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Pitak-Arnnop P, Tangmanee C, Mutirangura W, Apipan B, Auychai P, Meningaud JP, Neff A. What factors predict craniomandibular disorders in severe COVID-19 survivors after prolonged intubation? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e631-e638. [PMID: 35809797 PMCID: PMC9259603 DOI: 10.1016/j.jormas.2022.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 12/19/2022]
Abstract
PURPOSES To estimate and identify predictors of craniomandibular disorders (CMDs) in severe COVID-19 survivors after prolonged intubation ≥ 1 week (SCOVIDS-PI). METHODS This retrospective study enrolled two cohorts of SCOVIDS-PIs with vs. without CMD during a one-year period. The predictor variables were demographic, dental, anesthetic, and laboratory parameters. The main outcome was presence of CMD until six post-PI months (yes/no). Appropriate statistics were computed with α = 95%. RESULTS The sample comprised 176 subjects aged 59.2 ± 17.2 years (range, 27-89; 11.9% with CMDs; 30.1% females). CMDs were significantly associated with (1) bilateral posterior tooth loss (P = 0; number needed to screen [NNS] = 1.6), (2) dentofacial skeletal class II/convex face (P = .01; NNS = 2.2), and (3) peak CRP during intensive care ≥ 40 mg/l (P = .01; NNS = 3.5). With combined predictors, NNS became 2 to 4.3. CONCLUSIONS Three predictors of CMDs in SCOVIDS-PIs: bilateral molar loss, convex face, and CRP ≥ 40 mg/l, indicate CMD screening and/or referral to a CMD specialist, regardless of patients' age, gender, underlying CMDs, or previous dental checkups. Screening ∼2 to 4 "SCOVIDS-PIs with ≥ one predictor" will identify one CMD events/patients during the first six post-PI months.
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Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral and Craniomaxillofacial Plastic Surgery, Faculty of Medicine, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Philipps-University of Marburg, Marburg, Germany.
| | - Chatpong Tangmanee
- Department of Statistics, Chulalongkorn Business School, Chulalongkorn University, Bangkok, Thailand
| | - Wantanee Mutirangura
- Department of Occlusion and Accredited Training Center for Dental Occlusion and Orofacial Pain, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Benjamas Apipan
- Division of Anesthesiology, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Prim Auychai
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive, Esthetic and Maxillofacial Surgery, AP-HP, Faculty of Medicine, Henri Mondor University Hospital, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Plastic Surgery, Faculty of Medicine, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Philipps-University of Marburg, Marburg, Germany,Head of the TMJ Section of the Strasbourg Osteosynthesis Research Group (S.O.R.G), Past President of the European Society of TMJ Surgeons (ESTMJS), Member of the German Association for Functional Diagnostics and Therapy of the TMJ (DGFDT) and of the German Association for Oral and Maxillofacial Surgeons (DGMKG), Germany
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Ahuja K, Pande S, Kaushik R. Perioperative anterior dislocation of temporomandibular joint after use of I-gel. J Anaesthesiol Clin Pharmacol 2021; 37:667-668. [PMID: 35340945 PMCID: PMC8944381 DOI: 10.4103/joacp.joacp_20_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/22/2020] [Accepted: 07/20/2020] [Indexed: 11/04/2022] Open
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Talaván-Serna J, Montiel-Company JM, Bellot-Arcís C, Almerich-Silla JM. Implication of general anaesthetic and sedation techniques in temporomandibular joint disorders - a systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:40-44. [PMID: 28330573 DOI: 10.1016/j.jormas.2016.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest. Of these, 23 (82.14%) were case and case series reports, 4 (14.28%) were longitudinal studies and 1 (3.57%) was a cross-sectional study. General anaesthesia and sedation are risk factors for temporomandibular joint damage because of the drop in muscle tone caused by the drugs employed and because of airway management manoeuvres involving the joint. Joint complications have been described with spontaneous ventilation as well as with ventilation assisted by a face or laryngeal mask and with intubation. They are more frequent in women and/or patients with previous temporomandibular problems. Proper assessment is required both before and after anaesthesia or sedation in order to foresee and avoid or minimize temporomandibular complications. The data should be treated with caution, as the evidence of case and case series reports is not of a high standard and the small number of analytical studies is not entirely comparable. General anaesthesia and sedation techniques can influence the onset of temporomandibular joint disorders. More studies are needed to provide better clinical evidence.
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Affiliation(s)
- J Talaván-Serna
- Department of Anaesthesiology and Reanimation, Ontinyent General Hospital, Avda. Francisco Cerdà, 3, 46870 Valencia, Spain.
| | - J M Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain
| | - C Bellot-Arcís
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain
| | - J M Almerich-Silla
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain
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Duval F, Leroux A, Bertaud V, Meary F, Le Padellec C, Refuveille L, Lemaire A, Sorel O, Chauvel-Lebret D. [Relations between extraction of wisdom teeth and temporomandibular disorders: a case/control study]. Orthod Fr 2015; 86:209-219. [PMID: 26370592 DOI: 10.1051/orthodfr/2015021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 02/02/2015] [Indexed: 06/05/2023]
Abstract
The aim of this study was to assess the impact of extraction of third molars on the occurrence of temporo-mandibular disorders (TMD). A review of the literature and a case-control study have been conducted. The case-control study compares the frequency of extraction of third molars between the sample with TMD (case) and the sample without TMD (control). The proportion of patients who had undergone extractions of wisdom teeth was higher in the case group than in the control group. The difference was statistically significant when patients had undergone extraction of all four wisdom teeth or when the extraction of four wisdom teeth underwent in one sitting or under general anesthesia. The study of patients in case sample shows that all signs of TMD were more common in patients who had undergone extractions in several sessions and under local anesthesia. The temporomandibular joint sounds are significantly more frequent with local anesthesia. In the case group, 85 to 92% of patients have parafunctions and 5 to 11% have malocclusion. This demonstrates the multifactorial etiology of temporomandibular disorders.
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Affiliation(s)
| | | | - Valérie Bertaud
- UMR INSERM 1099 - UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes Cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Fleur Meary
- Laboratoire de Biomatériaux en Site Osseux, UMR CNRS 6226, UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes Cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Clément Le Padellec
- UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes Cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Laura Refuveille
- CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Arnaud Lemaire
- CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Olivier Sorel
- UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes Cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
| | - Dominique Chauvel-Lebret
- Laboratoire de Biomatériaux en Site Osseux, UMR CNRS 6226, UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, Bâtiment 15, 35043 Rennes Cedex, France - CHU de Rennes, Pôle d'Odontologie et de Chirurgie Buccale, 2 place Pasteur, 35000 Rennes, France
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Chung SB, Jeon H, Kim T. Unrecognized Bilateral Dislocation of Temporomandibular Joint during Orotracheal Intubation. JOURNAL OF TRAUMA AND INJURY 2015. [DOI: 10.20408/jti.2015.28.2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sang-Bong Chung
- Department of Neurosurgery, National Medical Center, Seoul, Korea
| | - Hyoungbae Jeon
- Department of Neurosurgery, National Medical Center, Seoul, Korea
| | - Taikwan Kim
- Department of Neurosurgery, National Medical Center, Seoul, Korea
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Pillai S, Konia MR. Unrecognized bilateral temporomandibular joint dislocation after general anesthesia with a delay in diagnosis and management: a case report. J Med Case Rep 2013; 7:243. [PMID: 24139071 PMCID: PMC4016029 DOI: 10.1186/1752-1947-7-243] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/23/2013] [Indexed: 11/15/2022] Open
Abstract
Introduction Anterior bilateral temporomandibular joint dislocation is not an uncommon occurrence and has been reported before. However, its diagnosis can easily be overlooked, especially by clinicians who are unfamiliar with this pathology. Continuous discussion of the pathology is required to prevent delays in diagnosis, which can lead to long-term sequelae for the patient. Case presentation We present the case of a 66-year-old Somali woman who experienced a bilateral anterior temporomandibular joint dislocation after a general anesthetic for an exploratory laparotomy for excision of a pelvic sarcoma. She first presented in the intensive care unit with preauricular pain and an inability to close her mouth, and was initially misdiagnosed and treated for a muscle spasm. The cause of her misdiagnosis was multifactorial - opioid-related sedation, language and cultural barrier, and unfamiliarity with the pathology. Her diagnosis was proven 18 hours after the completion of surgery with a plain X-ray. A manual closed reduction was performed with minimal sedation by oral surgery. Conclusion We provided an in-depth discussion of temporomandibular joint dislocation and suggest a simple test that would prevent delayed diagnosis of temporomandibular joint dislocation in any patient undergoing general anesthesia. A normal mandibular excursion should be tested in every patient after surgery in the postoperative care unit, by asking the patient to open and close their mouth during the immediate postoperative recovery period or passively performing the range of motion test.
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Affiliation(s)
| | - Mojca Remskar Konia
- Department of Anesthesiology, University of Minnesota, B-515 Mayo Memorial Building, 420 Delaware Street SE, Mayo Mail Code 294, Minneapolis, MN 55455, USA.
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Chauvel-Lebret D, Leroux A, Sorel O. [Relations between orthognathic surgery and temporomandibular disorders: a systematic review]. Orthod Fr 2013; 84:169-83. [PMID: 23719245 DOI: 10.1051/orthodfr/2013049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 02/14/2013] [Indexed: 11/14/2022]
Abstract
A painful and dysfunctional temporomandibular joint can be associated with a musculoskeletal anomaly. The multifactorial character of the etiology is now recognized. Among the etiologies, the role of orthognathic surgery is still debated. The analysis of the literature from 2000 to 2011 reveals for most authors a decrease in the frequency and intensity of signs and symptoms after surgery, especially pain and clicking. Risk factors may influence post-surgical results. Studies on patient risk factors such as age, sex, type of dysmorphia are inconclusive. Surgical techniques and the procedure used may have an influence on the development of post-surgical clinical signs and symptoms of temporomandibular disorders.
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Affiliation(s)
- Dominique Chauvel-Lebret
- Laboratoire de Biomatériaux en Site Osseux, UMR CNRS 6226, UFR d'Odontologie, Université de Rennes 1, Université Européenne de Bretagne, 2 avenue du Pr Léon Bernard, bâtiment 15, 35043 Rennes Cedex, France
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Luxation mandibulaire survenant à l’ablation d’un masque laryngé. ACTA ACUST UNITED AC 2010; 29:738-9. [DOI: 10.1016/j.annfar.2010.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/25/2010] [Indexed: 11/21/2022]
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