Search Results (384)

Background: Considering the significant impact on quality of life and the chronic nature of temporomandibular dysfunction (TMD), seeking healthcare is also part of the reality of individuals with this disorder. However, cultural differences and similarities in the experiences of individuals with TMD have not yet been investigated. This study aimed to describe and compare the experiences, beliefs, and sociocultural factors of Brazilian and Spanish individuals with TMD, focusing on their perceptions of the disorder, diagnostic pathways, information-seeking behaviors, and treatment expectations. Methods: A descriptive qualitative study was conducted. A purposive sample of 50 participants (25 Brazilian, 25 Spanish), aged 18–50 and diagnosed with TMD according to DC/TMD criteria, was recruited. Data were obtained through semi-structured interviews and analyzed using thematic analysis. Results: Six themes emerged, revealing both similarities and differences between the groups. Brazilian participants reported uncertainty about which professional to consult and difficulty accessing specialized care. In contrast, Spanish participants frequently sought physical therapists as their first option and identified them as primary sources of information. Beliefs about TMD etiology varied across samples. Treatment expectations also differed. Brazilians emphasized the difficulty of obtaining effective care, while Spanish participants perceived physiotherapy as being limited to muscular disorders. Perceptions of occlusal splint effectiveness showed variation between the groups. Conclusions: These findings underscore the necessity of culturally sensitive approaches to patient care that address not only clinical aspects, but also the sociocultural context that influences health behaviors. Full article

Background/Objectives: Septic temporomandibular joint disease (STMJ) is a rare condition with a potentially dangerous course. Its etiology includes bacterial and fungal infections, systemic factors (e.g., diabetes, immunodeficiencies), and molecular mechanisms. Methods: Reports of SATMJ in adults, clinically and microbiologically confirmed, published up to the time of protocol registration (PROSPERO CRD42024613462), were included. ACM, BASE, CENTRAL, PubMed, ClinicalTrials.gov, Embase, Scopus, Google Scholar, and reference lists were searched. The search included strategies using the terms “temporomandibular joint septic arthritis” and related phrases. Two independent reviewers studied a selection of articles and extracted data (demographics, microbiology, risk factors, molecular mechanisms). Risk of bias was assessed using JBI tools, and the certainty of evidence was assessed using the GRADE tool. Results: The analysis included 59 cases of SATMJ. Anaerobic infections were found in 77%, Gram-positive infections in 72%, and fungal infections in only 7%. Diabetes and immunoincompetence were associated with SATMJ. Conclusions: The results highlight the predominance of Gram-positive and anaerobic infections. Systemic factors, such as diabetes, increase the risk of SATMJ. Limitations result from the heterogeneity and retrospective nature of the analyzed cases and possible publication biases. Full article

Background/Objectives: Considering that the kinematics of the temporomandibular joints (TMJs) is concomitant with head movements and that temporomandibular joint disorders (TMDs) are frequently associated with neck pain in clinics but seldom or never investigated, the aim of this study was to develop a reliable in vivo measurement protocol of the simultaneous amplitudes of the mandible and of the skull. The development of such a protocol is part of a project to build an accurate kinematic assessment tool for clinicians in the orofacial field who treat patients suffering from TMD. Methods: Mouth opening, laterotrusion and protrusion movements for three different positions of the head (neutral, slouched and military) on 12 asymptomatic voluntary subjects (5 men and 7 women, mean 33.6 yo +/− 11.1) were recorded using 20 markers palpated and taped and 14 optoelectronic cameras. The acquisition frequency was set at 150 hertz. The inter- and intra-examiner reliability of marker palpation in mm was calculated using standard deviation (SD), mean difference (MD) and standard error (SE). Amplitudes of movement according to axes defined by the International Society of Biomechanics (ISB) are given for the mandible and skull segments. The propagation of error on the amplitudes was calculated with the root mean square propagation error (RMSPE) in degrees. Repeated-measures ANOVA or Friedman tests were used to assess the influence of the position of the head on the amplitudes of the jaw. Power analysis of the sample size was estimated with Cohen’s f3 size effect test. Steady-state plots (SSPs) and normalized motion graphs between the skull and the mandible motion were performed to study the coordination of their maximum amplitude over time. Results: The protocol demonstrated good intra-examiner reliability (1.5 < MD < 5.8; 2.6 < SD < 7.8; 2.0 < SE < 3.8), good inter-examiner reproducibility (0.2 < MD < 4.0; 3.5 < SD < 4.6; 2.0 < SE < 2.5) and small error propagation (0.0 < RMSPE intra < 2.8; 0.0 < RMSPE inter < 1.0). The amplitudes of the jaw and head found during the three types of movements correspond to the values reported in the literature. Head positions did not appear to significantly influence the amplitudes of jaw movements, which could be explained by the power estimation of our sample (Type II error β = 0.692). The participation of head movements in those of the jaw, for all motions and in all positions, was demonstrated and discussed in detail. Conclusions: The accuracy, test–retest reliability, and intra-individual variability of the TMJ kinematic analysis, including head movements, was ensured. The small sample size and the absence of standardized head positions for the subjects limit the scope of the intra- and inter-group analysis results. Given the natural biological and complex coordination of jaw–head movement, the authors consider its evaluation useful in clinical intervention and would like to further develop the present protocol. The next step should be to test the feasibility of its clinical application with a larger group of asymptomatic subjects compared to patients suffering from TMD. Full article

Age-related differences in temporomandibular joint osteoarthritis (TMJ OA) have been suggested; however, age-specific patterns of functional recovery following occlusal splint therapy remain insufficiently characterized. This retrospective observational study evaluated longitudinal changes in bite force across different age groups in patients with unilateral TMJ OA undergoing stabilization splint therapy. Thirty-two patients diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were categorized into three age groups (20–39, 40–59, and ≥60 years). Maximum bite force was measured repeatedly from baseline to 2 weeks and up to 6 months during the observation period following splint application. Patients aged 60 years and older exhibited significantly lower baseline maximum bite force compared with younger groups (p = 0.011), but demonstrated a gradual and statistically significant increase over the observation period (p = 0.011). In contrast, patients aged 20–39 years showed a significant improvement in bite force asymmetry after 2 weeks of treatment (p = 0.047), which was maintained throughout follow-up. These findings suggest that functional recovery patterns in unilateral TMJ OA may vary according to age, with younger patients showing earlier improvement and older patients demonstrating slower but progressive functional gains. Bite force assessment may serve as a complementary functional parameter for characterizing age-related differences in functional change in patients with unilateral TMJ OA. Full article

The objective of the present study was to investigate whether orthodontic treatment alters the morphology and bone mineral density (BMD) distribution of the mandibular condyle in growing adolescent patients. Cone-beam computed tomography (CBCT) images were retrospectively analyzed for 29 patients (10 males and 19 females, aged 12.5 to 17.0 years) treated with full fixed orthodontic appliances. The right and left mandibular condyles were digitally isolated. For the internal control sample, the basal cortical bone (CB) at both mandibular first molar sites was also digitally dissected. A frequency plot of the CBCT gray values, proportional to BMD, was analyzed to calculate the mean and the 5th percentile of low and high gray values (Low₅ and High₅). Morphological changes in the condylar surface were assessed based on temporomandibular joint osteoarthritis (TMJOA) counts. Lateral cephalometric radiographs were used to measure facial morphology parameters and classify skeletal patterns. The cervical vertebral gray values of the same patients were compared. No radiographic signs of TMJ disorder were observed with no significant difference in TMJOA counts between before and after treatment (p = 0.56). The volume, mean and Low₅ gray values of the mandibular condyle, facial morphology parameters, and cervical vertebral gray values significantly increased following orthodontic treatment (p < 0.05). Skeletal Class II patients exhibited greater changes in mean, Low₅, and High₅ mandibular condyle gray values compared to their Class I patients (p < 0.05), whereas cervical vertebral gray values were not significantly influenced by skeletal classification (p > 0.19). The findings suggest that orthodontic treatment, combined with natural patient growth, contributes to nonpathological condylar alterations in adolescent patients. Full article

Background: This study aimed to investigate the association between occlusal splint use and several key parameters, including body position perception, tongue pressure, temporomandibular joint dysfunction (TMD) severity, jaw functional limitation, and neck muscle endurance. Methods: A total of 157 individuals diagnosed with bruxism were screened, and 52 eligible participants were enrolled and divided into two groups: occlusal splint users (n = 26) and non-users (n = 26). Body position perception was assessed with a digital inclinometer, tongue pressure was measured using the Iowa Oral Performance Instrument (IOPI), and neck muscle endurance was evaluated by the Cranio-Cervical Flexion Test (CCFT). TMD severity and jaw functional limitation were assessed via the Fonseca Anamnestic Questionnaire and Jaw Functional Limitation Scale-20, respectively. Gender-based analyses showed higher TMD severity and mandibular limitation scores in females using occlusal splints than in males. Results: No statistically significant differences were found between the splint and non-splint groups in body position perception, tongue pressure and neck muscle endurance (p > 0.05). However, significant differences were observed in the Jaw Functional Limitation Scale (CFKS) subscales. Splint users reported higher functional limitations in chewing, mobility, and expression compared to non-splint users (all p = 0.000), with small effect sizes (d = 0.23–0.29). Conclusions: Occlusal splint use was not associated with better proprioception, orofacial muscle function, or TMD-related symptoms compared with non-splint users. However, splint users were associated with higher mandibular functional limitation based on CFKS subscale scores. Full article

Temporomandibular disorders (TMD) are increasingly prevalent in the adult population. Given the multifactorial and often chronic nature of TMD, the ideal therapeutic approach must be multimodal and personalized, with a preference for conservative treatments. However, standardized protocols combining occlusal devices and biobehavioral therapy for internal derangement (ID) are still lacking. Case Presentation: A 20-year-old male patient presented with bilateral anteromedial reducible disc displacement, with intermittent locking on the right. He reported joint noises, difficulty chewing, and occasional painful mouth opening. A comprehensive diagnostic workup, including clinical, functional, and radiographic evaluations, was performed. The patient underwent a biobehavioral gnathological therapy involving two oral devices: RA.DI.CA. and By-Te ® Reali. The protocol included personalized exercises, patient education, and behavioural counselling. Results. The patient achieved full remission of pain, disappearance of joint noises, and restoration of mandibular function, without dental movement. Pre- and post-treatment MRI and condylography confirmed improved condyle-disc relationships, increased intra-articular space, and better symmetry of movements, particularly on the right. Conclusion. The combined use of RA.DI.CA. and by-Te ® Reali devices, supported by a personalized functional programme, appears effective in managing TMD with ID. Further studies on larger populations are needed to confirm the efficacy and safety of this protocol. Full article

The International Association of Orofacial Myology (IAOM) held its 2025 Convention in Salt Lake City, UT, USA, from 26 to 28 September with the theme “Summit for Elevated Myofunctional Health.” The Proceedings of the Convention contain abstracts and summaries of each presentation. Podium presentations were available in person and virtually, and poster presentations were posted online. Full article

We aimed to investigate the type of bone changes in temporomandibular disorder patients with disc displacement. The subjects were 117 temporomandibular joints that were diagnosed with anterior disc displacement using magnetic resonance imaging (MRI). Temporomandibular joint (TMJ) pain and opening dysfunction were examined. Disc displacement with and without reduction, joint effusion, and bone changes in the mandibular condyle were assessed on MRI. The types of bone changes were classified into erosion, flattening, osteophyte, and atrophy on the MR images. Fisher’s exact test and χ² test were performed for analyses. Bone changes were found on 30.8% of subjects with erosion, flattening, osteophyte, and atrophy types (p < 0.001). The occurrence of joint effusion appearance (p < 0.001), TMJ pain (p = 0.027), and opening dysfunction (p = 0.002) differed among the types of bone changes. Gender differences were also found among the types of bone changes (p < 0.001). The rate of disc displacement with reduction was significantly smaller than that of disc displacement without reduction on flattening and osteophyte (p < 0.001). The results made it clear that the symptoms, gender, and presence or absence of disc reduction differed among the types of bone changes. Full article

Background: Temporomandibular disorders (TMDs) are the most common source of non-dental orofacial pain, with peak prevalence during adolescence and young adulthood—the same age group when orthodontic treatment is typically initiated. Although orthodontics is not a proven cause of TMD, pre-existing dysfunction may be aggravated during treatment, creating clinical and medico-legal risks. Objective: This paper proposes a structured diagnostic questionnaire and scoring framework for pre-orthodontic TMD assessment. The protocol aims to enhance the early recognition of high-risk patients, facilitate interdisciplinary communication, and lay a foundation for systematic validation. Methods: The framework was developed through synthesis of international diagnostic criteria (DC/TMD), a targeted narrative review of the literature, and expert clinical input. Diagnostic categories were selected based on prevalence, impact on orthodontic outcomes, and medico-legal significance. Weighted scoring stratifies patients into three pathways: (1) proceed with orthodontics without concern, (2) proceed with monitoring, or (3) defer orthodontics until TMD is managed. Results: The proposed questionnaire is designed to address inconsistencies in the literature by applying standardized diagnostic items and objective thresholds (e.g., jaw opening < 38 mm) and structured follow-up intervals. Case scenarios illustrate how risk stratification guides decision-making. The questionnaire includes intra-articular and pain-related TMD entities such as disk displacement, degenerative joint disease, myalgia, myofascial pain, arthralgia, headache, and trismus. The framework provides orthodontists with defensible baseline documentation while supporting safe and individualized patient care. Conclusions: Inconsistent diagnostic frameworks, malocclusion classifications, and outcome measures have fragmented the evidence base in orthodontics and TMD. The framework aims to provide orthodontists with structured baseline documentation that may support clinical decision-making and medico-legal risk management. Validation studies are required to establish psychometric reliability and international applicability. Full article

Introduction: Malocclusion and dysfunctional or atypical swallowing are two conditions that significantly affect the health and well-being of the stomatognathic system, so much so that they often interact, influencing each other, and the presence of one can cause the onset or aggravation of the other. In this regard, over the years studies have been carried out that tried to discover the correlation between atypical swallowing and malocclusion. The aim is to evaluate the prevalence of dysfunctional swallowing in patients with malocclusion, to examine the pathophysiological mechanisms linking malocclusion and dysfunctional swallowing, and above all to investigate what potential risk factors may be. Materials and Methods: A sample of 60 patients aged between 6 and 16 years was analyzed at the Department of Dentistry of the University of L’Aquila. Some characteristics of the subjects’ face and posture were analyzed both from a frontal and lateral point of view. An orthodontic, temporomandibular joint, and masticatory muscle diagnosis was made. In addition, an examination of oral structures and functions was performed that allowed breathing, swallowing, chewing, and phono-articulation to be assessed. Results: It was observed that all the children had atypical swallowing, with significant postural abnormalities of the tongue; in fact, only 5% had a correct posture of the tongue at rest. In the analysis of occlusal characteristics, it emerged that with regard to the transverse plane, 21.67% of subjects have a condition of No Cross, while 10% show a Unilateral Cross. Finally, 68.33% show a Bilateral Cross. As far as the anterior–posterior plane is concerned, most of the subjects, equal to 76.67%, are placed in Class I, while 23.33% are in Class II. Finally, in relation to the vertical plane, 63.33% of subjects have normal occlusion, while 25% suffer from deep bite and 11.67% from open bite. The sample, stratified by presence or absence of alerts, shows significant differences for atypical swallowing (p = 0.031), for the presence of Class II malocclusion (p = 0.002), for low lingual posture, (p < 0.001), and for labial incompetence (p = 0.001). The multivariate logistic regression model showed that the presence of atypical swallowing (OR 1.04, 95% CI 1.04–1.07, p = 0.029), open bite malocclusion (OR 1.09, 95% CI 1.01–1.18, p = 0.013), low lingual posture (OR 1.11, 95% CI 1.04–1.18, p = 0.002), and the presence of labial incompetence (OR 1.06, 95% CI 1.02–1.10, p = 0.029) were significant clinical risk factors independently associated with the presence of alerts. Conclusions: The data collected confirm that atypical swallowing is a key element in the development of malocclusions, with a strong impact on posterior crossbite, anterior overjet, and other occlusal discrepancies. Among the data collected in the diagnostic phase, patients who presented at least one significant alert were also considered and atypical swallowing, low lingual posture, open bite malocclusion, and the presence of labial incompetence were statistically significant. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are a heterogeneous subset of orthodontic conditions with persistent diagnostic and reporting variability. This review compared transparency, reporting quality, and spin prevalence in TMD/TMJ (temporomandibular joint)-focused orthodontic randomized controlled trials (RCTs) versus general orthodontic RCTs. Methods: The review followed PRISMA 2020 and was registered in PROSPERO (4201024184). Searches were performed in PubMed/MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform from the earliest available records in each database up to 15 October 2025. Eligible studies were peer-reviewed human orthodontic RCTs. Five transparency indicators (funding disclosure, bias discussion, confounder consideration, protocol registration, reporting-guideline adherence) and five spin indicators (selective focus, unsupported efficacy claims, emphasis on benefits, recommendations despite nonsignificance, “trend toward significance” language) were coded dichotomously. Beta–binomial mixed-effects models compared composite scores between groups, adjusting for publication era, impact factor, and journal clustering. Results: Among 874 included trials (840 general, 34 TMD/TMJ-focused), TMD/TMJ-focused studies showed lower adjusted transparency (odds ratio (OR) = 0.58; 95% confidence interval (CI) 0.34–0.99; p = 0.047), mainly due to limited registration and incomplete guideline adherence. Predicted transparency proportions were 0.82 for general and 0.73 for TMD/TMJ-focused studies. Composite spin did not differ (OR = 1.05; 95% CI 0.68–1.62; p = 0.821), though TMD/TMJ-focused abstracts more often emphasized benefits (OR = 4.62) and recommended interventions despite nonsignificant primary outcomes (OR = 2.83). Conclusions: TMD-focused orthodontic trials exhibited lower transparency and a distinct pattern of interpretive spin, particularly a greater tendency to emphasize benefits or recommend interventions despite non-significant results, compared with general orthodontic research. Full article

Background: Functional imbalance within the stomatognathic system can develop long before clinical symptoms become evident. Subtle biological changes, such as low-grade inflammation or metabolic disturbance, may precede gingival inflammation, temporomandibular discomfort, or masticatory muscle sensitivity. This study introduces the BioRisk-S (Biological Risk–Stomatognathic System) algorithm, a predictive model designed to identify early systemic alterations associated with the subclinical stage of stomatognathic dysfunction. Methods: A total of 260 clinically healthy adults without apparent stomatognathic disorders were enrolled and evaluated at baseline (T0) and re-examined after six months (T1). Routine laboratory tests were performed to determine high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and 25-hydroxyvitamin D levels. These biomarkers were integrated into the BioRisk-S algorithm to estimate systemic biological imbalance. Follow-up examinations focused on detecting early functional changes, including gingival inflammation, signs of temporomandibular joint (TMJ) dysfunction, and masticatory muscle tenderness. Results: Participants with higher baseline BioRisk-S scores showed significantly higher hs-CRP and NLR values, as well as lower vitamin D levels, indicating a mild but persistent inflammatory profile. After six months, these individuals exhibited early gingival inflammation, muscle tenderness, or mild TMJ discomfort more frequently than those with low BioRisk-S values (p < 0.01). The predictive model demonstrated good accuracy for detecting early biological imbalance preceding clinical dysfunction, with an area under the curve (AUC) of 0.84 (95% CI: 0.78–0.89). Conclusions: The BioRisk-S algorithm represents a feasible, low-cost tool for early systemic screening of functional imbalance within the stomatognathic system. By integrating routine laboratory parameters, this method may help identify individuals at risk before the onset of visible symptoms, supporting preventive and personalized approaches in oral and systemic health management. Full article

Background/Objectives: Previous studies have demonstrated an association between migraine headache and temporomandibular joint disorders (TMDs), with a higher prevalence of TMD symptoms in patients with migraine. Methods: In this study, we conducted RNA sequencing to identify differentially expressed genes (DEGs) in the spinal trigeminal nucleus caudalis of mice with migraine-like pain and/or myogenic TMD. Results: We observed 204 upregulated and 274 downregulated genes in the comorbid migraine and TMD group compared to the control group. We identified 15 ferroptosis-related DEGs enriched in the pathways of neurodegeneration, cellular homeostasis, interleukin signaling, and pain response. Gene Ontology analysis highlighted the involvement of neuroinflammatory response and monoamine transmembrane transporter activity, while Gene Set Enrichment analysis showed enrichment in chemokine signaling, cell cycle, and calcium signaling pathways. Immune infiltration analysis identified M0 macrophages, immature dendritic cells, neutrophils, and eosinophils as key responders. Hub genes in the protein–protein interaction network included Gm7536, Rpl17, Rpl22l1, Rpl14, Rps8, Rps29, Rpl35, Gm4889, Gm11808, Rps27rt, Rps12-ps3, Rpl10-ps3, Gm9843, Oas1c, Il1b, and Serpine1, indicating their synergistic roles in such orofacial pain comorbidity. Conclusions: Our results suggest that the comorbid migraine and TMD can regulate gene expressions involving ferroptosis and immune cell responses and the identified DEGs could be targeted to develop novel therapies for this painful comorbidity. Full article

Background: Myogenous temporomandibular disorders (TMDs) typically present with pain but without obvious restriction of mandibular motion, making subtle dysfunctions difficult to detect clinically. In this study, we evaluated mandibular kinematics in myogenous TMDs using an electronic axiography system (Cadiax Diagnostic). The specific objective of this study was to evaluate whether patients with myogenous temporomandibular disorders exhibit qualitative abnormalities in mandibular movements that are not detectable using conventional clinical examination. Methods: Twenty-six patients with myogenous TMD (muscle pain without intra-articular disorders, diagnosed per DC/TMD) and 26 matched controls were examined. Clinical assessment (DC/TMD Axis I) measured mandibular range of motion and deviations. Instrumental recordings of maximal opening, protrusion, and laterotrusion were obtained with Cadiax 4. Quantitative (excursion ranges) and qualitative (movement symmetry and sagittal deviations) parameters were analyzed. Condylar position changes between the reference position and maximum intercuspation were evaluated (Condyle Position Measurement, CPM). Exact χ² or Fisher tests were applied with effect sizes (φ) and 95% confidence intervals (CI). Results: Maximal opening, lateral excursions, and protrusion ranges were statistically similar between groups (mean opening: 47.96 ± 6.5 mm in TMDs vs. 49.46 ± 5.4 mm in controls, p = 0.40; 95% CI of difference −1.8 to 4.8 mm). However, qualitative deviations were more frequent in TMD. Of note, 12/26 (46.2%) patients vs. 6/26 (23.1%) controls showed a ΔY deflection during protrusion (χ² = 3.06, p = 0.08; φ ≈ 0.24; difference = 23.1%, 95% CI −2.0–48.2%). Identical proportions (46.2% vs. 23.1%) showed a ΔY deflection upon opening (χ² = 3.06, p = 0.08). Inferior condylar shifts (distractions) on closing into intercuspation occurred only in the mTMD group: 5/26 (19.2%) left condyles vs. 0% (p ≈ 0.05; 95% CI diff 4.1–34.4%) and 2/26 (7.7%) right vs. 0% (p ≈ 0.49; 95% CI −2.5–17.9%). Condylar compressions (superior shifts) were similar between groups. In summary, roughly half of TMD patients exhibited lateral jaw deflections (ΔY) and exclusive condylar “distraction” on closure; upon comparison, these conditions were rare in controls. Conclusions: Despite normal mandibular range of motion, patients with myogenous TMDs exhibited qualitative abnormalities in jaw kinematics, including movement deflections, condylar asymmetries, and centric–intercuspal discrepancies. Axiographic analysis with Cadiax enabled detection of subtle functional changes not identifiable in routine examinations, underscoring its diagnostic value in early dysfunction and potential therapeutic planning. The detection of kinematic abnormalities could influence early diagnosis or treatment planning for myogenous TMDs. Full article