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A Decade of Complications Following Total Temporomandibular Joint Reconstruction (TJR) in a Patient with Ehlers-Danlos Syndrome. Another Surgical Misadventure or An Absolute Contraindication for TJR?

J Oral Maxillofac Surg 2021 May 19. Epub 2021 May 19.

Associate Professor of Surgery, Chief of Oral & Maxillofacial Surgery, University of Cincinnati, Department of Surgery, Division of Oral & Maxillofacial Surgery, Cincinnati, OH. Electronic address:

This report describes an extensive surgical journey for a patient with Ehlers-Danlos syndrome (EDS) who underwent a total temporomandibular joint reconstruction and illustrates an ongoing challenge for oral and maxillofacial surgeons treating patients with connective tissue disorders and managing chronic pain symptoms. The surgical team attempted multiple procedures including 2 failed total temporomandibular joint replacements and a myocutaneous vascularized free flap. This case demonstrates the potential for postoperative complications in patients with Ehlers-Danlos syndrome. Read More

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Mechanical Loading Disrupts Focal Adhesion Kinase Activation in Mandibular Fibrochondrocytes During Murine TMJ Osteoarthritis.

J Oral Maxillofac Surg 2021 May 13. Epub 2021 May 13.

Adjunct Professor, Department of Bioengineering, University of Illinois at Chicago, Chicago, IL; Professor and Head, Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, Chicago, IL.

Purpose: Mechanical overloading is a key initiating condition for temporomandibular joint (TMJ) osteoarthritis (OA). The integrin-focal adhesion kinase (FAK) signaling axis is implicated in the mechanobiological response of cells through phosphorylation at Tyr397 (pFAK) but poorly defined in TMJ health and disease. We hypothesize that mechanical overloading disrupts TMJ homeostasis through dysregulation of FAK signaling. Read More

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Risk Factors Associated With Poor Outcomes Following Temporomandibular Joint Discectomy and Fat Graft.

J Oral Maxillofac Surg 2021 May 19. Epub 2021 May 19.

Melbourne Dental School, University of Melbourne, Parkville, Australia; Maxillofacial Surgery Unit, Epworth-Freemasons Hospital East Melbourne, Melbourne, Australia.

Purpose: Temporomandibular joint (TMJ) discectomy is performed for patients with degenerative joint disease with an unsalvageable disc, but with a salvageable condylar head and glenoid fossa. The purpose of this study was to estimate the incidence and risk factors associated with poor postoperative outcomes following TMJ discectomy and abdominal fat grafting.

Methods: A retrospective cohort study was conducted on patients who underwent TMJ discectomy. Read More

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Physical therapist guided active intervention of chronic temporomandibular disorder presenting as ear pain: A case report.

Physiother Theory Pract 2021 Jun 21:1-13. Epub 2021 Jun 21.

Rehabilitation Department, Pantai Jerudong Park Medical Centre, Brunei Darussalam.

This case report describes the successful physical therapy management of a 40-year-old female who presented with left ear pain referred from the temporomandibular joint. Diagnosis was primarily based on clinical examination findings and ruling out of red flags. Guidance was given on active self-care approaches consisting of pain neuroscience education designed with individualized pain curriculum, exercise therapy, manual therapy, and breathing exercises for a period of  sixweeks. Read More

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Granulomatous Mucormycosis of the Temporal Bone extending Into Temporomandibular Joint and Infratemporal Fossa: A Case Report.

Ear Nose Throat J 2021 Jun 21:1455613211022079. Epub 2021 Jun 21.

ENT institute and Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China.

Mucormycosis of temporal bone is extremely rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal. We performed a literature review and found only 10 reported cases of temporal bone mucormycosis. Read More

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Conceptualizing the clinical decision-making process in managing temporomandibular disorders: A qualitative study.

Eur J Oral Sci 2021 Jun 17:e12811. Epub 2021 Jun 17.

School of Dental Sciences, Newcastle University, Newcastle, UK.

Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision-making process in TMD management, and thereby to conceptualize the decision-making process in dentistry. Individual semi-structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. Read More

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Number and type of temporomandibular disorder symptoms: their associations with psychological distress and oral health-related quality of life.

Oral Surg Oral Med Oral Pathol Oral Radiol 2021 May 12:4624. Epub 2021 May 12.

Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China. Electronic address:

Objective: In this case-control study, we investigated the presence of differing numbers and types of temporomandibular disorder (TMD) symptoms, their association with psychological distress, and their impact on oral health-related quality of life (OHRQoL).

Study Design: We recruited a total of 814 participants with TMD and 147 control subjects. The participants were instructed to complete the Diagnostic Criteria for Temporomandibular Disorders Symptom Questionnaire; the Depression, Anxiety and Stress Scale-21; and the Oral Health Impact Profile-Temporomandibular Disorders. Read More

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Comparison of stress distribution of TMJ with different mandibular deformities under incisal clenching.

Comput Methods Biomech Biomed Engin 2021 Jun 18:1-8. Epub 2021 Jun 18.

Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China.

Temporomandibular joint (TMJ) is an important and complex joint in the human body. It is necessary to explore the biomechanical influence on the TMJs caused by different mandibular deformities. The maxillofacial models from 34 subjects were built to analyze the maximum and minimum principal stresses of the TMJs in the control group and three test groups. Read More

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Differential gene expression response of synovial fibroblasts from temporomandibular joints and knee joints to dynamic tensile stress.

J Orofac Orthop 2021 Jun 17. Epub 2021 Jun 17.

Department of Orthodontics, University Medical Centre of Regensburg, Regensburg, Germany.

Purpose: Apart from other risk factors, mechanical stress on joints can promote the development of osteoarthritis (OA), which can also affect the temporomandibular joint (TMJ), resulting in cartilage degeneration and synovitis. Synovial fibroblasts (SF) play an important role in upkeeping joint homeostasis and OA pathogenesis, but mechanical stress as a risk factor might act differently depending on the type of joint. We thus investigated the relative impact of mechanical stress on the gene expression pattern of SF from TMJs and knee joints to provide new insights into OA pathogenesis. Read More

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Electromyographic changes in masseter and sternocleidomastoid muscles can be applied to diagnose of temporomandibular disorders: An observational study.

Integr Med Res 2021 Dec 16;10(4):100732. Epub 2021 May 16.

Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.

Background: The diagnosis of temporomandibular disorders (TMDs) is an important part of the functional cerebrospinal technique (FCST). In addition, surface electromyography (sEMG) is an important candidate for diagnosing TMD. In FCST, despite the importance of the cranio-cervical-mandibular system, few sEMG parameters consider TMDs. Read More

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December 2021

Differences between the temporal and mandibular components of the temporomandibular joint in topographic distribution of osseous degenerative features on cone-beam computerized tomography.

J Dent Sci 2021 Jul 3;16(3):1010-1017. Epub 2021 Mar 3.

Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.

Background/purpose: Temporomandibular joint osteoarthritis (TMJOA) pathology is characterized by degenerative changes of the subchondral bone. The topographic distribution of osseous degenerative changes in TMJ is not clear. This study aimed to evaluate the topographic distribution of osseous degenerative features in the TMJ by using cone-beam computerized tomography (CBCT). Read More

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Clinical characteristics of temporomandibular disorders presenting posterior open bite - A report of 12 cases.

J Dent Sci 2021 Jul 6;16(3):861-867. Epub 2021 Jan 6.

Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.

Background/purpose: There is a paucity of comprehensive information about posterior open bite (POB) in patients with temporomandibular disorders (TMD) because of its rare prevalence. The purpose of this study was to investigate the etiologies, clinical characteristics, and treatment outcomes of patients with TMD presenting POB.

Materials And Methods: This study includes a careful review of medical records and imaging findings of 12 patients with TMD (seven men and five women, 50. Read More

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Ultrasound is Effective to Treat Temporomandibular Joint Disorder.

J Pain Res 2021 10;14:1667-1673. Epub 2021 Jun 10.

Department of Ultrasound, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, People's Republic of China.

Background: Temporomandibular joint disorder (TMD) affects millions of people. It is unclear if low intensity ultrasound (US) is effective to treat TMD.

Methods: A total of 160 patients with TMD were enrolled in this study. Read More

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Vertical Dimension of Occlusion: A comparative study between Anthropometric and Knebelman's craniometric methods.

Acta Odontol Latinoam 2021 Apr;34(1):43-49

Universidad Católica de Cuenca, Facultad de Odontología, Azogues, Ecuador.

The masticatory system changes as time passes. The vertical dimension of occlusion (VDO) undergoes alterations due to temporomandibular joint disorders which in turn may be caused by related muscle modifications or pathological tooth wear. There are many methods to measure VDO. Read More

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Research progress on tissue engineering in repairing tempomandibular joint.

Zhejiang Da Xue Xue Bao Yi Xue Ban 2021 Apr;50(2):212-221

Hospital.

Temporomandibular joint osteoarthritis (TMJOA) is mainly manifested as perforation of temporomandibular joint disc (TMJD) and destruction of condylar osteochondral complex (COCC). In recent years, tissue engineering technology has become one of the effective strategies in repairing this damage. With the development of scaffold material technology, composite scaffolds have become an important means to optimize the performance of scaffolds with the combined advantages of natural materials and synthetic materials. Read More

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Temporomandibular disorders in an adult population in northern Norway: A cross-sectional study.

Clin Exp Dent Res 2021 Jun 16. Epub 2021 Jun 16.

The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.

Objectives: The aim of the study was to assess the prevalence of symptoms indicative of temporomandibular disorders (TMD) in an adult population in Troms County in Northern Norway, as well as the associations between TMD and socio-demographic factors, dental status, self-reported general, and oral health as well as oral health related quality of life (OHQoL).

Methods: Data were collected from a structured questionnaire and a clinical examination of a random sample of almost 2000 adults, 20-79-year-old, in Troms County in Northern Norway.

Results: Women had a higher prevalence of all self-reported and clinical signs of pain and dysfunction in the temporomandibular complex compared to men. Read More

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A simplified CAD/CAM extraoral surgical guide for therapeutic injections.

J Dent Anesth Pain Med 2021 Jun 1;21(3):253-260. Epub 2021 Jun 1.

School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.

Therapeutic injections into the craniofacial region can be a complex procedure because of the nature of its anatomical structure. This technical note demonstrates a process for creating an extra-oral template to inject therapeutic substances into the temporomandibular joint and the lateral pterygoid muscle. The described process involves merging cone-beam computed tomography data and extra-oral facial scans obtained using a mobile device to establish a correlated data set for virtual planning. Read More

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Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis.

J Dent Anesth Pain Med 2021 Jun 1;21(3):183-205. Epub 2021 Jun 1.

Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA.

This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. Read More

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Validation of the Temporomandibular Disorder Pain Screener in a Specialized Headache Center.

J Oral Facial Pain Headache 2021 Spring;35(2):150-156

Aims: To investigate the sensitivity and specificity of the TMD pain screener in a headache population.

Methods: A cross-sectional study was conducted at the Danish Headache Center (DHC). Patients were included if they had primary or secondary headache, trigeminal neuralgia, or facial pain. Read More

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Headache Attributed to Temporomandibular Disorders: Axis I and II Findings According to the Diagnostic Criteria for Temporomandibular Disorders.

J Oral Facial Pain Headache 2021 Spring;35(2):119-128

Aims: To analyze Axis I and II findings of patients diagnosed as having painful temporomandibular disorder (TMD) with headache attributed to TMD (HAattrTMD) in order to assess whether HAattrTMD is associated with a specific Axis I and II profile suggestive of the central sensitization process.

Methods: This retrospective study included 220 patients with painful TMD divided into those with (n = 60) and those without (n = 160) HAattrTMD, and the patients were compared for Axis I and II results according to the Diagnostic Criteria for TMD (DC/TMD). A P value < . Read More

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Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up.

J Oral Facial Pain Headache 2021 Spring;35(2):113-118

Aims: To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up.

Methods: A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to manage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. Read More

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An investigation of biomechanics, muscle performance, and disability level of craniocervical region of individuals with temporomandibular disorder.

Cranio 2021 Jun 15:1-11. Epub 2021 Jun 15.

Department of Physical Medicine & Rehabilitation, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey.

Objective: To investigate biomechanics, muscle performance, and disability of the craniocervical region in temporomandibular disorder (TMD) patients and compare them with controls.

Methods: Craniocervical posture was evaluated using lateral photography and radiography. Range of motion, muscle performance, disability, and TMD severity were assessed using an inclinometer, Functional Strength Testing of Cervical Spine, Neck Disability Index, and Fonseca Anamnestic Index, respectively. Read More

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Integrative Medicine: Manual Therapy.

FP Essent 2021 Jun;505:11-17

F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.

Manual therapy, or manipulative therapy, is performed primarily by osteopathic physicians, chiropractors, and physical therapists to relieve pain and improve function. As safe prescribing of opioids has become a concern and nondrug therapies for pain management are used more widely, manual therapy has become an attractive treatment option for many patients. A variety of techniques are used, including myofascial release, strain-counterstrain, muscle energy, high velocity/low amplitude, Still, and others. Read More

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Treatment effects of Carriere Motion Appliance on patients with class II malocclusion: A systematic review and meta-analysis.

Int Orthod 2021 Jun 11. Epub 2021 Jun 11.

University of Damascus Dental School, Department of Orthodontics, Damascus, Syria.

Objective: To investigate the treatment effects of Carriere Motion Appliance (CMA) on class II patients.

Methods: A comprehensive electronic search was performed in PubMed, Scopus, Web of science, ScienceDirect, ProQuest (dissertation and thesis), Google Scholar and ClinicalTrials.gov. Read More

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Mineral deposition intervention through reduction of phosphorus intake suppresses osteoarthritic lesions in temporomandibular joint.

Osteoarthritis Cartilage 2021 Jun 11. Epub 2021 Jun 11.

State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of Oral Anatomy and Physiology and TMD, School of Stomatology, the Fourth Military Medical University. Electronic address:

Objective: To explore the suppressing impact of low phosphorus intake on osteoarthritic temporomandibular joint and the possible mechanisms of nuclear acid injury in the insulted chondrocytes.

Design: Chondrocytes were loaded with fluid flow shear stress (FFSS) with or without low phosphorus medium. Seventy-two mice (sampled at 3-, 7- and 11-wk, n = 6) and forty-eight rats (sampled at 12-wks for different testing purpose, n = 6) were applied with unilateral anterior crossbite (UAC) with or without low phosphorus diet. Read More

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Alloplastic Temporomandibular Joint Replacement in Patients With Systemic Inflammatory Arthritis and Connective Tissue Disorders.

J Oral Maxillofac Surg 2021 May 8. Epub 2021 May 8.

Assistant Professor, University of Toronto Department of Oral and Maxillofacial Surgery; Co-founder, Sinai Health System Centre for Excellence in TMJ Surgery; Co-director, University of Toronto Fellow ship Program in Advanced TMJ and Orthognathic Surgery.

Purpose: We present a retrospective study to report the outcomes of total temporomandibular joint (TMJ TJR) replacement with alloplastic devices in patients suffering from systemic inflammatory arthropathies.

Methods: A total of 39 patients with a diagnosis of rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PA), juvenile idiopathic rheumatoid arthritis (JIA), or systemic lupus, underwent alloplastic total joint replacement(s) (TJR) from 1999 to 2019. Maximal interincisal opening (in mm) was recorded before surgery (T0), at 1-year post-surgery (T1) and at last follow-up (T2). Read More

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Synovial entrapment in alloplastic temporomandibular joint replacement.

Int J Oral Maxillofac Surg 2021 Jun 7. Epub 2021 Jun 7.

Instituto Português da Face, Lisboa, Portugal.

Complications of alloplastic temporomandibular joint (TMJ) prostheses can lead to stress and anxiety for the patient and the surgical team, and prosthesis substitution is sometimes required. The aim of this case report is to describe the surgical finding of synovial entrapment with interposed fibrosis in a postoperative alloplastic TMJ revision, managed effectively with adequate surgical debridement. The authors believe that synovial entrapment needs to be considered as a possible postoperative complication of total joint replacement when no clear symptoms of infection, metal hypersensitivity, osteolysis, or heterotopic bone formation are present. Read More

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Oral manifestations in chikungunya patients: A systematic review.

PLoS Negl Trop Dis 2021 Jun 10;15(6):e0009401. Epub 2021 Jun 10.

Postgraduate Program in Family Health/Professional Master in Family Health, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.

Background: Chikungunya fever is considered an abrupt onset arbovirus transmitted by mosquitoes, mainly Aedes aegypti and Aedes albopictus. The disease has a significant impact on the quality of life of affected persons, and many of its numerous symptoms have not yet been properly clarified, such as the manifestations that can occur in the oral cavity. The aim of this study was to identify the main oral manifestations related to chikungunya fever, as well as describe the demographic characteristics of patients, by conducting a systematic review of the literature. Read More

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[Clinical study of modified posterior dental splint in the treatment of anterior disk displacement without reduction of the temporomandibular joint].

Shanghai Kou Qiang Yi Xue 2021 Apr;30(2):210-213

Department of Temporomandibular Joint Disorders, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University. Guangzhou 510140, Guangdong Province, China.

Purpose: To investigate the clinical effect of modified posterior dental splint in the treatment of anterior disk displacement without reduction of the temporomandibular joint (TMJ).

Methods: Eight-nine patients with anterior disk displacement without reduction of the TMJ who were treated in Stomatology Hospital of Guangzhou Medical University from October 2016 to October 2017 were selected in the study. 47 patients in the first group were treated by modified posterior dental splint, while 42 patients in the second group were treated by stabilization splint. Read More

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[Control study of forward head posture between patients with temporomandibular disorders and healthy people].

Shanghai Kou Qiang Yi Xue 2021 Apr;30(2):173-176

Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China.

Purpose: To investigate the difference of forward head posture between patients with temporomandibular disorders(TMD) and healthy people.

Methods: Ninety-one TMD patients (18 males and 73 females) were recruited from the Department of Rehabilitation; Meanwhile, eighty-three healthy participants(20 males and 63 females)were recruited. A digital camera was used to capture images of the sagittal plane of the head and neck and upper thorax. Read More

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