| 1.AUTHOR
| Sheppard-I-M, Sheppard-S-M.
|
| INSTITUTION | Montefiore
Hospital and Medical Center, 111 E. 210th St. Bronx, Ny. 10467. |
| TITLE | Characteristics
of temporomandibular joint problems. |
| SOURCE
| J-Prosthet-Dent 1977 Aug, VOL:
38 (2), P: 180-91, ISSN: 0022-3913. |
| Abstract | A
review of the characteristics of 145 patients with temporomandibular joint and
myofascial pain-dysfunction syndrome is presented. The material includes both
temporomandibular and myofascial involvements. The evidence supports the psychophysiologic
etiology theory for most patients. This does not exclude anatomic abnormalities
which may be present in such patients nor anatomic abnormalities which may be
present without psychogenic causes. The lack of awareness of the range of condylar
movement is contributory to iatrogenic trauma. A classification of etiologic factors
is proposed. The superimposition of one upon another can create a severe problem.
The superimposition of two upon a third can create an unusually severe problem.
Author.
|
| 2.AUTHOR
| Vimpari-S-S, Knuuttila-M-L,
Sakki-T-K, Kivela-S-L. |
| INSTITUTION | Department
of Periodontology and Geriatric Dentistry, University of Oulu, Finland. |
| TITLE | Depressive
symptoms associated with symptoms of the temporomandibular joint pain and dysfunction
syndrome. |
| SOURCE
| Psychosom-Med 1995 Sep-Oct, VOL:
57 (5), P: 439-44, ISSN: 0033-3174. |
| Abstract | This
paper discusses the findings in the 1012 55-year-old inhabitants of Oulu (a medium-sized
Finnish town), 780 of whom (77%) were examined. The purpose was to determine the
possible associations between depressive symptoms and subjective and clinical
symptoms of the temporomandibular joint pain and dysfunction syndrome (PDS). The
PDS symptoms were determined using Helkimo's Clinical Dysfunction Index. Depressive
symptoms in 768 subjects were determined using Zung's self-rating depression scale.
The prevalences of high rates of depressive symptoms, subjective symptoms of PDS,
and clinical symptoms of PDS in the population were 12.2%, 12.0%, and 4.9%, respectively.
Subjective symptoms of PDS were more common in depressed dentate men and women
than in nondepressed dentate men and women. There was a significantly higher prevalence
of subjective symptoms of PDS in depressed edentulous women than in nondepressed
edentulous women. There were significantly more moderate or severe clinical symptoms
of PDS in depressed dentate women than in nondepressed dentate women. A similar
trend was seen in dentate men. An integrated approach is of crucial importance
in the diagnosis and treatment of depression and the temporomandibular joint pain
and dysfunction syndrome. Author.
|
| 3.AUTHOR
| Curran-S-L, Carlson-C-R,
Okeson-J-P. |
| INSTITUTION | Department
of Psychology, College of Dentistry, University of Kentucky, Lexington 40506-0044,
USA. |
| TITLE | Emotional
and physiologic responses to laboratory challenges: patients with temporomandibular
disorders versus matched control subjects. |
| SOURCE | J-Orofac-Pain
1996 Spring, VOL: 10 (2), P: 141-50, ISSN: 1064-6655. |
| Abstract | This
study explored psychologic and physiologic factors differentiating patients with
temporomandibular disorders (n = 23) from sex-, age-, and weight-matched asymptomatic
control subjects. Each subject completed several standard psychologic questionnaires
and then underwent two laboratory stressors (mental arithmetic and pressure-pain
stimulation). Results indicated that patients with temporomandibular disorders
had greater resting respiration rates and reported greater anxiety, sadness, and
guilt relative to control subjects. In response to the math stressor, patients
with temporomandibular disorders reacted with greater anger than did control subjects.
There were no differences between patients with temporomandibular disorders and
control subjects on pain measures or any other measured variable for the pressure-pain
stimulation trial. In addition, there were no differences in electromyography
levels between patients with temporomandibular disorders and control subjects.
The results are discussed in terms of their implications for the etiology and
treatment of this common and debilitating set of disorders. Author.
|
| 4.AUTHOR
| Seligman-D-A, Pullinger-A-G. |
| INSTITUTION | Section
of Diagnostic Sciences and Orofacial Pain, University of California at Los Angeles,
School of Dentistry, USA. |
| TITLE | A
multiple stepwise logistic regression analysis of trauma history and 16 other
history and dental cofactors in females with temporomandibular disorders. |
| SOURCE | J-Orofac-Pain
1996 Winter, VOL: 10 (4), P: 351-61, ISSN: 1064-6655. |
| Abstract | The
simultaneous contribution of 11 occlusal factors, dental attrition severity, orthodontic
history, trauma (motor vehicle accident (MVA) and non-MVA), and age in defining
two independent large populations of females diagnosed with five mutually exclusive
temporomandibular disorders was tested through multiple stepwise logistic regression
analysis. Non-MVA trauma was significant in both groups in defining disc displacement
(DD) with and without reduction, and osteoarthrosis (OA) (both primary and following
DD). Anterior open bite was also a significant factor in defining OA in both groups.
Much smaller contributions were also made by missing teeth in one of the populations
with OA following DD, and by retruded contact position-intercuspal position slide
lengths and overjet in one of the primary OA populations. Motor vehicle accident
trauma was significant in defining myofascial pain (MP) in both populations, and
laterotrusive attrition mildly defined MP in one population. Only a minority of
total variance was explained: 6% to 8% of DD with reduction; 10% to 14% of DD
without reduction; 11% to 20% of OA following DD; 17% to 38% of primary OA; and
4% to 10% of MP. Non-MVA trauma was the major defining feature of the temporomandibular
joint intracapsular disorders, and MVA trauma explained a very small percentage
of the MP patients. Implications are discussed and recommendations are made for
future research. Author.
|
| 5.AUTHOR
| Probert-T-C, Wiesenfeld-D,
Reade-P-C. |
| INSTITUTION | Royal
Melbourne Hospital, Victoria, Australia. |
| TITLE | Temporomandibular
pain dysfunction disorder resulting from road traffic accidents--an Australian
study. |
| SOURCE | Int-J-Oral-Maxillofac-Surg
1994 Dec, VOL: 23 (6 Pt 1), P: 338-41, ISSN: 0901-5027. |
| Abstract | The
relationship between temporomandibular pain dysfunction disorder (TMPD) and trauma
to the head and neck is unclear. A retrospective analysis of the records from
the Transport Accident Commission (TAC) of Victoria, Australia, in the year 1987,
was done to identify those subjects who received treatment for TMPD resulting
from a road traffic accident (RTA). Twenty-eight subjects with TMPD were identified
from a total of 20 673 subjects who claimed health care services from the TAC
for RTA-related disorders. In this study, TMPD for which subjects sought treatment
was uncommonly associated with either direct or indirect trauma to the temporomandibular
joints: 0.4% of subjects with mandibular fractures and 0.5% of subjects with whiplash
injuries presented for treatment of an associated TMPD. Females were found to
present for treatment of TMPD more commonly than males at a ratio of 5:2. It was
also noted that 75% of subjects complained of symptoms of TMPD immediately after
the accident and approximately 96% within 2 months of the accident. Subjects were
not lost to follow-up because all claims for treatment were made to the TAC, regardless
of the clinician involved. In this study, 25% of subjects attended more than one
dentist for management. It was concluded that TMPD for which subjects sought treatment
was an uncommon result of an RTA and was infrequently associated with a mandibular
fracture or whiplash injury. Author.
|
| 6.AUTHOR
| Garcia-R-Jr, Arrington-J-A. |
| INSTITUTION | Department
of Radiology at the University of South Florida College of Medicine, USA. |
| TITLE | The
relationship between cervical whiplash and temporomandibular joint injuries: an
MRI study. |
| SOURCE | Cranio
1996 Jul, VOL: 14 (3), P: 233-9, ISSN: 0886-9634. |
| Abstract | Temporomandibular
joint (TMJ) symptoms are a common finding in motor vehicle accident (MVA) patients
with hyperextension/hyperflexion injuries of the cervical spine (cervical whiplash).
The relationship between cervical whiplash and TMJ injuries was documented with
magnetic resonance imaging (MRI) in 87 consecutive MVA cervical whiplash patients
who presented with TMJ symptoms and had sustained no direct trauma to the face,
head or mandible and had no TMJ complaints prior to the MVA. One hundred sixty-four
TMJ patients were evaluated for internal derangement, effusion and inflammation,
utilizing T1 and T2 weighted images. A high percentage of the TMJ patients demonstrated
abnormal findings: disk displacement with reduction (DDR), 118/164 (72%); disk
displacement without reduction (DDNR), 25/164 (15%); effusion, 113/164 (69%);
inflammation or edema, 84/164 (51%); total TMJ abnormalities, 156/164 (95%). The
high percentage of TMJ abnormalities in this study significantly illustrates the
proximate relationship between cervical whiplash and TMJ injuries. Author.
|
| 7.AUTHOR
| Brady-C, Taylor-D,
O-Brien-M. |
| INSTITUTION | Department
of Anatomy and Bioengineering Research Centre, Trinity College, Dublin, Ireland. |
| TITLE | Whiplash
and temporomandibular joint dysfunction. |
| SOURCE | J-Ir-Dent-Assoc
1993, VOL: 39 (3), P: 69-72, ISSN: 0021-1133 26 Refs. |
| Abstract | This
article examines the relationship between Temporomandibular joint dysfunction
and rear-end (whiplash) motor vehicle accidents. The clinical and statistical
evidence relating TMJ damage to whiplash is reviewed. The sequence of events regarding
the head, neck and jaw movements which occur in these accidents is considered.
The jaw movements are discussed in detail. An analysis of the forces resulting
from these movements indicates that tensile, compressive and shear forces occur
which challenge the integrity of the soft tissues of the Temporomandibular joint.
An overview of the mechanisms whereby damage may occur is considered. A more detailed
analysis of these mechanisms will be dealt with in further articles, to evaluate
the precise magnitude and direction of forces in all phases of the accident. Author.
|
| 8.AUTHOR
| McNamara-J-A-Jr, Turp-J-C. |
| INSTITUTION | Department
of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan,
Ann Arbor 48109-1078, USA. |
| TITLE | Orthodontic
treatment and temporomandibular disorders: is there a relationship? Part 1: Clinical
studies. |
| SOURCE | Fortschr-Kieferorthop
1997, VOL: 58 (2), P: 74-89, ISSN: 0015-816X 89 Refs. |
| Abstract | The
relationship between orthodontic treatment and temporomandibular disorders (TMD)
has long been of interest to the practicing orthodontist, but only during the
last decade or so have a significant number of methodologically-sound clinical
studies been conducted that have investigated this association. The aim of this
paper is to critically review particularly those studies that have been published
since 1989 and to answer the following questions: 1. Does orthodontic treatment
with fixed or removable appliances lead to a greater incidence of TMD? 2. Does
the extraction of premolars as part of an orthodontic treatment plan result in
a greater incidence of TMD? 3. Does orthodontic treatment prevent or cure TMD?
For this purpose, we conducted a MEDLINE search, complemented by a hand search
in selected journals. We found 21 publications of studies related to the orthodontic-TMD
interface. Based on these studies, the following statements can be made: 1. Orthodontic
treatment performed during adolescence does not increase or decrease the chances
of developing TMD later in life. There is no evidence of an elevated risk for
TMD associated with any particular type of orthodontic mechanics. 2. The extraction
of teeth as part of an orthodontic treatment plan does not increase the risk of
TMD. 3. Thus far, there is no compelling evidence that orthodontic treatment prevents
TMD, although the role of unilateral posterior crossbite correction in children
may warrant further investigation. Likewise, there is no convincing evidence that
TMD can be cured by orthodontic treatment. Author.
|
| | |
| 9.AUTHOR
| McNeill-C. |
| INSTITUTION | Department
of Restorative Dentistry, School of Dentistry, University of California, San Francisco,
USA. |
| TITLE | Management
of temporomandibular disorders: concepts and controversies. |
| SOURCE | J-Prosthet-Dent
1997 May, VOL: 77 (5), P: 510-22, ISSN: 0022-3913 106 Refs. |
| Abstract | STATEMENT
OF PROBLEM: Controversy continues in
the area of epidemiology, etiology, diagnosis, and management of temporomandibular
disorders (TMD). The field is replete with testimonials and clinical opinion,
but it has been lacking in scientific foundation. PURPOSE:
This article reviews the recent temporomandibular disorder
and orofacial pain literature and summarizes the concepts published in the 1993
and 1996 American Academy of Orofacial Pain guidelines. Temporomandibular disorders
rarely occur as single entities but rather as multiple problems with overlapping
symptoms. CLINICAL SIGNIFICANCE:
The multicausal nature of these problems and the number
of conditions with similar signs and symptoms demand an effective differential
diagnostic process. Diagnostic criteria are used from an operational standpoint
to establish specific diagnoses based on a multiaxial diagnostic model. CONCLUSION:
Because little is known about the natural course of the
various classifications of temporomandibular disorders, and because most treatment
approaches are reported to be equally effective, a conservative, noninvasive management
program is endorsed. The emphasis is on a medical multidisciplinary model similar
to ones used for other musculoskeletal disorders that involve the patient in the
physical and behavioral management of his or her own problem. This article concludes
that a majority of temporomandibular disorder patients achieve good relief of
symptoms with noninvasive reversible therapy. Author. |
| | |
| 10.AUTHOR
| Goldberg-M-B, Mock-D,
Ichise-M, Proulx-G, Gordon-A, Shandling-M, Tsai-S, Tenenbaum-H-C. |
| INSTITUTION | Department
of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada. |
| TITLE | Neuropsychologic
deficits and clinical features of posttraumatic temporomandibular disorders. |
| SOURCE | J-Orofac-Pain
1996 Spring, VOL: 10 (2), P: 126-40, ISSN: 1064-6655. |
| Abstract | Previous
studies have shown that characteristics of posttraumatic temporomandibular disorders
(pTMD) differ considerably from those of nontraumatic or idiopathic temporomandibular
disorders (iTMD). Both the rate of recovery and the amount of treatment required
appear to be different for both groups. In this blinded study, 14 patients with
iTMD and 13 patients with pTMD were examined. Patients submitted to a variety
of reaction-time tests and neuropsychologic assessments to test their ability
to cope with simple and more complex tasks with and without a variety of cognitive
interferences. Clinical examination was used to assess signs of TMD. Eleven of
the subjects (six iTMD, five pTMD) consented to a second phase of the investigation,
whereby the patients were studied with single-photon emission computerized tomography
(SPECT) using 99mTc- hexamethylpropyleneamineoxime (HMPAO). For simple and complex
reaction-time tests, the pTMD group was significantly slower than the iTMD group
(P < .05 to P < .001). Other neuropsychologic assessment tools such as the
Consonant Trigram Test and the California Verbal Learning Test indicated that
pTMD patients were more affected by both proactive and retroactive interferences
and were more likely to perseverate on a single thought. In clinical examination,
pTMD patients demonstrated greater reaction to muscle palpation than did i TMD
patients (P < .05). The SPECT results suggested that there were mild differences
between the two populations, and further ther studies are required to confirm
this finding. The results lend support to the concept that there are differences
between pTMD and i TMD populations. It is suggested that although patients with
pTMD may have some similarities to those with iTMD, the former population may
benefit from being handled somewhat differently and should be assessed and treated
using a more broad, multidisciplinary treatment paradigm. These results must be
confirmed in studies of larger populations.Author.
|
| 11.AUTHOR
| Kolbinson-D-A, Epstein-J-B,
Burgess-J-A. |
| INSTITUTION | Department
of Diagnostic and Surgical Sciences, University of Saskatchewan College of Dentistry,
Saskatoon, Canada. |
| TITLE | Temporomandibular
disorders, headaches, and neck pain following motor vehicle accidents and the
effect of litigation: review of the literature. |
| SOURCE | J-Orofac-Pain
1996 Spring, VOL: 10 (2), P: 101-25, ISSN: 1064-6655 84 Refs. |
| Abstract | A
literature review concerning the relationships between motor vehicle accidents
and temporomandibular disorders, whiplash, headache, neck pain, and litigation
was undertaken. The review shows that many patients recover or resume work prior
to settlement, but most unsuccessfully treated patients do not generally recover
following the settlement of legal claims; the postinjury problems are not strictly
psychologic. Litigating patients and nonlitigating patients are often not dramatically
different in most important regards (including pain and return to work), with
litigating patients deserving the same treatment as other patients with chronic
pain. It was found that postinjury neck symptoms and headaches can be persistent.
Employment appears to be a better predictor of long-term outcome than compensation
and litigation. In addition, limited consensus is available concerning prognostic
factors. Patients with postinjury temporomandibular disorders tend to respond
less well to treatment than do noninjury patients with temporomandibular disorders,
as do litigating compared to nonlitigating temporomandibular disorders patients,
but a cause and effect relationship is not known. The incidence of temporomandibular
disorders following motor vehicle accidents may not be as high as has been claimed
in whiplash cases. More research is required in the area of temporomandibular
disorders, motor vehicle accidents, and litigation. Author. |