Journal of Clinical Medicine

Research

15 pages, 1402 KiB

Open AccessArticle

Short-Term Effects of 3D-Printed Occlusal Splints and Conventional Splints on Sleep Bruxism Activity: EMG–ECG Night Recordings of a Sample of Young Adults

by Andrea Bargellini, Elena Mannari, Giovanni Cugliari, Andrea Deregibus, Tommaso Castroflorio, Leila Es Sebar, Gianpaolo Serino, Andrea Roggia and Nicola Scotti

J. Clin. Med. 2024, 13(3), 776; https://doi.org/10.3390/jcm13030776 - 29 Jan 2024

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Abstract

(1) Background: This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) Methods: Twenty-six patients (19 M, 7 F, 25.8 ± 2.6 years) were randomly allocated to a study group [...] Read more.

(1) Background: This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) Methods: Twenty-six patients (19 M, 7 F, 25.8 ± 2.6 years) were randomly allocated to a study group (3D splints) and a control group (conventional manufactured splints) and followed for a period of three months with night EMG–ECG recordings. Samples of the involved materials were analyzed for nanoindentation. The outcomes of interest considered were the overall SB index, the total amount of surface masseter muscle activity (sMMA), and general and SB-related phasic and tonic contractions. A statistical evaluation was performed with a confidence interval (CI) between 2.5% and 97.5%. (3) Results: Differences between groups with OAs were observed for general tonic contraction (p = 0.0009), while differences between recording times were observed for general phasic contractions (p = 0.002) and general tonic contractions (p = 0.00001). Differences between recording times were observed for the total amount of sMMA (p = 0.01), for general phasic contractions (p = 0.0001), and for general tonic contractions (p = 0.000009) during night recordings without OAs. (4) Conclusions: Three-dimensional splints seem to have a higher impact on SB-related electromyographic activity but not on the overall sleep bruxism index. The more regular surfaces offered by 3D splints could be related to phasic contraction stabilization. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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17 pages, 1286 KiB

Open AccessArticle

Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7–14 Years

by Mathias Rentsch, Aleksandra Zumbrunn Wojczyńska, Luigi M. Gallo and Vera Colombo

J. Clin. Med. 2023, 12(12), 4109; https://doi.org/10.3390/jcm12124109 - 17 Jun 2023

Cited by 1 | Viewed by 1929

Abstract

The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7–14 years and evaluate the consistency [...] Read more.

The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7–14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7–10) and adolescents (aged 11–14) of both sexes were invited to participate in this study (n = 1468). Descriptive statistics for all observed variables and Mann–Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants (n = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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14 pages, 5298 KiB

Open AccessFeature PaperArticle

Prevalence of Clinical Signs and Symptoms of Temporomandibular Joint Disorders Registered in the EUROTMJ Database: A Prospective Study in a Portuguese Center

by David Faustino Ângelo, Beatriz Mota, Ricardo São João, David Sanz and Henrique José Cardoso

J. Clin. Med. 2023, 12(10), 3553; https://doi.org/10.3390/jcm12103553 - 18 May 2023

Cited by 2 | Viewed by 1677

Abstract

Temporomandibular joint disorders (TMDs) are characterized by their multifactorial etiology and pathogenesis. A 3-year prospective study was conducted in a Portuguese TMDs department to study the prevalence of different TMDs signs and symptoms and their association with risk factors and comorbidities. Five hundred [...] Read more.

Temporomandibular joint disorders (TMDs) are characterized by their multifactorial etiology and pathogenesis. A 3-year prospective study was conducted in a Portuguese TMDs department to study the prevalence of different TMDs signs and symptoms and their association with risk factors and comorbidities. Five hundred ninety-five patients were included using an online database: EUROTMJ. Most patients were female (80.50%), with a mean age of 38.20 ± 15.73 years. The main complaints were: (1) temporomandibular joint (TMJ) clicking (13.26%); (2) TMJ pain (12.49%); (3) masticatory muscle tension (12.15%). The main clinical findings were myalgia (74%), TMJ clicking (60–62%), and TMJ arthralgia (31–36%). Risk factors such as clenching (60%) and bruxism (30%) were positively associated with TMJ pain and myalgia. Orthodontic treatment (20%) and wisdom tooth removal (19%) were positively associated with TMJ clicking, while jaw trauma (6%), tracheal intubation (4%) and orthognathic surgery (1%) were positively associated with TMJ crepitus, limited mandibular range of motion, and TMJ pain, respectively. In total, 42.88% of TMDs patients had other associated chronic diseases, most of them were mental behavioral or neurodevelopmental disorders (33.76%), namely, anxiety (20%) and depression (13%). The authors also observed a positive association of mental disorders with the degree of TMJ pain and myalgia. The online database seems to be a relevant scientific instrument for healthcare providers who treat TMDs. The authors expect that the EUROTMJ database can serve as a milestone for other TMDs departments. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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11 pages, 732 KiB

Open AccessArticle

Influence of Soft Stabilization Splint on Electromyographic Patterns in Masticatory and Neck Muscles in Healthy Women

by Grzegorz Zieliński, Marcin Wójcicki, Michał Baszczowski, Agata Żyśko, Monika Litko-Rola, Jacek Szkutnik, Ingrid Różyło-Kalinowska and Michał Ginszt

J. Clin. Med. 2023, 12(6), 2318; https://doi.org/10.3390/jcm12062318 - 16 Mar 2023

Cited by 1 | Viewed by 1246

Abstract

This study investigates the influence of soft stabilization splints on electromyographic patterns in masticatory and neck muscles in healthy women. A total of 70 healthy women were qualified for the research. The resting and clenching electromyographic patterns of the temporalis (TA), masseter (MM), [...] Read more.

This study investigates the influence of soft stabilization splints on electromyographic patterns in masticatory and neck muscles in healthy women. A total of 70 healthy women were qualified for the research. The resting and clenching electromyographic patterns of the temporalis (TA), masseter (MM), digastric (DA), and sternocleidomastoid (SCM) muscles were measured using the BioEMG III™ apparatus. The interaction between splint application and resting muscle activity affected the results in all examined muscles except the temporalis muscle. A large effect size was observed in masseter (2.19 µV vs. 5.18 µV; p = 0.00; ES = 1.00) and digastric (1.89 µV vs. 3.17 µV; p = 0.00; ES = 1.00) both-sided RMS activity. Significant differences between the two conditions were observed in all Functional Clenching Indices (FCI) for MM, SDM, and DA muscles. All FCI values for the MM and DA muscles were significantly lower with than without the splint. We observed an increase in all activity indices due to splint application, which suggests a masseter muscle advantage during measurement. The soft stabilization splint influenced resting and functional activity in the MM, SDM, and DA muscles. During tooth clenching, a soft stabilization splint changed the involvement proportions of the temporalis and masseter muscles, transferring the main activity to the masseter muscles. Using a soft stabilization splint did not affect the symmetry of the electromyographic activity of the masticatory and neck muscles. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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Review

Jump to: Research, Other

19 pages, 2490 KiB

Open AccessReview

Current Clinical Research Directions on Temporomandibular Joint Intra-Articular Injections: A Mapping Review

by Maciej Chęciński, Kamila Chęcińska, Natalia Turosz, Anita Brzozowska, Dariusz Chlubek and Maciej Sikora

J. Clin. Med. 2023, 12(14), 4655; https://doi.org/10.3390/jcm12144655 - 13 Jul 2023

Cited by 4 | Viewed by 1320

Abstract

This mapping review aims to identify and discuss current research directions on intracavitary temporomandibular joints (TMJs) injections. The inclusion criteria allowed studies published in the last full six years, based on patients diagnosed with temporomandibular joint disorders (TMDs), treated by TMJ intra-articular injections. [...] Read more.

This mapping review aims to identify and discuss current research directions on intracavitary temporomandibular joints (TMJs) injections. The inclusion criteria allowed studies published in the last full six years, based on patients diagnosed with temporomandibular joint disorders (TMDs), treated by TMJ intra-articular injections. Medical databases covered by the Association for Computing Machinery, Bielefeld Academic Search Engine, PubMed, and Elsevier Scopus engines were searched. The results were visualized with tables, charts, and diagrams. Of the 2712 records identified following the selection process, 152 reports were qualified for review. From January 2017, viscosupplementation with hyaluronic acid (HA) was the best-documented injectable administered into TMJ cavities. However, a significant growing trend was observed in the number of primary studies on centrifuged blood preparations administrations that surpassed the previously leading HA from 2021. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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Other

Jump to: Research, Review

19 pages, 3384 KiB

Open AccessSystematic Review

Intra-Articular Local Anesthetics in Temporomandibular Disorders: A Systematic Review and Meta-Analysis

by Karolina Lubecka, Kamila Chęcińska, Filip Bliźniak, Maciej Chęciński, Natalia Turosz, Adam Michcik, Dariusz Chlubek and Maciej Sikora

J. Clin. Med. 2024, 13(1), 106; https://doi.org/10.3390/jcm13010106 - 24 Dec 2023

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Abstract

This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on [...] Read more.

This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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16 pages, 1742 KiB

Open AccessSystematic Review

Analysis of Mandibular Muscle Variations Following Condylar Fractures: A Systematic Review

by Francesco Inchingolo, Assunta Patano, Angelo Michele Inchingolo, Lilla Riccaldo, Roberta Morolla, Anna Netti, Daniela Azzollini, Alessio Danilo Inchingolo, Andrea Palermo, Alessandra Lucchese, Daniela Di Venere and Gianna Dipalma

J. Clin. Med. 2023, 12(18), 5925; https://doi.org/10.3390/jcm12185925 - 12 Sep 2023

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Abstract

This review analyzes muscle activity following mandibular condylar fracture (CF), with a focus on understanding the changes in masticatory muscles and temporomandibular joint (TMJ) functioning. Materials and Methods: The review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) [...] Read more.

This review analyzes muscle activity following mandibular condylar fracture (CF), with a focus on understanding the changes in masticatory muscles and temporomandibular joint (TMJ) functioning. Materials and Methods: The review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A search was performed on online databases using the keywords “masticatory muscles” AND (“mandibular fracture” OR “condylar fracture”). The eligibility criteria included clinical trials involving human intervention and focusing on muscle activity following a condylar fracture. Results: A total of 13 relevant studies were reviewed. Various studies evaluated muscle activity using clinical evaluation, bite force measurement, electromyography (EMG), magnetic sensors and radiological examinations to assess the impact of mandibular fractures on masticatory muscles. Conclusions: Mandibular condylar fractures can lead to significant changes in muscle activity, affecting mastication and TMJ functioning. EMG and computed tomography (CT) imaging play crucial roles in assessing muscle changes and adaptations following fractures, providing valuable information for treatment planning and post-fracture management. Further research is required to explore long-term outcomes and functional performance after oral motor rehabilitation in patients with facial fractures. Standardized classifications and treatment approaches may help improve the comparability of future studies in this field. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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8 pages, 226 KiB

Open AccessOpinion

Temporomandibular Joint Facts and Foibles

by Louis Gerard Mercuri

J. Clin. Med. 2023, 12(9), 3246; https://doi.org/10.3390/jcm12093246 - 01 May 2023

Cited by 2 | Viewed by 1349

Abstract

The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader [...] Read more.

The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader must be an “out of the box thinker” which requires openness to new ways of seeing the world and a willingness to accept new concepts based on evolving evidence. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

12 pages, 979 KiB

Open AccessSystematic Review

Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis

by Giuseppe Minervini, Rocco Franco, Maria Maddalena Marrapodi, Salvatore Crimi, Almir Badnjević, Gabriele Cervino, Alberto Bianchi and Marco Cicciù

J. Clin. Med. 2023, 12(7), 2652; https://doi.org/10.3390/jcm12072652 - 02 Apr 2023

Cited by 60 | Viewed by 4567

Abstract

Background: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, [...] Read more.

Background: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, severe pain stimuli, parafunctional activities, and psychological elements, including stress, anxiety, and depression. The position of the human body as it is displayed in space is referred to as posture. Several nerve pathways regulate posture, and through ligaments, TMD and posture affect each other. The purpose of this study is to evaluate the possible correlation between posture and TMD through a meta-analysis of the literature; Methods: A literature search was performed on PubMed, Lilacs, and Web of science, and articles published from 2000 to 31 December 2022 were considered, according to the keywords entered. The term “temporomandibular disorders” has been combined with “posture”, using the Boolean connector AND; Results: At the end of the research, 896 studies were identified from the search conducted on the 3 engines. Only three were chosen to draw up the present systematic study summarizing the article’s main findings. The meta-analysis showed through forest plot analysis a correlation between posture and TMD Conclusions: This literature meta-analysis showed a correlation between posture and TMD. Nerve pathways probably regulate both body posture and mandibular posture. Further clinical studies will be needed to confirm this hypothesis and to indicate the main conclusions or interpretations. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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19 pages, 3986 KiB

Open AccessSystematic Review

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

by Maciej Chęciński, Kamila Chęcińska, Natalia Turosz, Maciej Sikora and Dariusz Chlubek

J. Clin. Med. 2023, 12(4), 1664; https://doi.org/10.3390/jcm12041664 - 19 Feb 2023

Cited by 5 | Viewed by 2595

Abstract

This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the [...] Read more.

This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12–20% lower Helkimo index, and 5–17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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21 pages, 607 KiB

Open AccessSystematic Review

Immunohistochemical Markers of Temporomandibular Disorders: A Review of the Literature

by Luis Eduardo Almeida, Andrea Doetzer and Matthew L. Beck

J. Clin. Med. 2023, 12(3), 789; https://doi.org/10.3390/jcm12030789 - 18 Jan 2023

Cited by 3 | Viewed by 1353

Abstract

Temporomandibular disorders (TMD) are a group of internal derangements encompassing dysfunction, displacement, degeneration of the temporomandibular joints and surroundings muscles of mastication, often accompanied by pain. Relationships between TMD and various chemical biomarkers have been examined throughout the years. This paper aims to [...] Read more.

Temporomandibular disorders (TMD) are a group of internal derangements encompassing dysfunction, displacement, degeneration of the temporomandibular joints and surroundings muscles of mastication, often accompanied by pain. Relationships between TMD and various chemical biomarkers have been examined throughout the years. This paper aims to gather evidence from the literature regarding other biomarkers and presenting them as one systematic review to investigate the potential links between TMD and different biochemical activity. To identify relevant papers, a comprehensive literature search was carried out in MEDLINE/PubMED, EMBASE, Web of Science and a manual search was performed in the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial surgery, and Journal of Cranio-Maxillo-Facial Surgery. The literature review produced extensive results relating to the biochemical and immunohistochemical markers of TMD. Many enzymes, inflammatory markers, proteoglycans, and hormones were identified and organized in tables, along with a brief description, study design, and conclusion of each study. Through this review, recurring evidence provides confidence in suggesting involvement of certain biomarkers that may be involved in this complex pathogenesis, in addition to pointing to differences in gender prevalence of TMD. However, more organized research on large human samples needs to be conducted to delve deeper into the understanding of how this disease develops and progresses. Full article

(This article belongs to the Special Issue New Insights into the Diagnosis and Treatment of Temporomandibular Joint Diseases)

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