a broad spectrum of etiological factors and clinical manifestations. Many treatment options have been developed for TMDs; nevertheless, conservative and non-invasive approaches ought to be prioritized. Laser therapy is an effective treatment for [...] Read more.
Background/Objectives: Temporomandibular joint disorders (TMDs) express a condition derived from a broad spectrum of etiological factors and clinical manifestations. Many treatment options have been developed for TMDs; nevertheless, conservative and non-invasive approaches ought to be prioritized. Laser therapy is an effective treatment for pain management due to its non-invasive nature and capacity for tissue regeneration. This review aimed at bringing an overview of the present evidence regarding the efficiency of laser therapy on myofascial or temporomandibular joint disorders pain. Methods: The search was conducted in four electronic databases: PubMed, Web of Science, Embase, and Scopus, of studies published between January 1997 and January 2023. The following terms have been extensively searched: “laser treatment”, pain management”, “temporomandibular joint disorders”, “masseter muscle pain”, “pterygoid muscle pain”, and “temporal muscle pain”. The inclusion criteria were original papers, available in full text, and written in English. Cohen’s Kappa coefficient was used to assess the inter-rater reliability for article selection. The methodological quality was assessed with the Cochrane Risk of Bias tool for randomized controlled trials and the National Heart, Lung, and Blood Institute’s quality assessment tool for before-after studies with no control group. Results: Out of 846 identified records, 7 studies were included, of which 5 were randomized controlled trials. The inter-rater reliability for article selection showed an almost perfect agreement (Cohen’s Kappa = 0.832, p < 0.001). The protocol of laser application was not standardized; the laser wavelength ranged from 633 to 940 nm, with a power output range from 25 to 1600 mW. The number of sessions varied from 3 to 12, with a frequency of application from 1 time per week to 3 times per week. All studies reported pain reduction after laser therapy. Conclusions: Laser therapy is an efficient method to treat TMDs related to muscle pain. To accomplish the desired results, a standard procedure must be followed; however, the protocol is still not fully designed. Full article
(This article belongs to the Special Issue Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions)
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17 pages, 861 KiB  
Systematic Review
Estrogen Hormones’ Implications on the Physiopathology of Temporomandibular Dysfunction
by Daniel-Corneliu Leucuța, Damaris Anton and Oana Almășan
J. Clin. Med. 2024, 13(15), 4406; https://doi.org/10.3390/jcm13154406 - 27 Jul 2024
Cited by 3 | Viewed by 1841
Abstract
Background/Objectives: Temporomandibular dysfunction syndrome consists of several disorders of the masticatory system, namely those of the muscles, the joint itself, as well as the dental and periodontal system. This syndrome is often characterized by pain and an inability to perform functions within the [...] Read more.
Background/Objectives: Temporomandibular dysfunction syndrome consists of several disorders of the masticatory system, namely those of the muscles, the joint itself, as well as the dental and periodontal system. This syndrome is often characterized by pain and an inability to perform functions within the dental–maxillary apparatus, which creates a certain degree of disability in patients. Women are more susceptible to this syndrome than men and hormonal factors, particularly estrogen, are central to its etiology and physiopathology. Methods: A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Embase, and Web of Science databases regarding articles published from January 2008 to December 2023. Two authors conducted searches in the mentioned databases based on a pre-established search strategy using agreed-upon keywords. Additionally, each review author performed the selection process of eligible studies based on established inclusion criteria. The Newcastle–Ottawa scale and Risk of Bias tool 2 were used to assess each article for its methodological quality. Results: Of the 1030 records found in the four bibliographic databases, 22 studies were included in this review. Polymorphism in the alpha estrogen receptor appears to be significantly more prevalent in women with temporomandibular dysfunction, suggesting a genetic predisposition. There is a significant role of estrogen in the physiopathology of TMD-related pain. Women with polycystic ovary syndrome (PCOS) have a significantly higher incidence of TMD, accompanied by elevated inflammatory factors and decreased progesterone levels. In premenopausal women, there is scientific relevance to the association between beta-estradiol levels and TMD development and progression. The effects of estrogen hormones on temporomandibular dysfunction remain highly debated and challenging. Conclusions: These findings emphasize the importance of considering hormonal factors, genetic predisposition, and reproductive life stages in understanding and managing temporomandibular dysfunction. Further research is needed to elucidate the specific mechanisms underlying these associations. Full article
(This article belongs to the Special Issue Interdisciplinary Approach on the Oral Cavity Management Due to Musculoskeletal Conditions)
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