Research Abstracts: Temporomandibular Disorders

ABSTRACT

There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.

Copyright © 2022 The Authors. Licensee MDPI, Basel, Switzerland. This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY) license. creativecommons.org/licenses/by/4.0

ABSTRACT

Background

This observational study investigates the potential link between temporomandibular disorders (TMD) and personality disorders. The Personality Inventory for Diagnostic and statistical manual of mental disorders (DSM)-5-Brief Form (PID-5-BF) was used to assess personality traits, while TMD diagnosis was established by combining dental and clinical history with specific screening questionnaires, including the TMD-Pain Screener.

Methods

The study sample was recruited based on inclusion criteria requiring the presence of TMD-related symptoms (pain, joint clicking or functional limitations of the temporomandibular joint), with no active systemic or psychiatric conditions. Collected data were analyzed using descriptive and inferential statistical methods to identify significant correlations between PID-5-BF scores and the severity of temporomandibular symptoms.

Results

Results highlight a relevant connection between specific personality domains and TMD symptom severity, suggesting that psychological factors may influence both the onset and persistence of the disorder. Statistically significant associations were found in the domains of antagonism (p = 0.039), negative affectivity (p = 0.024), and the mean total PID-5-BF score (p = 0.021), confirming the role of specific personality traits in modulating temporomandibular pain.

Conclusions

These findings underscore the importance of an integrated approach, combining dental and psychological expertise, to improve clinical management and develop more effective prevention and treatment strategies.

Copyright © 2025 The Authors. Published by MRE Press. This is an open access article under the CC BY 4.0 license. creativecommons.org/licenses/by/4.0

ABSTRACT

Background

Temporomandibular joint (TMJ) degenerative joint disease (DJD) involves progressive osseous changes and is commonly associated with temporomandibular disorders (TMD). Cone-beam computed tomography (CBCT) is a valuable diagnostic tool for evaluating these changes. However, the relationship between clinical signs and symptoms, such as TMJ clicking or pain and radiographic findings remains poorly understood. Clarifying these associations can refine imaging prescribing practices and improve patient-specific diagnostic strategies.

Objective

This study aimed to investigate the association between clinical signs and symptoms of TMD and radiographic features of TMJ DJD detected on CBCT, emphasising its diagnostic value and limitations.

Methods

A retrospective chart review of 98 patients (196 TMJs) was conducted at a university-based oral medicine clinic. Clinical signs, including TMJ clicking, muscle pain and joint pain, were documented and CBCT findings, such as osteophytes and erosions, were analysed. Logistic regression was used to assess associations.

Results

A significant association was identified between TMJ clicking and the presence of osteophytes (p < 0.05). No significant associations were observed between other clinical features, including muscle and joint pain and CBCT findings.

Conclusion

The findings support an indication-driven approach to CBCT imaging, highlighting its diagnostic value in patients with specific clinical presentations, such as TMJ clicking, combined with additional clinical indicators. Routine CBCT imaging for all patients with TMD is not justified and future research should focus on refining imaging guidelines to ensure judicious use in TMJ diagnostics.

Copyright © 2025 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd. This is an open access article distributed under the terms of the Creative Commons CC BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. creativecommons.org/licenses/by/4.0

ABSTRACT

Background

Temporomandibular joint disorders (TMDs) are a variety of conditions that affect different parts of the temporomandibular joints (TMJ) and can cause orofacial pain and functional impairment. This study aims to investigate dental practitioners’ knowledge and management of Temporomandibular Joint Disorders (TMDs), particularly their knowledge of the role physical therapy plays in TMD treatment.

Methods

A mixed-methods approach was adopted to provide a comprehensive view of current knowledge, management practices, and attitudes toward collaboration among dental practitioners in treating TMD. Data were collected from a convenience sample of 335 dentists in Karachi using a detailed questionnaire to assess their knowledge of the role of physical therapy in the treatment of TMD. Twenty dentists were chosen for face-to-face, in-depth interviews to explore their experiences and challenges in managing TMDs based on their responses to the administered questionnaire.

Results

The cumulative quantitative and qualitative findings of the study revealed a landscape marked by individualized approaches to referral practices and significant gaps in interdisciplinary collaboration. Most practitioners holding a bachelor’s degree predominantly used medication (65.2%) and cause-specific treatment (65.3%) for TMD treatment. Thematic analysis of clinical efficacy and practitioner challenges in managing TMD revealed significant issues faced by dental professionals.

Conclusions

The study successfully validated a questionnaire to understand dental practitioners’ knowledge regarding physical therapy in TMD treatment. The study identified significant gaps in knowledge and a lack of collaboration between dentists and physiotherapists. The limited referral practices highlighted in the study, along with insights from dentist interviews, emphasize the need for improved interdisciplinary approaches to managing TMDs within dental practice.

Copyright © 2024 The Authors. Springer Nature. This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY) license. creativecommons.org/licenses/by/4.0

ABSTRACT

Temporomandibular disorders (TMDs) significantly affect an individual’s quality of life by limiting jaw mobility, causing chronic pain, and contributing to psychological distress. TMDs are more prevalent among adult populations and are reported more frequently in women than men. The multifactorial etiology of TMDs, including anatomical, physiological, psychological, and functional factors, contributes to the challenges of accurate diagnosis and effective management. Among the various treatment options, occlusal splints are widely used in clinical practice for their potential to alleviate symptoms. These devices are designed to alter the occlusal aspects of the teeth and redistribute jaw forces, aiming to reduce joint loading, minimize muscle tension, and protect against bruxism. However, despite their widespread use, the effectiveness of these treatments as the sole modality for TMDs remains a subject of considerable debate within the dental and medical communities. Therefore, this review aims to evaluate the effectiveness of occlusal splints in managing symptoms of TMDs and to determine their role in improving patient outcomes by synthesizing existing evidence from the literature. It will focus on key outcomes, including pain reduction, improved jaw function, and enhanced quality of life, in addition to the potential risks and benefits associated with their use. Occlusal splints may offer benefits in reducing pain and improving jaw function in the management of TMD, but their effectiveness as a standalone treatment remains uncertain, highlighting the need for individualized, multidisciplinary approaches and further research to define their optimal use.

Copyright © 2025 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution (CC BY) license. creativecommons.org/licenses/by/4.0

ABSTRACT

Temporomandibular disorders include various conditions that impact the masticatory system, affecting its structure, function, or physiology. Clinicians face a complex array of therapeutic options when treating this group of diseases, emphasizing the importance of evaluating the current evidence to guide decisions in patient care. The main objective of this article is to conduct a scoping review on the available treatment approaches to manage temporomandibular disorders (TMDs). An extensive search of the literature was performed on Scopus, Pubmed, Embase, and Web of Science. Systematic reviews published in the last 5 years were considered. Out of the 2183 publications identified, 109 studies were included in this review. Among them, 39 articles focused on the non-invasive approach, while 120 delved into the minimally invasive approach, and 15 explored the surgical approach. Non-invasive or conservative approaches like cognitive-behavioral therapy, physical therapy, and acupuncture offer effective pain management and functional improvements in TMDs. Emerging treatments offer promising alternatives for treating these disorders. Surgery should be reserved for severe cases, with conservative therapies used in conjunction with invasive procedures for optimal patient outcomes.

Copyright © 2024 The Authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. creativecommons.org/licenses/by/4.0

ABSTRACT

Background and objectives

To evaluate the impact of impacted mandibular third molars on temporomandibular joint dysfunction using the Modified Helkimo Index, analyzing symptom severity across age groups.

Materials and methods

A cohort of 140 patients (70 with impacted molars, 70 without) was assessed using the Modified Helkimo Index. Patients were categorized by age (<25, 26–30, 31–35, >36 years), and statistical comparisons between Icdⁱ (with impacted molars) and Icd^a (without impacted molars) were performed. Key parameters included mandibular movement limitation, joint noises, and pain scores. Data were analyzed using descriptive statistics and statistical tests, with significance set at p < 0.05.

Results

TMJ dysfunction was significantly more prevalent in patients under 25 years (Icdⁱ = 13.5, Icd^a = 11.0; p = 0.045), with a progressive decrease in severity in older groups (>36 years: Icdⁱ = 3.5, Icd^a = 4.5; p = 0.072). Women exhibited a higher prevalence across all age categories (female-to-male ratio: <25 years = 2.7, >36 years = 3.0). The most frequent symptoms were mandibular movement restriction (42.5%), joint noises (38.2%), and pain (35.7%).

Conclusions

Impacted third molars may significantly exacerbate TMJ dysfunctions, particularly in younger individuals and females, with a strong association between impacted molars and increased Modified Helkimo Index scores. Early extraction might mitigate symptoms, emphasizing the need for proactive clinical management.

Copyright © 2025 The Authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. creativecommons.org/licenses/by/4.0