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Lekaviciute R, Kriauciunas A. Relationship Between Occlusal Factors and Temporomandibular Disorders: A Systematic Literature Review. Cureus 2024; 16:e54130. [PMID: 38487145 PMCID: PMC10939299 DOI: 10.7759/cureus.54130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Temporomandibular disorders (TMD) originate from various components within the temporomandibular joint (TMJ), causing an impact on the masticatory muscles, the joint itself, and associated structures. They are a widely prevalent issue across the world. According to epidemiological research, up to 50% of adults in the population have TMD-related symptoms. The objective of this work was to analyze the existing scientific literature regarding the association between malocclusion classes, bruxism, and tooth loss in relation to the etiology of TMD. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 analysis protocol. For the development of the question focus, the population, intervention, control, and outcomes (PICO) study design protocol was used. The question in focus according to the PICO format was: "Do malocclusion, tooth loss, and bruxism contribute to temporomandibular disorders?". The review was performed with articles from PubMed, Web of Science, and Google Scholar databases according to the specified inclusion and exclusion criteria. The included articles were not older than five years. The risk of bias was assessed in the included studies by using the Cochrane Risk-of-bias 2 (RoB-2) tool. Out of a total of 32 results received, 21 articles were chosen according to the established criteria after conducting a review and analysis of their full texts. The article search sequence was presented in the PRISMA 2020 flow diagram, and the outcomes of the chosen articles were presented. The literature results revealed a relationship between occlusion and the development of TMD. The influence of occlusal factors on the TMJ was explained by an examination of joint anatomy and symptoms related to TMD. This study revealed variations in TMJ factors across different malocclusion classes. Additionally, it was observed that the occurrence and attributes of TMD are influenced by the number of tooth loss quadrants and the frequency of missing teeth. Furthermore, a correlation was found between bruxism and the symptoms of TMD, including myofascial pain, disc displacement, arthralgia, and muscle disorders. This literature review provides comprehensive information on the relationship between malocclusion classes, bruxism, tooth loss, and TMDs. This prompts healthcare professionals to prioritize patients' occlusal assessment and TMJ condition.
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Affiliation(s)
- Roberta Lekaviciute
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
| | - Albertas Kriauciunas
- Faculty of Odontology, Clinic of Dental and Maxillofacial Orthopaedics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, LTU
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Bargellini A, Castroflorio T, Graziano V, Cugliari G, Deregibus A. Effects on Sleep Bruxism Activity of Three Different Oral Appliances: One Year Longitudinal Cohort Study. Curr Drug Deliv 2024; 21:1151-1159. [PMID: 35598244 DOI: 10.2174/1567201819666220519123754] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Different oral appliances (OAs) have been proposed to control sleep bruxism (SB) detrimental effects on the stomatognathic system. OBJECTIVE The aim of the study was to evaluate the effect of different OAs on SB activity and masticatory muscle activity (sMMA) measured by EMG. METHODS This longitudinal cohort study was conducted on 51 patients (21 M, 30 F, mean age 26,5 ± 3,5) suffering from SB diagnosed with a validated portable EMG-ECG holter and wearing different OAs: occlusal splints, functional appliance with metallic bites and clear aligners followed after 1 week, 1 month, 3 months, 6 months and 12 months from delivery. A control group of 16 non-treated SB patients (6 M, 10 F mean age 27,1 ± 1,4) was used as a reference. A multiple regression analysis was performed to estimate the differences between groups. The level of significance was set as P value <0,05. RESULTS Occlusal splint reduced sleep bruxism index after 1 week, 3, 6 and 12 months from delivery while functional appliance only after 12 months. Occlusal splints reduced general phasic contractions only in the first week and sleep bruxism-related phasic contractions at 1 week, 3 and 6 months after delivery with no significant reductions after 12 months. Patients wearing clear aligners showed a reduction in general tonic contractions after 6 and 12 months. CONCLUSION Resin and metal bites can reduce sleep bruxism index, while resin bites can reduce sleep bruxism-related phasic contractions. Clear aligners do not influence sleep bruxism index but can reduce tonic contractions.
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Affiliation(s)
- Andrea Bargellini
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
| | - Tommaso Castroflorio
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
| | - Vanessa Graziano
- Department of Surgical Sciences, Dental School, University of Torino, Torino, Italy
| | | | - Andrea Deregibus
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
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Lee YJ, Lim C, Lim S, Cho S. Tooth-Cutting-Induced Maxillary Malocclusion Exacerbates Cognitive Deficit in a Mouse Model of Vascular Dementia. Brain Sci 2023; 13:brainsci13050781. [PMID: 37239252 DOI: 10.3390/brainsci13050781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Treatments to restore the balance of the temporomandibular joint (TMJ) are performed in the field of complementary and alternative medicine; however, evidence supporting this approach remains weak. Therefore, this study attempted to establish such evidence. Bilateral common carotid artery stenosis (BCAS) operation, which is commonly used for the establishment of a mouse model of vascular dementia, was performed, followed by tooth cutting (TEX) for maxillary malocclusion to promote the imbalance of the TMJ. Behavioural changes, changes in nerve cells and changes in gene expression were assessed in these mice. The TEX-induced imbalance of the TMJ caused a more severe cognitive deficit in mice with BCAS, as indicated by behavioural changes in the Y-maze test and novel object recognition test. Moreover, inflammatory responses were induced via astrocyte activation in the hippocampal region of the brain, and the proteins involved in inflammatory responses were found to be involved in these changes. These results indirectly show that therapies that restore the balance of the TMJ can be effectively used for the management of cognitive-deficit-related brain diseases associated with inflammation.
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Affiliation(s)
- Young-Jun Lee
- Lee Young Jun Clinic of Korean Medicine, Institute of TMJ Integrative Medicine, Cheonan 31141, Republic of Korea
| | - Chiyeon Lim
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
- College of Medicine, Dongguk University, Goyang 10326, Republic of Korea
| | - Sehyun Lim
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
- School of Public Health, Far East University, Eumseong 27601, Republic of Korea
| | - Suin Cho
- School of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
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Thomas DC, Singer SR, Markman S. Temporomandibular Disorders and Dental Occlusion: What Do We Know so Far? Dent Clin North Am 2023; 67:299-308. [PMID: 36965932 DOI: 10.1016/j.cden.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Throughout the recorded history in the literature of temporomandibular disorders (TMD) there have been a variety of opinions as to its primary cause. Those supporting an occlusal basis of TMD opined that occlusal dysfunction is either the primary cause for or a significant etiopathogenic factor in the causation of TMD. Most of the current literature, however, points to evidence in another direction and questions the causal role of occlusion and occlusal disharmony in TMD etiopathogenesis. Recognition of this evidence-based literature is paramount in eliminating and preventing the chances of overtreatment of patients with TMD.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY 14642, USA.
| | - Steven R Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
| | - Stanley Markman
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA
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Wu J, Huang Z, Chen Y, Chen Y, Pan Z, Gu Y. Temporomandibular disorders among medical students in China: prevalence, biological and psychological risk factors. BMC Oral Health 2021; 21:549. [PMID: 34702237 PMCID: PMC8549286 DOI: 10.1186/s12903-021-01916-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/12/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The purpose of the present study is to evaluate the prevalence of temporomandibular disorders (TMD) and their associated biological and psychological factors in Chinese university students. METHODS A total of 754 students were included from Zunyi Medical University, each participant completed questionnaires and clinical examinations according to the Diagnostic Criteria for Temporomandibular Disorders. RESULTS The overall prevalence of TMD was 31.7% among medical students. Subjects with TMD had a high prevalence of bruxism, empty chewing, unilateral chewing, chewing gum, anterior teeth overbite, anterior teeth overjet, depression, anxiety, and sleep disturbance. Moreover, sleep bruxism, empty chewing, unilateral chewing, anterior teeth overbite, depression, and anxiety were the strongest risk factors for TMD. CONCLUSIONS Individuals with TMD have a high prevalence of psychological distress and oral parafunctional habits. Except for the psychological factors associated with TMD, bruxism, abnormal chewing, and malocclusion also shared similar risks for TMD.
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Affiliation(s)
- Jing Wu
- Department of Stomatology, Huzhou Traditional Chinese Medicine Hospital, Zhejiang Chinese Medicinal University, Huzhou, Zhejiang, China
| | - Zelun Huang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yong Chen
- Department of Stomatology, Stomatological Hospital of Honghuagang, Zunyi, Guizhou, China
| | - Yifan Chen
- Department of Stomatology, Huzhou Traditional Chinese Medicine Hospital, Zhejiang Chinese Medicinal University, Huzhou, Zhejiang, China
| | - Zhongqiang Pan
- Department of Acupuncture, Huzhou Traditional Chinese Medicine Hospital, Zhejiang Chinese Medicinal University, Huzhou, Zhejiang, China
| | - Yu Gu
- Department of Stomatology, Zhuhai Campus of Zunyi Medical University, 368 Jinwan Road, Zhuhai, 519041, Guangdong Province, China.
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The Prevalence of Temporomandibular Disorders and Dental Attrition Levels in Patients with Posterior Crossbite and/or Deep Bite: A Preliminary Prospective Study. Pain Res Manag 2021; 2021:8827895. [PMID: 33628356 PMCID: PMC7895576 DOI: 10.1155/2021/8827895] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/18/2022]
Abstract
Background The prevalence of various temporomandibular disorders (TMD) and the severity of attrition in patients with either bilateral or unilateral deep bite and/or posterior crossbite has not been established, nor has the effect of one year of orthodontic treatment on TMD. Methods Of 310 patients presenting with suspected TMD, 160 were diagnosed with various TMD and 150 were TMD-free. Diagnosis was according to the Axis I of the Diagnostic Criteria for TMD. All participants underwent a dental examination, and 100 patients were reevaluated after one year of orthodontic treatment. Fisher's exact test and the proportion test with Bonferroni's correction were used for the categorical univariate analysis. Results There was a significant association (P < 0.001) between deep bite and dental attrition (wear), but not between crossbite and/or deep bite in patients diagnosed with either painful TMD or disc displacement. The risk of sustaining painful TMD when crossbite presented simultaneously on the anterior and the posterior dentition was 2.625-fold greater than when it presented with a normal bite, although this difference was not significant (P=0.286) due to the lack of statistical power. There was no significant sex-related association between the occurrence of either painful TMD or disc displacement. A reduction in TMD findings was demonstrated after one year of treatment, but no statistical power was reached due to the small sample size. Conclusions Deep bite may be related to dental wear but not to pain from TMD and/or disc displacement. Only crossbite that presents simultaneously on the anterior and the posterior dentition (mixed X-bite) may have some effect on the level of pain in TMD, but not on in the prevalence of disc displacement. Confirmation of these conclusions by well-designed studies on larger patient groups is warranted. There was a clinically significant improvement in TMD findings after one year of treatment.
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Phuong NTT, Ngoc VTN, Linh LM, Duc NM, Tra NT, Anh LQ. Bruxism, Related Factors and Oral Health-Related Quality of Life Among Vietnamese Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207408. [PMID: 33053710 PMCID: PMC7599561 DOI: 10.3390/ijerph17207408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
Although bruxism is a common issue with a high prevalence, there has been a lack of epidemiological data about bruxism in Vietnam. This cross-sectional study aimed to determine the prevalence and associated factors of bruxism and its impact on oral health-related quality of life among Vietnamese medical students. Bruxism was assessed by the Bruxism Assessment Questionnaire. Temporomandibular disorders were clinically examined followed by the Diagnostic Criteria for Temporomandibular Disorders Axis I. Perceived stress, educational stress, and oral health-related quality of life were assessed using the Vietnamese version of Perceived Stress Scale 10, the Vietnamese version of the Educational Stress Scale for Adolescents, and the Vietnamese version of the 14-item Oral Health Impact Profile, respectively. The prevalence of bruxism, sleep bruxism, awake bruxism, and both conditions in Vietnamese medical students were 51.2%, 38.2%, 23.4%, and 10.4% respectively. Stress, temporomandibular joint pain, masticatory muscle pain, and tooth attrition were associated with the presence of bruxism. Vietnamese medical students were negatively affected by bruxism in terms of oral health-related quality of life.
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Affiliation(s)
- Nguyen Thi Thu Phuong
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
| | - Vo Truong Nhu Ngoc
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
| | - Le My Linh
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
| | - Nguyen Minh Duc
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
- Division of Research and Treatment for Oral Maxillofacial Congenital Anomalies, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa, Nagoya, Aichi 464-8651, Japan
- Correspondence: (N.M.D.); (N.T.T.); Tel.: +81-807-893-2739 (N.M.D.); +84-963-036-443 (N.T.T.)
| | - Nguyen Thu Tra
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
- Correspondence: (N.M.D.); (N.T.T.); Tel.: +81-807-893-2739 (N.M.D.); +84-963-036-443 (N.T.T.)
| | - Le Quynh Anh
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.T.T.P.); (V.T.N.N.); (L.M.L.); (L.Q.A.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2000, Australia
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Self-Perceived Dentists' Knowledge of Temporomandibular Disorders in Krakow: A Pilot Study. Pain Res Manag 2020; 2020:9531806. [PMID: 32566064 PMCID: PMC7273367 DOI: 10.1155/2020/9531806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/02/2020] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
Introduction The most common nondental orofacial pain conditions are temporomandibular disorders (TMDs). TMD basic examination and clinical management are included in a curriculum of each dentistry programme taught in Poland, but it is not clear how the dentists cope with diagnosis and possible treatment in their routine dental practices. The objective of the present study was to assess a level of self-perceived knowledge of TMD amongst dentists in Poland. Materials and methods. The participants, of whom all studied and graduated from a Polish university, were randomly selected from dental offices in Krakow (Poland). The selected dentists were administered an anonymous questionnaire, which contained questions measuring self-assessment of knowledge of TMD diagnosis and therapy and assessing knowledge of ethology and TMD symptoms. Results Only 6.5% of the participants identified their TMD knowledge as very good, 32.3% assessed it as good, 39.3% thought it was sufficient, 20.4% as insufficient, and 1.49% considered it as poor. 9.4% of all participants have attempted to diagnose and treat TMD patients very often, 26.4% declared performing it often, 45.8% rarely, and 18.4% had never made such an attempt. There was a significant relationship between the dentists' knowledge and their attempts at diagnosing and treating TMD patients (p < 0.05). Conclusion The level of TMD knowledge amongst the Polish dentists is still insufficient. Raising its level would considerably help the dentists to refer their patients to right specialists for a diagnosis and TMD treatment and/or interdisciplinary management of TMD patients.
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