BACKGROUND: The present study is to evaluate the clinical characteristics of patients with temporomandibular disorders (TMD).
METHODS: A total of 3362 TMD patients were included. Each participant had complete medical records according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The clinical characteristics including symptoms and signs in relation to age and gender were analyzed.
RESULTS: The mean age of the patients seeking care was 29.89 ± 13.73Y, and 68.6% of patients were aged 16-35 years. The female-to-male ratio of patients was 2.2: 1, and the average age of males was significantly lower than that of females. The prevalence of clicking symptoms decreased with age, while the prevalence of pain symptoms and limitations in jaw movement increased with age. Females were more likely to have limitations in jaw movement than males. Among the patients with pain, the average visual analogue scale (VAS) was 2.96 ± 1.23. The average VAS score of acute TMD patients (≤ 3 months) was significantly higher than that of chronic TMD patients (> 3 months).
CONCLUSIONS: The majority of TMD patients seeking care were young people. The number and average age of female patients was higher than the males. Female patients were more likely to have limitations in jaw movement than males.

BACKGROUND: Changes in the fatty infiltration and/or muscle volume of neck muscles can alter cervical spine alignment and cranial load distribution, which may cause pain in the orofacial region.
OBJECTIVE: The aim of the study was to examine the muscle volume and fatty infiltration of neck muscles in patients with temporomandibular disorders (TMD).
METHODS: This case-control study included 18 patients with TMD and 18 ageand sex-matched controls. The muscle volume and fatty infiltration of the neck muscles of the participants were measured using magnetic resonance imaging (MRI) and ITK-SNAP software. The 3D models of the sternocleidomastoid (SCM), splenius capitis (SPLC), semispinalis cervicis (SC)-semispinalis capitis (SCP), and multifidus (M) muscles within the C3-C7 range were created using ITK-SNAP, a semi-automatic segmentation software. The models were used to determine the volumes and fatty infiltration levels. The Neck Disability Index (NDI) was used to assess neck pain-related disability. The severity of TMD was determined using the Fonseca Anamnestic Index (FAI), while jaw-related disability was measured with the Jaw Functional Limitation Scale-20 (JFLS-20). Pain levels were recorded at rest and during chewing using the numeric rating scale (NRS).
RESULTS: There were no statistically significant differences in total muscle volume, fatty infiltration volume and fatty infiltration percentage of the SCM, SPLC, SCP, SC, and M muscles between the 2 groups (p > 0.05). The patient group had higher NDI scores compared to the controls (p < 0.001). The NDI scores correlated positively with the JFLS-20 (r = 0.831, p < 0.001), FAI (r = 0.815, p < 0.001) and NRS scores at rest (r = 0.753, p < 0.001) and during chewing (r = 0.686, p < 0.001).
CONCLUSIONS: The present study did not identify any significant differences in the neck muscle volume or fatty infiltration between the TMD patients and controls. However, the severity of neck disability was found to correlate with jaw function, pain and TMD levels.

OBJECTIVE: TMD is a multifaceted condition with various contributing factors, but the actual impact of the lateral pterygoid plate on the development of TMD remains uncertain. This research aims to investigate the relationship between anatomical variations of the lateral pterygoid plate (LPP), including its angle and proximity to the condyle, and the prevalence of temporomandibular disorders (TMD), to improve diagnostic accuracy and therapeutic approaches for TMD.
METHODS: A retrospective analysis was conducted on 189 Cone Beam Computed Tomography (CBCT) images of individuals aged 18 to 45. Inclusion criteria were based on definitive diagnoses of degenerative joint disease, excluding individuals with orthodontic treatments, injuries, or craniofacial disorders.Participants were divided into TMD and control groups using standardized DC/TMD protocols for assessment. A radiologist, blinded to the patient\'s clinical status, then analyzed the CBCT images. LPP dimensions, angles, and condyle distances were measured using OnDemand 3D Imaging Software.
RESULTS: The study found a statistically significant higher average LPP length in females compared to males (right LPP p < 0,001, left LPP p = 0,004), with no significant differences in LPP-condyle distances and angles between genders. Comparing the TMD and control groups revealed a positive correlation between lateral plate angles and TMJ disorders (p = 0,044), suggesting a potential biomechanical linkage.
CONCLUSIONS: Conclusively, the study challenges the assumption that LPP anatomical variations significantly impact TMD while underscoring a potential link between LPP angle and TMD. The novel insight into the potential role of the LPP angle in TMD provides a new direction for research and clinical practice, emphasizing the importance of considering subtle anatomical differences in the management of TMD.

BACKGROUND: The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years.
METHODS: TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth.
RESULTS: At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom.
CONCLUSIONS: Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.

UNASSIGNED: The role of autoimmune diseases (ADs) in temporomandibular disorders (TMDs) has been emphasized in observational studies. However, whether the causation exists is unclear, and controversy remains about which specific disorder is destructive in TMDs. This Mendelian randomization (MR) study aims to estimate the causal effect of common ADs on TMDs.
UNASSIGNED: Genetic data from published genome-wide association studies for fourteen common ADs, specifically multiple sclerosis (MS, N = 15,283), ankylosing spondylitis (AS, N = 22,647), asthma (N = 408,422), celiac disease (N = 15,283), Graves\' disease (N = 458,620), Hashimoto thyroiditis (N = 395,640), primary biliary cirrhosis (PBC, N = 11,375), primary sclerosing cholangitis (PSC, N = 14,890), psoriasis vulgaris (N = 483,174), rheumatoid arthritis (RA, N = 417,256), systemic lupus erythematosus (SLE, N = 23,210), Type 1 diabetes (T1D, N = 520,580), inflammatory bowel disease (IBD, N = 34,652), and Sjogren\'s syndrome (SS, N = 407,746) were collected. Additionally, the latest summary-level data for TMDs (N = 228,812) were extracted from the FinnGen database. The overall effects of each immune traits were assessed via inverse-variance weighted (IVW), weighted median, and MR-Egger methods, and performed extensive sensitivity analyses. Finally, 731 immune cell phenotypes (N = 3,757) were analyzed for their mediating role in the significant causality.
UNASSIGNED: Univariable MR analyses revealed that genetically predicted RA (IVW OR: 1.12, 95% CI: 1.05-1.19, p < 0.001) and MS (IVW OR: 1.06, 95% CI: 1.03-1.10, p = 0.001) were associated with increased risk of TMDs. Two out of 731 immune cell phenotypes were identified as causal mediators in the associations of RA with TMDs, including \"CD25++ CD8+ T cell % CD8+ T cell\" (mediation proportion: 6.2%) and \"CD3 on activated CD4 regulatory T cell\" (5.4%). Additionally, \"CD127 on granulocyte\" mediated 10.6% of the total effect of MS on TMDs. No reverse directions, heterogeneity, and pleiotropy were detected in the analyses (p > 0.05).
UNASSIGNED: This MR study provides new evidence regarding the causal impact of genetic predisposition to RA or MS on the increased risk of TMDs, potentially mediated by the modulation of immune cells. These findings highlight the importance for clinicians to pay more attention to patients with RA or MS when consulting for temporomandibular discomfort. The mediating role of specific immune cells is proposed but needs further investigation.

OBJECTIVE: Few studies investigated the influence of oral parafunctional habits during the COVID-19 pandemic. Since some studies have demonstrated that signs and symptoms of temporomandibular disorder (TMD), as well as psychological alterations, increased during the COVID-19 pandemic lockdown, the aim of this study was to investigate whether social isolation is a situation that increases the prevalence of oral parafunctional habits.
METHODS: This was an observational case-control study. An online survey with questions about TMD symptoms (Diagnostic Criteria Symptom Questionnaire) and oral parafunctional habits (Oral Behaviours Checklist [OBC]) was administered to Brazilian residents at two different times (2020 and 2021). The participants were divided according to social isolation practices into study groups (GI: 2020, n = 507; GIII: 2021, n = 282) and control groups (GII: 2020, n = 98; GIV: 2021, n = 202).
RESULTS: In each group, we evaluated the association of the frequency of oral parafunctional habits with the symptoms of TMD, and we observed that individuals with a greater presence of painful TMD present a greater number of oral parafunctional habits. Despite the literature showing that individuals who practiced social isolation developed more oral parafunctional habits, when analysing the association of the OBC questions in Groups GI × GII and GIII × GIV, only \'sustained talking\' (p = .0022) and \'hold telephone between your hand and shoulders\' (p = .0124) showed a significant difference in GI × GII. Kendall\'s coefficient of concordance revealed that there was a very strong concordance (GI × GII 0.9515 (p = .0087) and GIII × GIV 0.9655 (p = .0074)) between the ranks of the analysed oral parafunctional habits in all groups.
CONCLUSIONS: We can state that Individuals who practiced social isolation did not present more oral parafunctional habits than individuals who did not.

BACKGROUND: Few studies have been conducted on treating temporomandibular disorders (TMDs) with new digital occlusal splints, which has increasingly attracted wide attention.
METHODS: To evaluate the clinical efficacy and quality of life (QoL) of Kovacs digital occlusal splint (KDOS) treatment in patients with TMD.
METHODS: Eighty-nine patients with TMD who were treated using KDOS were analyzed. The patients were divided into three groups according to the Wilkes stage. The clinical symptoms and QoL scores of the patients in each group were recorded before and at least three months after treatment, and the data were statistically analyzed and compared. The relationships between the disease severity, sex, age, and level of QoL before treatment and improvement in the clinical symptoms were analyzed using binary logistic regression.
RESULTS: The mean age and follow-up period of the patients were 28.0 ± 10.4 years and 4.9 ± 2.1 months, respectively. After KDOS treatment, the improvement rates of joint noise and pain were 80.4% and 69.8%, respectively. Additionally, the patients\' maximum mouth opening and global QoL mean scores significantly improved compared to those before treatment (p < 0.001). Binary logistic regression analysis revealed that the factors affecting the improvement in the clinical symptoms were disease severity and level of QoL before treatment.
CONCLUSIONS: KDOS can improve the clinical symptoms and QoL of patients with TMD. Moreover, patients without osteoarthritis and with low pretreatment QoL levels are more likely to demonstrate clinical improvement.
BACKGROUND: The trial was registered with Chinese Clinical Trial Registry (ChiCTR) (ID: ChiCTR2300076518) on 11/10/2023.

BACKGROUND: The authors retrospectively studied the relationship between the morphology and position of the articular disc in magnetic resonance imaging (MRI) and the morphology and position of the condyle in cone beam computed tomography (CBCT), with the purpose for providing reference for clinical diagnosis and treatment of temporomandibular disorders (TMD).
METHODS: Patients with both CBCT and MRI imaging data were studied retrospectively, excluding TMJ tumour, fracture, severe condylar morphological abnormalities, non-intercuspal position, and poor quality images. A total of 744 temporomandibular joints (TMJs) from 372 patients were included, with the mean age of 25.94±11.04Y (75 males and 297 females). T2-weighted image (T2WI) of MRI imagings were used to evaluate disc morphology and disc displacement, while CBCT was obtained to evaluate the condylar bone and sagittal condylar position. Data were analysed by Pearson Chi square test and Spearman correlation coefficient.
RESULTS: THE DISTRIBUTION OF 744 TMJS IS AS FOLLOWS: 1) DISC MORPHOLOGY: contracture (37.1 %) > biconcave (32.9 %) > irregular (18.5 %) > lengthened (11.4 %); 2) disc position: ADDWoR (48.3 %) > NA (26.9 %) > ADDWR (21.6 %) > PDDWR (2.8 %) > PDDWoR (0.4 %); 3) condylar position: concentric (43.7 %) > posterior (37.6 %) > anterior (18.7 %); 4) condylar bone: normal (63.4 %)> abnormal (36.6 %). There were significant differences in the distribution of disc morphology and disc position between the sex (P < 0.05). There were significant differences in the distribution of disc position and condylar morphology amongst the age groups (P < 0.05). There were significant differences in the distribution of disc position, condylar position and condylar morphology amongst disc morphology (P < 0.05), and there were positive correlation between disc position(r = 0.703, P = 0.000), the score of condyle (r = 0.478, P = 0.000) and disc morphology respectively. There were significant differences in the distribution of disc position and condylar position amongst condylar morphology (P < 0.05). There was a positive correlation between disc position and condyle morphology (r = 0.413, P = 0.000), and a negative correlation between condyle position and condyle morphology (r=-0.152, P = 0.000). There were significant differences in the distribution of disc position amongst condylar position (P < 0.05), but there was no linear correlation (P = 0.159).
CONCLUSIONS: The mutual distribution of disc morphology, disc position, condylar morphology and condylar position was statistically significant. Disc displacement did not necessarily lead to condylar bone changes, but 92.7 % TMJs with condylar bone abnormalities had disc displacement.
BACKGROUND: This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).

UNASSIGNED: This study aimed to investigate the effect of a home exercise program on pain and quality of life (QoL) in TMD.
UNASSIGNED: Twenty patients were included in the study. The Group A received both a home exercise program and a physiotherapy program, while only a physiotherapy program was given to the Group B. Pain was measured using the Visual Analogue Scale (VAS) and QoL using the Short-Form 36 (SF-36).
UNASSIGNED: Pain decreased in both groups (p < 0.05). Among the SF-36 domains, bodily pain, vitality and social functioning scores improved in the Group A, while only the bodily pain parameter improved in the Group B (p < 0.05). On between-group comparison, the positive effect on pain and quality of life was greater in the Group A (p < 0.05).
UNASSIGNED: The addition of a home exercise program to the conventional physiotherapy program provided greater improvement in pain and QoL in patients with TMD.

UNASSIGNED: Obstructive Sleep Apnea (OSA) is a temporary airflow obstruction during periods of sleep. Patients with OSA often suffer from poor work performance, compromised sleep quality, and low quality of life which may lead to a life-threatening event. Adequate knowledge and a positive attitude toward OSA among medical and dental practitioners are crucial to the initial diagnosis and treatment.
UNASSIGNED: This study aimed to identify the differences in knowledge and attitude toward OSA between medical and dental practitioners working in North-Eastern Peninsular Malaysia.
UNASSIGNED: A comparative cross-sectional study was performed from February 2020 to February 2021. A total of fifty-two medical practitioners and fifty-two dental practitioners working at university-based outpatient clinics, government health clinics, and oral health clinics located in Kelantan State of Malaysia participated in the study, and data were collected by the structured questionnaire including sociodemographic inquiry and OSAKA questionnaire by non-probability stratified random sampling. The Mann-Whitney U test was used to compare knowledge and attitude scores between the two groups.
UNASSIGNED: The mean age of the respondents was 34.6 years. The current study shows that 92.3% of medical doctors and 96.1% of dental doctors were able to correctly answer the question \"Most of the patients with OSA snore\" a significant finding in our study. Only 1% of medical professionals could answer seventeen questions correctly with a median score of 11, and only 1% of dental professionals could answer sixteen questions correctly with a median score of 9. None of them could provide an accurate answer to all the knowledge questions. Medical and dental practitioners exhibited different knowledge levels on OSA (z- statistics=-4.39, U = 827.00 with p <  0.05, and effect size, r = 0.61). However, no significant differences were found in total knowledge score by gender (p-value>0.05), ethnicity (p-value>0.05), total service years (p-value>0.05), and training attended. In addition, significant differences in attitude levels between medical and dental practitioners have been observed (z-statistics=-3.42, U = 725.00 with p <  0.05, and effect size, r = 0.47). Nevertheless, no significant differences have been seen in total attitude score by ethnicity (p-value >  0.05), total service years (p-value >  0.05), attending training on OSA (p-value >  0.05), and professional status (p-value >  0.05) except gender (p-value <  0.05).
UNASSIGNED: A Significant difference is evident concerning knowledge and attitude toward OSA diagnosis and management between medical and dental practitioners working in North-Eastern Peninsular Malaysia. Medical practitioners in this study recorded a higher knowledge and attitude score compared to dental practitioners.