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Yanez-Regonesi F, Eisa E, Judge S, Carlson C, Okeson J, Moreno-Hay I. Diagnostic accuracy of a portable device (Bruxoff®) to measure sleep bruxism. J Oral Rehabil 2023; 50:258-266. [PMID: 36648354 DOI: 10.1111/joor.13416] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/05/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diagnosis of sleep bruxism (SB) challenges clinicians every day due to multiple forms of assessment tools available, including self-reported questionnaires, clinical examinations, portable devices and laboratory polysomnography (PSG). PSG has become the gold standard for evaluating SB, but it can be limited due to cost and restricted accessibility which often is characterised by long waiting times. Hence, there is a need for the development of a reliable method that can assess SB in a simple and portable manner, which would offer acceptable sensitivity and specificity to evaluate SB. OBJECTIVE The objective of this study was to investigate reliability and validity of the Bruxoff® device for the diagnosis of SB compared to the PSG. METHODS Forty-nine subjects underwent one night of polysomnographic study with simultaneous recording with the Bruxoff® device. Rhythmic masticatory muscle activity (RMMA) index was scored according to published criteria. Pearson correlation, Bland-Altman plot and receiver operating characteristic (ROC) curve outcomes were used to quantify the agreement between both methods. RESULTS Receiver operating characteristic analysis showed an acceptable accuracy for the Bruxoff® with sensitivity of 83.3% and specificity of 72% when the cut-off was set at two events per hour. Pearson correlation analysis showed a nearly significant correlation between PSG and Bruxoff® for RMMA index (r = .282 p = .071) and for total SB episodes per night (r = .295 p = .058). Additionally, the Bland-Altman plot revealed a consistent and systematic difference in the measurement of events between devices. CONCLUSION The Bruxoff® device appears to be a promising diagnostic method for clinical use, but further study is needed.
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Affiliation(s)
- Fernanda Yanez-Regonesi
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Elfatih Eisa
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Stephanie Judge
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Charles Carlson
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Jeffrey Okeson
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Isabel Moreno-Hay
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
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Dumbuya A, Gomes AF, Marchini L, Zeng E, Comnick CL, Melo SLS. Bone changes in the temporomandibular joints of older adults: A cone-beam computed tomography study. SPECIAL CARE IN DENTISTRY 2019; 40:84-89. [PMID: 31799710 DOI: 10.1111/scd.12441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/05/2019] [Accepted: 11/22/2019] [Indexed: 12/14/2022]
Abstract
AIMS To assess the prevalence of degenerative bone changes in the temporomandibular joint (TMJ) of older adults using cone-beam computed tomography (CBCT), and to verify possible associations between these findings and patient health history. METHODS CBCT scans comprising both TMJs were acquired for 137 patients aged 65+, regardless of TMD status. Images were assessed by two oral radiologists and evaluated for the presence of flattening, erosion, sclerosis, subchondral cysts, and osteophytes in the TMJ bony components, and self-reported patient systemic health histories were retrieved from records. RESULTS There were 59 males, and the mean age was 73.35 ± 6.28. A total of 31.4% had bone changes in both TMJs, and 65.7% had bone changes in at least one side. Bone changes were more prevalent in females, with subchondral cysts (63.3%) and osteophytes (60%) the most common findings. There was a higher prevalence of osteoporosis/osteopenia (38.5%) and connective tissue disorders (39.8%) in patients with TMJ bone changes than in those with normal TMJs. CONCLUSION Degenerative bone changes of TMJ were prevalent among older adults, and females were more affected. There was a greater prevalence of osteoporosis/osteopenia and connective tissue disorders in patients with TMJ bone changes than in subjects with normal TMJs.
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Affiliation(s)
- Aminata Dumbuya
- The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | | | - Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa
| | - Erliang Zeng
- Department of Preventive & Community Dentistry, Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.,Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa.,Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa
| | - Carissa L Comnick
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, School of Dentistry, Oregon Health and Science University, Portland, Oregon
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Chang CL, Wang DH, Yang MC, Hsu WE, Hsu ML. Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint. Kaohsiung J Med Sci 2018; 34:223-230. [DOI: 10.1016/j.kjms.2018.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/02/2018] [Accepted: 01/12/2018] [Indexed: 01/01/2023] Open
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Agudelo-Suárez AA, Vivares-Builes AM, Posada-López A, Meneses-Gómez EJ. Signs and symptoms of temporomandibular joint disorders in elderly population treated within the public hospital network of Medellin (Colombia). ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rodmex.2016.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Motro PFK, Motro M, Oral K. Orthodontics and Temporomandibular Disorders. Are They Related? Turk J Orthod 2015. [DOI: 10.13076/tjo-d-14-00030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Guarda-Nardini L, Piccotti F, Mogno G, Favero L, Manfredini D. Age-Related Differences in Temporomandibular Disorder Diagnoses. Cranio 2014; 30:103-9. [DOI: 10.1179/crn.2012.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Camacho JGDD, Oltramari-Navarro PVP, Navarro RDL, Conti ACDCF, Conti MRDA, Marchiori LLDM, Fernandes KBP. Signs and symptoms of Temporomandibular Disorders in the elderly. Codas 2014; 25:584-7. [DOI: 10.1590/s2317-17822014000100011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 11/07/2013] [Indexed: 12/23/2022] Open
Abstract
Purpose: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. Methods: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. Results: The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. Conclusion: The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.
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Reid KI, Greene CS. Diagnosis and treatment of temporomandibular disorders: an ethical analysis of current practices. J Oral Rehabil 2013; 40:546-61. [DOI: 10.1111/joor.12067] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
- K. I. Reid
- Division of Orofacial Pain; Department of Dental Specialties; Mayo Clinic; Rochester MN USA
| | - C. S. Greene
- Department of Orthodontics; UIC College of Dentistry; Chicago IL USA
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Ogura I, Kaneda T, Mori S, Sakayanagi M, Kato M. Magnetic resonance characteristics of temporomandibular joint disc displacement in elderly patients. Dentomaxillofac Radiol 2011; 41:122-5. [PMID: 22116131 DOI: 10.1259/dmfr/1286942] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the MR characteristics of temporomandibular joint (TMJ) disc displacement in elderly patients. METHODS Of the MR images of 1660 TMJs in 847 patients with disc displacement who underwent MRI for suspected temporomandibular disorders, 301 TMJs in 154 patients aged over 50 years were studied as an elderly group. These MR images of the elderly group were compared with those of a control group (1359 TMJs in 693 patients aged under 51 years) concerning disc displacement with or without reduction, joint effusion and osteoarthrosis. RESULTS The incidence of disc displacement with osteoarthrosis was significantly different between the elderly (41.9%) and the control (19.8%) groups (p = 0.000). Logistic multivariate regression analysis demonstrated that the osteoarthrosis was a significant variable (odds ratio = 2.94, p = 0.000). CONCLUSIONS This study suggests that MR characteristics of TMJ disc displacement in elderly patients includes osteoarthrosis.
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Affiliation(s)
- I Ogura
- Department of Radiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
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Ikebe K, Hazeyama T, Iwase K, Sajima H, Gonda T, Maeda Y, Nokubi T. Association of symptomless TMJ sounds with occlusal force and masticatory performance in older adults. J Oral Rehabil 2008; 35:317-23. [PMID: 18405267 DOI: 10.1111/j.1365-2842.2007.01841.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K Ikebe
- Division of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Osaka, Japan
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Hassel AJ, Rammelsberg P, Schmitter M. Inter-examiner reliability in the clinical examination of temporomandibular disorders: influence of age. Community Dent Oral Epidemiol 2006; 34:41-6. [PMID: 16423030 DOI: 10.1111/j.1600-0528.2006.00250.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of the age of the subject on inter-examiner reliability of the clinical signs of temporomandibular disorder (TMD). METHODS Forty-three elderly (ES) and 44 younger adults (YS) were selected. The female/male distribution was almost the same in the two groups. All participants underwent clinical examination according to the Research Diagnostic Criteria for TMD, performed successively by two clinicians. RESULTS For metric measurements - with the exception of unassisted opening - the ES gave a significantly lower range of motion with both examiners and significantly worse percentage agreement between the examiners. A remarkable inter-examiner disagreement in the elderly was found with laterotrusion and protrusion movements. The prevalence of joint sounds was rated inconsistently by the examiners. The reliability of detection was not different in the two groups. The prevalence of tender muscle sites was also inconsistent. The overall percentage agreement for subjects with at least one tender muscle point was not age dependent. Because of the very low prevalence in ES, further statistical assessment of reliability is not possible. CONCLUSIONS The age-dependent lower range of motion and the inferior reliability of metric measurements in the elderly could lead to wrong diagnoses. The reliability of detecting joint sounds and tender muscles was not age dependent within the limitations of the study.
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Schmitter M, Rammelsberg P, Hassel A. The prevalence of signs and symptoms of temporomandibular disorders in very old subjects. J Oral Rehabil 2005; 32:467-73. [PMID: 15975125 DOI: 10.1111/j.1365-2842.2005.01449.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Previous studies on the prevalence of signs of temporomandibular disorders (TMD) in elderly people have used non-standardized and invalidated examination protocols. The prevalence of the different signs of TMD in this group is therefore still unclear. The aim of this study was to evaluate the prevalence of signs of TMD in subjects of advanced aged, using a standardized and validated examination protocol. Additionally, young subjects were examined as a control group. Fifty-eight old peoples' home inhabitants and 44 young subjects were examined using a standardized and validated examination protocol. Differences between the groups were assessed using Mann-Whitney U-test or t-test. Geriatric subjects more often exhibited objective symptoms of TMD (38% exhibited joint sounds on opening), but rarely suffered from pain (pain at rest: 0%, joint pain: 0%, muscle pain: 12%). In contrast, young subjects rarely exhibited objective symptoms (joint sounds: 7%), but suffered more frequently from pain (facial: 7%, joint pain: 16%, muscle pain: 25%). The mandibular range of motion was higher in young subjects. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (joint sounds) of TMD, they rarely suffered from pain. In contrast, younger subjects rarely exhibited objective TMD signs but more frequently suffered from subjective signs (muscular pain on palpation) and facial pain.
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Affiliation(s)
- M Schmitter
- Poliklinik für Zahnärztliche Prothetik, Im Neuenheimer Feld, Heidelberg, Germany.
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Rollman GB, Gillespie JM. The role of psychosocial factors in temporomandibular disorders. CURRENT REVIEW OF PAIN 2001; 4:71-81. [PMID: 10998718 DOI: 10.1007/s11916-000-0012-8] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The temporomandibular disorders (TMDs) comprise a constellation of symptoms affecting the joints and muscles involved in jaw movement. Patients complain of orofacial pain, limited jaw opening, and clicking or popping sounds. Although pain is generally the defining characteristic of TMD, patients often report marked degrees of stress and interference in daily life. This article reviews recent studies on epidemiology, sex differences, pediatric TMD, classification systems, comparisons to other chronic pain disorders of uncertain etiology, psychological assessment, depression, central modulation and hypervigilance, sleep disturbances, stress, and the management of TMD by conservative physical interventions and cognitive behavioral therapy. Both the assessment and the management of TMD requires a multidisciplinary perspective with strong emphasis on psychosocial variables.
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Affiliation(s)
- G B Rollman
- Department of Psychology, University of Western Ontario, London, ON N6A 5C2, Canada.
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Abstract
Thirty-eight pediatric patients with temporomandibular joint (TMJ) dysfunction were diagnosed and treated. The etiology for the TMJ dysfunction was trauma in 30 (79%) patients, degenerative joint disease in two (5%) patients, growth disturbances in two (5%) patients and tumor in one (3%) patient. In three (8%) patients the etiology was unclear. The treatment modalities were: non-invasive therapy in 19 (50%) patients, occlusal therapy in 10 (26%) patients and surgical treatment in nine (24%) patients. The reported symptoms of temporomandibular joint dysfunction using the Helkino anamnestic index revealed that, at the initial examination, eight (21%) reported mild symptoms and 30 (79%) severe symptoms. One year later, 33 (87%) reported no symptoms, four (10%) mild symptoms and one (3%) severe symptoms. These differences were significant (P < 0.05-0.01). Maximum mouth opening 1 year after treatment as compared to the initial examination increased (P < 0.05) in all three treatment modalities. Deviation of the mandible on opening, 1 year after treatment as compared to the initial examination, decreased (P < 0.05) in all three treatment modalities. No differences were found between the modalities in both the maximum mouth opening or deviation of the mandible. TMJ dysfunction in children can be effectively treated by non-surgical treatment modalities. Surgery should be considered only when the non-surgical therapies were ineffective.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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