Search Results (117)

Introduction: Total temporomandibular joint replacement (TMJR) is a well-established surgical solution for patients with severe TMJ disorders. It aims to relieve chronic pain, restore jaw mobility, and significantly enhance quality of life. This systematic review evaluates QoL outcomes following TMJR, analyzes complication profiles, compares custom versus stock prostheses, explores pediatric applications, and highlights technological innovations shaping the future of TMJ reconstruction. Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted throughout April 2025 in accordance with PRISMA 2020 guidelines. Sixty-four studies were included, comprising 2387 patients. Results: Primary outcomes assessed were QoL improvement, pain reduction, and functional gains such as maximum interincisal opening (MIO). Secondary outcomes included complication rates and technological integration. TMJR consistently led to significant pain reduction (75–87%), average MIO increases of 26–36 mm, and measurable QoL improvements across physical, social, and psychological domains. Custom prostheses were particularly beneficial in anatomically complex or revision cases, while stock devices generally performed well for standard anatomical conditions. Pediatric TMJR demonstrated functional and airway benefits with no clear evidence of growth inhibition over short- to medium-term follow-up. Complications such as heterotopic ossification (~20%, reduced to <5% with fat grafting), infection (3–4.9%), and chronic postoperative pain (~20–30%) were reported but were largely preventable or manageable. Recent advancements, including CAD/CAM planning, 3D-printed prostheses, augmented-reality-assisted surgery, and biofilm-resistant materials, are enhancing personalization, precision, and implant longevity. Conclusions: TMJR is a safe and transformative treatment that consistently improves QoL in patients with end-stage TMJ disease. Future directions include long-term registry tracking, growth-accommodating prosthesis design, and biologically integrated smart implants. Full article

Temporomandibular disorders (TMDs) impact quality of life and present diagnostic and treatment challenges. Biomarkers may serve as an additional tool to support diagnosis and monitor disease progression, offering supplementary information for treatment strategies in specific and selected patients. This systematic review aimed to assess the role of biomarkers in diagnosing TMD and guiding personalized treatment. It also examined key biomarkers linked to chronic temporomandibular joint (TMJ) pain and how therapies affect biomarker levels and clinical outcomes. A comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify observational and interventional studies assessing the role of biomarkers in synovial fluid/tissue, saliva, and blood. The research was registered in PROSPERO, adhered to PRISMA guidelines, and employed Cochrane Risk of Bias tools. To assess the effect, only studies examining biomarker levels were considered. A total of forty-six studies met the inclusion criteria: three randomized controlled trials were rated as having some concerns, as were most of the observational studies. Elevated levels of interleukins (1ß and 6), tumour necrosis factor alpha, and prostaglandin E2 in synovial fluid were correlated with temporomandibular joint (TMJ) inflammation. Increased matrix metalloproteinases (2, 7, and 9) indicated cartilage deterioration, while oxidative stress markers such as malondialdehyde were higher in TMD patients. Treatments including hyaluronic acid, platelet-rich plasma, and low-level laser therapy effectively reduced inflammatory biomarkers and improved symptoms. Biomarkers show potential to contribute to the understanding of pathophysiological mechanisms in TMD and may support future diagnostic and therapeutic strategies for selected patients. After high-quality studies confirm these findings, this approach will enable personalized medicine by tailoring treatments to individual patient profiles, ultimately leading to improved outcomes and quality of life. Full article

Background: The primary objective of our preliminary study was to estimate the prevalence of temporomandibular disorders (TMDs) in people with multiple sclerosis (MS). Furthermore, we aimed to investigate whether there is a correlation between the presence of TMDs and the level of MS-related disability. Methods: The study was conducted at two centers in Poland dealing with the treatment of MS between March 2025 and April 2025. The study used an original survey questionnaire, the European Academy of Craniomandibular Diseases (EACD) questionnaire and the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study group included people with multiple sclerosis, while the control group consisted of healthy people without neurological deficits. The study group was examined using the following methods: the McDonald criteria and the Expanded Disability Status Scale (EDSS). Results: The study involved 90 people (45 in both groups). The majority of the study participants were women (80.0%), aged 20–30 years (51.1%) and people living in small towns (51.1%). The largest number of patients with MS were noted with RRMS (75.5%). The duration of the disease was on average 3.3 ± 2.4, and the EDSS score was on average 2.5 ± 1.5. People from the study group significantly (p ≤ 0.05; ES = 0.52–0.86) reported TMDs more frequently based on EACD (pain on opening the mouth: 86.7%; facial pain: 57.8%; joint locking: 28.9%; headaches: 75.3%). The diagnosis of TMDs was confirmed in 40.0% of people with MS and 11.1% of healthy volunteers (p ≤ 0.05). Patients most frequently reported muscle pain and disk displacement with reduction (p ≤ 0.05). The disability score in the MS group did not exhibit differences in the occurrence of TMDs (p > 0.05). Conclusions: The study showed that TMDs are more common in people with multiple sclerosis. The degree of disability did not differentiate the occurrence of TMDs. The authors intend to expand research on the influence of potential risk factors on the occurrence of TMDs in people with multiple sclerosis. Full article

Background/Objectives: Arthroscopy and arthrocentesis are routinely performed for temporomandibular joint (TMJ) disorders, but high-quality evidence regarding their efficacy relative to each other is scarce. The current study, as part of an ongoing randomized controlled trial, aimed to compare office-based arthroscopic lysis and lavage with arthrocentesis for TMJ pain and dysfunction. Methods: Adults (≥18 years old) referred to a tertiary care hospital with TMJ arthralgia were included. The exclusion criteria comprised systemic rheumatic disease, connective tissue disease, bony ankylosis, congenital or acquired dentofacial deformities, a history of significant jaw trauma, or systemic illnesses. The primary outcome was joint pain during mandibular movement/function (visual analog scale (VAS); 0–100 mm). The secondary outcomes included pain at rest (VAS), maximum mouth opening (mm), maximum mouth opening without increased pain (mm), protrusive and lateral movements (mm), joint noises (absent/present), and mandibular function (mandibular function impairment questionnaire score). The outcomes were registered at baseline and 3-, 6-, and 12-month follow-ups. Linear mixed models and mixed-effects logistic regressions were utilized to evaluate the effects of interventions on the repeated outcome measurements. Results: Twenty subjects were randomly allocated to office-based arthroscopic lysis and lavage (n = 10) or arthrocentesis (n = 10). Multivariable mixed-effects models showed significantly higher pain scores during mandibular movement/function in the arthrocentesis group compared with arthroscopy (22.42 mm (95% CI: 5.28 to 39.57); p = 0.011). The secondary outcomes were not significantly different between the interventions. Conclusions: The preliminary results show the superiority of office-based arthroscopy over arthrocentesis in reducing pain during mandibular movement/function over a follow-up period of 1 year while showing no differences between interventions regarding other study outcomes. Full article

Osteoarthritis (OA) of the temporomandibular joint (TMJ) is a progressive disease characterized by the progressive destruction of the internal surfaces of the joint. Certain epigenetic biomarkers have been detected in TMJ-OA. We summarized the available evidence on the epigenetic biomarkers in TMJ-OA. There is an increase in the expression of non-coding RNAs related to the degradation of the extracellular matrix, chondrocyte apoptosis, and proinflammatory cytokines, while there is a decrease in the expression of those related to COL2A1, as well as the osteogenic and chondrogenic differentiation of mesenchymal stem cells. Certain methylated genes and histone modifications in TMJ-OA were also identified. In the early stage, DNA methylation was significantly decreased; that is, the expression of inflammation-related genes such as TNF and genes associated with extracellular matrix degradation, such as Adamts, were increased. While in the late stage, there was an increase in the expression of genes associated with the TGF-β and MAPK signaling pathway and angiogenesis-related genes. Although research on the role of epigenetic markers in TMJ-OA is still ongoing, the results here contribute to improving the basis for the identification of accurate diagnostic and prognostic markers and the development of new therapeutic molecules for the prevention and management of TMJ-OA. It also represents a significant advancement in elucidating its pathogenesis. Full article

Background/Objectives: Septic arthritis of the temporomandibular joint is an infectious disease with a rapid course and possible long-term complications. It is crucial to diagnose and implement treatment quickly and to know the potential causes of the occurrence of SATMJ. The planned systematic review aims to summarize current knowledge on this subject. Methods: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. The following scientific databases will be searched: ACM, BASE, ClinicalTrials.gov, Cochrane Library, Google Scholar, PubMed, and Scopus. Studies on SATMJ that are consistent with the pre-established PICOTS criteria will be included in the systematic review. Two authors will independently conduct the record screening, data extraction, and quality appraisal phases. The quality of the studies will be evaluated using the JBI critical appraisal tools. Certainty assessment will be conducted using the GRADE tool. The obtained research results and data will be used to define and establish the current scientific position on the diagnosis and treatment of SATMJ. Conclusions on the lack of association of gender, age, and race with the occurrence of this disease entity will be verified, among others. The planned systematic review will be based on extensive searches for studies with no high risk of bias. The aim is to assist clinicians in managing SATMJ, and to inspire future research. Full article

This review highlights the key molecular and cellular mechanisms contributing to aging, such as DNA damage, mitochondrial dysfunction, telomere shortening, protein dysfunction, and defective autophagy. These biological mechanisms are involved in various oral health conditions prevalent in the elderly, including periodontal disease, oral cancer, xerostomia, dental caries, and temporomandibular joint disorders. Exosomes generated by mesenchymal stem cells possess substantial therapeutic potential. These exosomes are nanosized extracellular vesicles derived from cells and are involved in essential intercellular communication and tissue homeostasis. The exosome-based therapies proved superior to traditional cell-based approaches, due to lower immunogenicity, ease of storage, and avoidance of complications associated with cell transplantation. Furthermore, the diagnostic potential of exosomes as non-invasive biomarkers for aging processes and age-related oral diseases offers insights into disease diagnosis, staging, and monitoring. Among the challenges and future perspectives of translating exosome research from preclinical studies to clinical applications is the need for standardized procedures to fully harness the therapeutic and diagnostic capabilities of exosomes. Full article

Background/Objectives: New devices such as surface electromyography (sEMG) have been proposed to support traditional gnathological examination and diagnostic protocols. The aim of this study is to investigate whether sEMG can be considered a diagnostic instrument to discriminate between healthy subjects and patients with temporomandibular disorders (TMDs) of an articular or muscular nature. Methods: A systematic review was conducted according to PRISMA guidelines using literature searches of MEDLINE (via PubMed), Scopus, and Web of Science. Inclusion criteria: recent clinical studies (≤10 years) in English or Italian, involving electromyography in TMD diagnosis, with a control group of healthy patients. Data considered to be homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05). Hedge g was calculated because all variables were continuous. Articles meeting the inclusion criteria were checked for further consideration, and relevant data were collected into two tables. In total, 18 studies were included after full-text reading. Meta-analyses were carried out for the static impact index (IMP), percentage overlapping coefficient (POC), and torque coefficient, and dynamic Symmetrical Mastication Index (SMI). Results: Patients with TMD had lower values in all parameters except IMP. sEMG registered a reduction in masseter activity, lower chewing efficiency, and an increase in fatigue during contractions in TMD patients. Conclusions: sEMG is not reliable to distinguish healthy from TMD patients, but despite the limitations related to the high variability in the studies (type of electromyography, static or dynamic tests, and population characteristics), the sEMG results are reliable considering the POC and SMI parameters, encouraging more in-depth studies for a predictable clinical practice. Patients with TMD had lower values in the dynamic index SMI and in static indexes POC and torque coefficient, except IMP. EMG might performs better if employed in muscle forms. Full article

Background/Objectives: Cervical spine arthritis (CSA) in children with juvenile idiopathic arthritis (JIA) can lead to clinically significant and irreversible functional impairment. Our study aimed to evaluate the features of the JIA disease course in children with CSA. Methods: In the retrospective cohort study, the data from medical charts of children with JIA (n = 753) who corresponded to the ILAR criteria and were treated from 2007 to 2016 were included. CSA was diagnosed by clinical manifestations (pain and limited range of motion) with radiological confirmation in the available cases. Results: CSA had 101 JIA patients (13.4%), predominantly with polyarticular (48%, OR = 1.8 (1.2; 2.7), p < 0.001) and systemic (18.9%, OR = 3.6 [2.0; 6.6], p < 0.001) JIA categories. CSA was associated with longer disease duration, higher inflammatory activity, a higher number of active joints, a lower probability of achieving remission (HR = 1.33 (95% CI: 1.01; 1.76, p = 0.04)), and a higher probability of being treated with biologics (HR = 1.78 (95% CI: 1.22; 2.59, p = 0.002)). Patients with temporomandibular arthritis (OR = 10.4 [5.4; 19.8], p < 0.001) and shoulder arthritis (OR = 14.1 [7.5; 26.3], p < 0.001) had the highest risk of having CSA. Conclusions: CSA was an independent predictor of treatment with biologics and failure to achieve remission. Identified predictors can help to find the group of patients with higher suspicion for whom the functional tests and MRI are required to not miss the CSA. A radiology assessment of CSA should be performed as far as possible in children, unless there are risks of general anesthesia for younger patients. Full article

Background/Objectives: Chronic kidney disease (CKD) influences different organs including the temporomandibular joint (TMJ). This study aims to identify structural and functional TMJ changes in children with CKD using ultrasound as the least invasive and most accessible method. Methods: TMJ changes were examined using ultrasound screening in 40 children. The first group (control, n = 10) included children with normal occlusion without TMJ complaints. The second group (n = 10) included children with CKD stage 1 and 2. The third group (n = 10) included patients on hemodialysis after renal transplantation. The forth group (n = 10) included patients at least 6 months after renal transplantation. Results: The size of the anterior section of the right TMJ gap in the third group was the largest among all the groups studied (1.085 mm) and statistically significantly different from the first group (0.570 mm; p = 0.001) and the second one (0.665 mm, p = 0.001). The width of the middle section was also greatest in the third group and statistically significantly different when compared to the first and second groups (0.390 mm; p = 0.023 and 0.340 mm; p < 0.001, respectively). A posterior articular gap width differences between the individual patient groups under study were not statistically significant in a posteriori comparison with Bonferroni correction. Statistical significance of differences between all groups when comparing the gap width was found in all sections of the left TMJ. The frequency of anterior disc displacement between groups ranged from 50 to 100% in all groups studied and was not statistically different when comparing right and left TMJs between groups (p = 0.084 and p = 0.662, respectively). Conclusions: CKD children have different TMJ changes, so TMJ ultrasound could screen joint pathology at early stages, and dental specialists can start timely rehabilitation. Full article

Adalimumab, a TNF-alpha inhibitor, is approved to treat juvenile idiopathic arthritis (JIA), helping control disease activity and reduce flare frequency. This study aims to investigate predictors of treatment response, including anti-drug antibodies. We reviewed 65 JIA patients (mean age 10.47 ± 3.90 years; 61.5% male) receiving adalimumab for an average of 2.64 ± 0.56 years, with demographics, laboratory parameters, therapeutic regimens, and treatment outcomes recorded. Disease status was evaluated using the Wallace criteria up to 36 months post-treatment initiation, and anti-adalimumab antibody levels were measured after 6 months of treatment. Enthesitis-related arthritis was the most common subtype (64.6%). Inactive disease status was achieved by 83.1% of patients, with 59.3% experiencing relapse. Detectable anti-adalimumab antibody at six months (p = 0.023) and temporomandibular joint (TMJ) involvement (p = 0.038) identified those less likely to achieve inactive disease. An antibody level cutoff of 7.426 ng/mL best predicted response (AUC = 0.808; p = 0.008), while high anti-adalimumab antibody levels after treatment (p = 0.032) and an injection intervals over two weeks (p = 0.042) were predictors of future flares. Our results highlight that the presence of anti-adalimumab antibodies six months after treatment is a risk factor for poor response to adalimumab therapy. Full article

Objectives: This overview of systematic reviews was carried out following the PRIOR guidelines. It aimed to collect and compare the results of systematic reviews on the etiology, diagnosis, and treatment standards of septic arthritis of the temporomandibular joint. Methods: ACM, BASE, Google Scholar, PubMed, and Scopus were searched on 5 January 2025, for systematic reviews on SATMJ etiology and treatment. Records underwent selection, AMSTAR 2 evaluation, data extraction, and qualitative synthesis. Results: Three systematic reviews were included, covering 38 reports (93 cases), 37 reports (91 cases), and 25 reports (40 cases), respectively. There are seven source reports common to all three reviews. The reviews co-indicate possible odontogenic etiology, differ in opinions about the impact of chronic diseases, and agree on the superiority of pharmacotherapy, though without consensus on specific antibiotics. Severe complications of SATMJ, including potentially lethal ones, were reported. Conclusions: SATMJ is a serious condition requiring urgent and precise medical intervention, yet no clear management guidelines exist. The low overlap and inconsistency of the previous systematic reviews provide a foundation for a more comprehensive synthesis. Full article

Background and Objectives: Pain in the TMJ is the second most common in the orofacial region. The objective of this systematic review was to assess whether a decrease in estrogen levels increases the risk of idiopathic condylar resorption by reviewing relevant literature and evidence. Material and Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search was performed in the PubMed (Medline), Science Direct (Elsevier), and Web of Science electronic databases. Results: The initial database search identified a total number of 453 studies. After applying the selection criteria, 36 articles were selected for a full-text analysis, and nine studies involving 1105 patients were included in the systematic review. According to the Newcastle–Ottawa Scale (NOS), two of the included articles were graded as being of “Moderate” quality and one was of “Fair” quality. After evaluating the rest of the articles according to the AXIS tool for cross-sectional studies, we generally found that the reliability is moderate. The results show that the decrease in estrogen promotes the occurrence of inflammation in the temporomandibular joint, and some sources mention that it increases the occurrence of idiopathic joint resorption, but we did not establish a complete correlation between the level of estrogen and idiopathic joint resorption. Conclusions: This systematic review indicates that there is no evidence suggesting that fluctuations in estrogen levels contribute to idiopathic mandibular condylar resorption, but reduced estrogen levels can be associated with chronic pain in the temporomandibular joint. Full article

Background/Objectives: Arterial Tortuosity Syndrome (ATS) is a rare, autosomal recessive connective tissue disorder characterized by arterial twists, abnormal bulges, constriction, and tears. Patients have distinctive features and disease manifestations. The syndrome’s full clinical spectrum and course remain incompletely understood. Methods: We sought to review the medical records of Qatari patients who had ATS. The cohort study included 21 patients who were genetically confirmed by mutations in the SLC2A10 gene. Results: The study revealed that the NM_030777.4(SLC2A10):c.243C>G (p.Ser81Arg) mutation in SLC2A10 leads to mild outcomes of no mortality and less morbidity. Novel features such as a flat philtrum, bulbous noses, bilateral nasolacrimal duct obstruction, allergic conjunctivitis, latent nystagmus, café au lait spots, eczema, dermatitis, allergic reactions, bilateral temporomandibular joint cysts, bilateral syndactyly (toes), parapelvic cysts, kidney malrotation, vesicoureteral reflux, and nephrolithiasis were identified in our cohort. Furthermore, rare features previously documented in a limited number of patients, including leg length discrepancy, epilepsy, and migraine headaches, were also observed in our cohort. Conclusions: Our data contributes new insights into the life course of ATS in Qatari patients. These findings underscore the importance of effective education strategies through repeated counseling aimed at preventing cousin marriage and the syndrome within the cohort. Full article

Background/Objectives: Generalized joint hypermobility (GJH) is a common condition characterized by an increased range of motion across multiple joints. Previous studies have suggested a possible association between GJH and temporomandibular disorders (TMDs). This study aimed to assess the prevalence of GJH in a Portuguese population of young university adults and to explore the relationship between GJH, temporomandibular joint (TMJ) symptoms/clinical findings, chronic painful TMDs, and chronic painful TMDs subtypes (myalgia, arthralgia, or combined myalgia and arthralgia). Methods: A cross-sectional study was carried out in Oporto university institutions, involving 1249 students (18–25 years). GJH was assessed using the Beighton score cut-off ≥ 4. TMJ symptoms and clinical findings were collected using the Research Diagnostic Criteria for TMD protocol, as well as TMD diagnoses. Univariate and multivariate analyses were carried out to examine the associations between GJH and the variables of interest. Results: The overall prevalence of GJH was 41.9%, with females exhibiting a significantly higher likelihood of GJH (p < 0.001). A statistically significant association was found between GJH and TMJ clicking (p < 0.05). Although no overall association was found between GJH and chronic painful TMDs, GJH was significantly associated with the combined diagnosis of myalgia and arthralgia (p < 0.05). Conclusions: The results suggest that GJH may be associated with the more complex subtypes of chronic painful TMDs. However, due to the small size effect of this association, future longitudinal studies with large samples using GJH broader diagnostic criteria are essential to elucidate the relationship between GJH and painful TMDs in asymptomatic nonsyndromic joint hypermobility populations. Full article