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.

BACKGROUND: Botulinum toxin type A (BTX-A), produced by the gram-positive anaerobic bacterium Clostridium botulinum, acts by cleaving synaptosome-associated protein-25 (SNAP-25), an essential component of the presynaptic neuronal membrane that is necessary for fusion with the membrane proteins of neurotransmitter-containing vesicles. Recent studies have highlighted the efficacy of BTX-A in treating chronic pain conditions, including lower back pain, chronic neck pain, neuropathic pain, and trigeminal neuralgia, particularly when patients are unresponsive to traditional painkillers. This review focuses on the analgesic effects of BTX-A in various chronic pain conditions, with a particular emphasis on the orofacial region.
CONCLUSIONS: This review focuses on the mechanisms by which BTX-A induces analgesia in patients with inflammatory and temporomandibular joint pain. This review also highlights the fact that BTX-A can effectively manage neuropathic pain and trigeminal neuralgia, which are difficult-to-treat chronic pain conditions. Herein, we present a comprehensive assessment of the central analgesic effects of BTX-A and a discussion of its various applications in clinical dental practice.
CONCLUSIONS: BTX-A is an approved treatment option for various chronic pain conditions. Although there is evidence of axonal transport of BTX-A from peripheral to central endings in motor neurons, the precise mechanism underlying its pain-modulating effects remains unclear. This review discusses the evidence supporting the effectiveness of BTX-A in controlling chronic pain conditions in the orofacial region. BTX-A is a promising therapeutic agent for treating pain conditions that do not respond to conventional analgesics.

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.

OBJECTIVE: This study aimed to conceptualise Temporomandibular disorder (TMD) symptom burden and severity and explored their interrelationships with somatic symptoms and psychological distress.
METHODS: Participants were recruited from a local polytechnic. The quintessential five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) were appraised and extended to evaluate the duration, frequency, intensity and interference of discrete TMD symptoms. Global TMD severity (GS) was computed by totaling the points for all TMD symptoms and dimensions. TMD (TS) and somatic symptom (SS) burden were assessed based on the Somatic Symptoms Scale-8, while psychological distress was measured with the Depression, Anxiety and Stress Scales-21. Statistical analyses were performed using Kruskal-Wallis/Dunn tests and Spearman\'s correlation (α = .05).
RESULTS: Of the 366 eligible participants (mean age 19.1 ± 2.3 years), 51.4% were 5Ts-negative and 48.6% were 5Ts-positive. Among the 5Ts-positive individuals, 25.3%/64.0% were \'bothered a little\' whereas 4.5%/10.7% were \'bothered a lot\' by TMD pain/headache. Correspondingly, 32.6%/12.4%/5.1% were \'bothered a little\' while 2.8%/2.8%/1.1% were \'bothered a lot\' by TMJ sounds/closed/open locking. TS burden was moderate-to-strongly correlated to aggregate symptom duration, frequency, intensity, interference, GS and SS burden (rs = .50-.88). While TS burden and GS were weakly associated with psychological distress (rs = .18-.36), SS burden was moderately related to depression, anxiety and stress (rs = .47-.53).
CONCLUSIONS: TS burden can serve as a proxy for global TMD severity and may be more meaningful than the mere presence of TMD symptoms in clinical and research settings.

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 prevalence of TMD indicates a need to develop new tools that are useful in the case of screening examinations. These methods can support diagnosis at the early stage of the disorder. The purpose of this research was to develop a comprehensive tool that would function as both a database of sounds generated by TMJ and as software which facilitates automated diagnosis. The software would also use the data from the RDC/TMD questionnaire. Such a tool may significantly reduce the time spent by dentists on making manual RDC/TMD diagnoses. Moreover, this solution would enable dentists who do not specialise in TMD to make effective diagnoses. 95 patient took part in the clinical examination: 30 man and 65 females. The mean age of the participants was 33 years. Patients participating in the clinical process were examined according to the Polish version of the RDC/TMD questionnaire (Axis I and Axis II). Subsequently, all subjects were auscultated with an electronic stethoscope. An application has been implemented based on the RDC/TMD diagnostic flow chart. This tool was used for the automated generation of RDC/TMD diagnoses for all patients. As a result of the kind permission and participation of the patients under examination, it was possible to store records of ninety-five people. Each record contains RDC/TMD questionnaire data, auscultation signals and RDC/TMD diagnoses. For the first time, a database was created that has the potential to facilitate further examination. However, the developed system is universal and can therefore be adapted to new DC/TMD criteria.

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。

BACKGROUND: Despite advances in temporomandibular disorders\' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.
OBJECTIVE: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.
METHODS: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.
RESULTS: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.
CONCLUSIONS: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.

OBJECTIVE: Studying the duration of treatment in patients with temporomandibular joint pain dysfunction syndrome, and the relationship of the duration of treatment with the age of the patient at the beginning of therapy.
METHODS: The study was carried out using information from medical records of dental patients, information from additional examinations of patients who were treated at the National Medical Research Centre for Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia from 2016 to 2022. Statistical research methods: to evaluate the normality of the distribution, graphical methods were used, as well as the Shapiro-Wilk criterion.
RESULTS: The duration of splint therapy in patients with temporomandibular joint pain dysfunction syndrome varied from 4 to 27 months. The average duration of treatment of patients using occlusive splints was 10.5±5.3 months. Without abnormal observations, the average duration of splint therapy in patients with TMJ pain syndrome was 9.6±4.1 months. The obtained data allow stating the absence of a correlation between the age of patients and the duration of splint-therapy.
CONCLUSIONS: The majority of patients (68.4%) complete the splint therapy stage within 1 year, and a very small part (1.8%) are treated for more than 1.5 years. The duration of treatment of patients with temporomandibular joint pain dysfunction syndrome does not depend on age or gender.
UNASSIGNED: Изучение сроков лечения у пациентов с синдромом болевой дисфункции височно-нижнечелюстного сустава (БД ВНЧС), а также связи сроков лечения с возрастом пациента на момент начала лечения.
UNASSIGNED: Исследование было проведено с использованием сведений медицинских карт стоматологических больных, данных дополнительных обследований пациентов, которые проходили лечение в клинике ФГБУ НМИЦ «ЦНИИС и ЧЛХ» Минздрава России с 2016 по 2022 г. Статистические методы исследования: для оценки нормальности распределения применялись графические методы, а также критерий Шапиро—Уилка. Для проверки взаимосвязи возраста пациентов и сроков лечения была построена диаграмма рассеяния и вычислен коэффициент корреляции рангов Спирмена.
UNASSIGNED: Продолжительность сплинт-терапии у пациентов с синдромом БД ВНЧС варьировала от 4 до 27 мес. Средний срок лечения пациентов с применением окклюзионных шин составил 10,5±5,3 мес. Без аномальных наблюдений средняя продолжительность сплинт-терапии пациентов с синдромом БД ВНЧС составила 9,6±4,1 мес. Полученные данные позволяют констатировать отсутствие корреляционной зависимости между возрастом пациентов и продолжительностью этапа сплинт-терапии.
UNASSIGNED: Большая часть пациентов (68,4%) завершает этап сплинт-терапии в течение 1 года, и очень небольшая часть (1,8%) лечатся дольше 1,5 года. Продолжительность лечения пациентов с синдромом БД ВНЧС не зависит ни от возраста, ни от пола.