BACKGROUND: Myofascial pain syndrome (MPS) is a particular type of temporomandibular joint disorder. Research findings comparing various treatment approaches are scarce and controversial. Therefore, this study aimed to compare the effectiveness of ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises in reducing pain intensity and improving mandibular mobility in patients with MPS.
METHODS: It was a single-blind, randomized, parallel-group, active-controlled trial that took place between April 2023 and October 2023 at the Department of Fixed Prosthodontics, Damascus University. Patients older than 18 years old with myofascial pain accompanied by limited jaw opening and pain lasting for at least 6 months were included. Eighty patients were randomly assigned into four groups using online randomization software: ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises. Only outcome assessors were masked to treatment allocation. The exercise regimen was the exercise program for patients with TMD. The following primary outcome measures were considered at the baseline (t0), at the first (t1), second (t2), and fourth (t3) week of treatment, and at the second (t4) and fifth (t5) month of follow-up: pain intensity using the visual analogue scale, maximum interincisal opening, right lateral movement, and left lateral movement measured in millimeters.
RESULTS: The pain level changed from severe to mild at t3 in ultrasound therapy, stabilization splint, and TheraBite device groups. In the masticatory muscle exercises group, it changed to moderate, with a significant difference between ultrasound therapy (p = 0.012) and stabilization splint (p = 0.013) groups. In addition, the mandibular mobility continued to improve at the subsequent follow-up periods (t4 and t5).
CONCLUSIONS: All therapies are equally effective after 5-month follow-up. However, ultrasound therapy and stabilization splints have the benefit of achieving rapid improvement.
BACKGROUND: ISRCTN20833186.

UNASSIGNED: This study aimed to explore the prevalence, signs, and symptoms of different types of TMD (Temporomandibular joint disorders) disorders in Tunisian patients.
UNASSIGNED: A retrospective cross-sectional study was conducted using the clinical records of patients from the Department of Functional Exploration, Pain, and Orofacial Dysfunction of the Dental Clinic of Monastir.
UNASSIGNED: TMD is associated with a female predominance, with a peak prevalence among those aged between 20 and 40 years. Pain and a limited range of motion were significantly more prevalent in women (p = 0.019 and p = 0.012, respectively). Clicking sounds were the most frequent joint noises (38.2 %). Crepitus was more prevalent among older adults (33 %). Of the different types of TMD, disk displacement with reduction was the most prevalent (n = 216, 39 %). Sleep bruxism was more prevalent than awake bruxism (20.7 % VS 9.5 %). Due to the heterogeneous TMD signs and symptoms, patients tend to seek medical attention from various specialties (e.g. neurology and otolaryngology).
UNASSIGNED: The prevalence of different types of TMD, and the different signs and symptoms varied depending on sociodemographic characteristics, such as sex, age and lifestyle. Diagnosis is challenging and TMD may be confused with other orofacial pain conditions.

UNASSIGNED: The aim of the study was to compare pain relief in temporomandibular disorder (TMD) patients with or without lifestyle modification.
UNASSIGNED: This randomized clinical trial was performed on patients with TMD, who did not regularly exercise or listen to music. The participants were allocated into two groups. In the treatment group, the participants were instructed to exercise five times or more per week (30 minutes per session) and listen to the music of their choice five times or more per week (15 minutes per session) for 12 weeks. In the control group, the participants had their usual lifestyle without any modifications. The participants were examined for clicking and crepitus in the joint and maximum mouth opening before and after the intervention. The pain severity was also documented based on a visual analog scale.
UNASSIGNED: Thirty five patients were studied in each group. Twelve weeks after the intervention, the mean pain severity was 2.70 ± 0.73 in the treatment group and 4.63 ± 0.77 in the control group. The results of data analysis demonstrated a significant difference between the two groups regarding the mean pain severity at 12 weeks after the intervention (P <.001).
UNASSIGNED: Lifestyle modification through physical exercise and listening to music may reduce pain in TMD patients.

The Damon system is an effective, less-invasive treatment that provides orthodontic dentists with an adequate biomechanical process, offering a reduction in treatment time; patients with temporomandibular dysfunction present even greater complexity in their clinical picture, relying on clinical and radiographic differential diagnoses to facilitate a good prognosis. The objective was to apply the orthodontic treatment (Damon technique) to stabilize patients with temporomandibular dysfunction. The patient with premature loss of the first lower molars (36 and 46) experienced pathological alterations in the temporomandibular joints (TMJs) (bilaterally). The diagnosis was reached using the clinical history of temporomandibular joint disorders (diagnostic criteria) axis II: moderate pain (VAS) in muscles, moderate stress (Hamilton 51/60), lateral and panoramic cephalic radiographs, magnetic resonance imaging of bilateral TMJ, cephalometry, photographs, and models. Treatment with the Damon system is recommended to recover optimal functional occlusion in a short period, followed by referral for oral rehabilitation as an adjunct to the treatment plan. The verticalization of the second molars, maximum optimal intercuspidation, appropriate overbite and overjet, and pain control in the TMJ were evaluated. Stabilization of the disc condyle complex by eliminating interference and premature points of contact providing cervical/cranio/mandibular balance.

暂无摘要。

Research on myofascial temporomandibular disorder (mTMD) has often focused on potential dysfunction in endogenous pain modulation. However, studies on the specific inhibitory and facilitatory components of endogenous pain modulation using conditioned pain modulation (CPM) and temporal summation of second pain (TSSP) have shown mixed results. This study aimed to 1) examine whether women with mTMD demonstrated efficient CPM compared to controls; 2) explore the association between independent measures of CPM and TSSP in women with mTMD relative to controls; and 3) determine whether resulting modulatory profiles differentially predicted pain intensity among cases. All participants were recruited from dental clinics. Cases were women who met the research diagnostic criteria for mTMD. Controls did not have facial pain on exam and were selected to be sociodemographically similar to cases. CPM and TSSP were assessed via independent psychophysical protocols. CPM was examined in linear mixed models predicting pain thresholds adjusted for age and stratified by TSSP. Mean CPM was estimated at a 2.2 (SD = 2.8) degree increase in pain thresholds (P ≤ .001), similar in cases and controls (P = .67). CPM was less efficient in cases with enhanced TSSP (P = .031), but not in controls. Although the double-pronociceptive profile of both low CPM and high TSSP trended higher among cases than controls, it did not predict higher levels of pain intensity among cases. This study does not support deficient inhibitory endogenous pain modulation in mTMD, but results suggest that inhibitory and facilitatory pain modulation should be examined concomitantly in the study of endogenous pain modulation. PERSPECTIVE: This manuscript presents a novel examination of inhibitory modulation by the level of facilitatory modulation in mTMD. The findings and approach may prove useful for mechanistic researchers studying endogenous pain modulation and clinical researchers seeking to jointly examine conditioned pain modulation and temporal summation in future research on chronic pain.

BACKGROUND: The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD).
METHODS: Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study.
RESULTS: Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = -3.00 for NPRS and -3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS.
CONCLUSIONS: A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.

UNASSIGNED: Conflicting reports from varying stakeholders related to prognosis and outcomes following placement of temporomandibular joint (TMJ) implants gave rise to the development of the TMJ Patient-Led RoundTable initiative. Following an assessment of the current availability of data, the RoundTable concluded that a strategically Coordinated Registry Network (CRN) is needed to collect and generate accessible data on temporomandibular disorder (TMD) and its care. The aim of this study was therefore to advance the clinical understanding, usage, and adoption of a core minimum dataset for TMD patients as the first foundational step toward building the CRN.
UNASSIGNED: Candidate data elements were extracted from existing data sources and included in a Delphi survey administered to 92 participants. Data elements receiving less than 75% consensus were dropped. A purposive multi-stakeholder sub-group triangulated the items across patient and clinician-based experience to remove redundancies or duplicate items and reduce the response burden for both patients and clinicians. To reliably collect the identified data elements, the identified core minimum data elements were defined in the context of technical implementation within High-performance Integrated Virtual Environment (HIVE) web-application framework. HIVE was integrated with CHIOS™, an innovative permissioned blockchain platform, to strengthen the provenance of data captured in the registry and drive metadata to record all registry transaction and create a robust consent network.
UNASSIGNED: A total of 59 multi-stakeholder participants responded to the Delphi survey. The completion of the Delphi surveys followed by the application of the required group consensus threshold resulted in the selection of 397 data elements (254 for patient-generated data elements and 143 for clinician generated data elements). The infrastructure development and integration of HIVE and CHIOS™ was completed showing the maintenance of all data transaction information in blockchain, flexible recording of patient consent, data cataloging, and consent validation through smart contracts.
UNASSIGNED: The identified data elements and development of the technological platform establishes a data infrastructure that facilitates the standardization and harmonization of data as well as perform high performance analytics needed to fully leverage the captured patient-generated data, clinical evidence, and other healthcare ecosystem data within the TMJ/TMD-CRN.

The temporomandibular joint can be affected by various conditions, such as joint dysfunction, degenerative changes, inflammatory processes, infections, tumors, and trauma. The aim of this pictorial essay is to help radiologists identify and describe the main findings on magnetic resonance imaging evaluation of the temporomandibular joint, given that the correct diagnosis is essential for the appropriate treatment of patients with temporomandibular joint disorders.
A articulação temporomandibular pode ser afetada por diversas afecções, como disfunções articulares, alterações degenerativas, doenças inflamatórias ou infecciosas, tumores e trauma. Este ensaio iconográfico visa auxiliar de forma prática o radiologista a identificar e descrever os principais achados nos exames de ressonância magnética da articulação temporomandibular, tendo em vista que o diagnóstico correto das alterações mais comuns é essencial para o tratamento adequado desses pacientes.

OBJECTIVE: Sleep bruxism (SB) can cause damage on teeth, headache and severe pain affecting both sleep and daily functioning. Yet despite the growing interest into bruxism, the underlying clinically relevant biological mechanisms remain unresolved. The aim of our study was to understand biological mechanisms and clinical correlates of SB including previously reported disease associations.
METHODS: We used data from the FinnGen release R9 (N = 377 277 individuals) that are linked with Finnish hospital and primary care registries. We identified 12 297 (3.26%) individuals with International Classification of Diseases (ICD)-10 codes used for SB. In addition, we used logistic regression to examine the association between probable SB and its clinically diagnosed risk factors and comorbidities using ICD-10 codes. Furthermore, we examined medication purchases using prescription registry. Finally, we performed the first genome-wide association analysis for probable SB and computed genetic correlations using questionnaire, lifestyle, and clinical traits.
RESULTS: The genome-wide association analysis revealed one significant association: rs10193179 intronic to Myosin IIIB (MYO3B) gene. In addition, we observed phenotypic associations and high genetic correlations with pain diagnoses, sleep apnea, reflux disease, upper respiratory diseases, psychiatric traits, and also their related medications such as antidepressants and sleep medication (p < 1e-4 for each trait).
CONCLUSIONS: Our study provides a large-scale genetic framework to understand risk factors for SB and suggests potential biological mechanisms. Furthermore, our work strengthens the important earlier work that highlights SB as a trait that is associated with multiple axes of health. As part of this study, we provide genome-wide summary statistics that we hope will be useful for the scientific community studying SB.