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Minervini G, Marrapodi MM, La Verde M, Meto A, Siurkel Y, Cicciù M, Russo D. The relationship between pregnancy and temporomandibular disorder (TMD) through diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: a case-control cross-sectional study. BMC Oral Health 2024; 24:342. [PMID: 38493079 PMCID: PMC10944601 DOI: 10.1186/s12903-024-04009-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/09/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION This study focuses on temporomandibular disorders (TMDs), which affect the temporomandibular joint and related muscles and have multiple causes. Recent studies have examined the connection between menstrual cycles, estrogen levels, and TMDs, but results are inconsistent, highlighting the need for more research. The aim is to explore the prevalence of TMDs in pregnant women and consider how hormonal changes during pregnancy might influence these disorders. METHODS In this cross-sectional case-control study, we compared 32 pregnant women with 35 non-pregnant women. We evaluated several TMD-related factors such as pain levels, chronic pain classification, scores on the Jaw Functional Limitation Scale-20 and Oral Behaviors Checklist, and psychological health. We used various statistical methods including descriptive statistics, chi-square tests, linear regression, and adjustments for multiple comparisons to analyze the data. RESULTS Pregnant women showed different pain perceptions, generally reporting less pain and lower severity. Nonetheless, these differences were not uniform across all TMD-related measures. Linear regression did not find a consistent link between pregnancy and TMD scores, except for chronic pain grade, which was not significant after adjusting for multiple comparisons. There was a significant relationship between depression and TMD severity, emphasizing the need to consider mental health in TMD evaluations. DISCUSSION The findings suggest that pregnancy is neither a risk nor a protective factor for TMD. Differences in pain perception, functional status, and psychological health were observed in pregnant women but were not consistent for all TMD-related aspects. The role of estrogen in TMJ health and TMD risk is complex and requires further study. The research highlights the necessity of including mental health, especially depression, in TMD assessments. More comprehensive research with larger sample sizes is essential to better understand the connections between pregnancy, TMD, and hormones, aiming to improve TMD management in pregnant women and others.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy
| | - Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Largo Madonna delle Grazie 1, 80138, Naples, Italy.
| | - Aida Meto
- Department of Dental Therapy, Faculty of Dental Medicine, University of Medicine, Tirana, Albania
| | - Yuliia Siurkel
- International European University School of Medicine, Akademika Hlushkova Ave, 42B, Kyiv, 03187, Ukraine.
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Diana Russo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy.
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Zhu J, Gong Y, Zheng F, Yin D, Liu Y. Relationships between functional temporomandibular joint space and disc morphology, position, and condylar osseous condition in patients with temporomandibular disorder. Clin Oral Investig 2024; 28:193. [PMID: 38438806 DOI: 10.1007/s00784-024-05579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To investigate the correlations between joint space and temporomandibular joint (TMJ) components and the compressive states of the disc and condyle subsequent to joint space changes. MATERIALS AND METHODS A total of 240 TMJs were categorized according to disc morphology, disc position, and condylar osseous condition. The two-dimensional (2D) and three-dimensional (3D) measurements were compared. The functional joint space (FJS) and disc areas on closed- and open-mouth images (DA-C and DA-O) were also calculated, and the joint space was measured in five directions. Different groups of TMJ components were compared. A spring model was used to simulate the effect of condylar displacement on the disc and condyle. RESULTS Disc morphology was strongly correlated with its position. The measurements were equivalent between 2D and 3D methods. DA-C and FJS differed significantly between groups. The DA-C to FJS ratio differed between the Class 2 and Class 3 groups and between disc displacement groups with and without reduction. Altered disc morphology and position were correlated with significant changes in joint space in the 60°, 90°, and 120° directions. Despite minor discrepancies among condylar osseous conditions, reduced joint space was correlated with bone destruction at the corresponding site. The spring model stimulation revealed that condylar displacement caused elevated stresses on the disc and condyle. CONCLUSIONS Condylar displacement causes joint space alterations while exerting compressive pressure on both the disc and condyle. CLINICAL RELEVANCE Proper condylar positioning within the fossa is recommended to ensure sufficient articular disc accommodation.
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Affiliation(s)
- Jinyi Zhu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yanji Gong
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Fangjie Zheng
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China.
| | - Yang Liu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Minervini G, Di Blasio M, Franco R, Marrapodi MM, Vaienti B, Cicciù M, Ronsivalle V. Prevalence of temporomandibular disorders diagnosis in patients treated with Herbst appliance: a systematic review and meta-analysis. BMC Oral Health 2024; 24:137. [PMID: 38281907 PMCID: PMC10822183 DOI: 10.1186/s12903-023-03738-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/05/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The Herbst appliance is an excellent therapy for treating class II malocclusions with increased overjet. Its mechanics involve propelling the mandibular bone using two pistons the patient cannot remove. The so-called bite-jumping keeps the mandible in a more anterior position for a variable period, usually at least 6 months. This appliance does not inhibit joint functions and movements, although there are scientific papers in the literature investigating whether this appliance can lead to temporomandibular disorders. This systematic review aims to evaluate whether Herbst's device can cause temporomandibular diseases by assessing the presence of TMD in patients before and after treatment. METHODS A literature search up to 3 May 2023 was carried out on three online databases: PubMed, Scopus and Web of Science. Only studies that evaluated patients with Helkimo scores and Manual functional analysis were considered, as studies that assessed the difference in TMD before and after Herbst therapy. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (pre and post-Herbst). RESULTS The included papers in this review were 60. Fifty-seven were excluded. In addition, a manual search was performed. After the search phase, four articles were considered in the study, one of which was found through a manual search. The overall effect showed that there was no difference in TMD prevalence between pre-Herbst and post-Herbst therapy (OR 0.74; 95% CI: 0.33-1.68). CONCLUSION Herbst appliance seems not to lead to an increase in the incidence of TMD in treated patients; on the contrary, it appears to decrease it. Further studies are needed to assess the possible influence of Herbst on TMDs.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Caserta, 81100, Italy.
| | - Marco Di Blasio
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Rocco Franco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00100, Rome, Italy.
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", 80121, Naples, Italy.
| | - Benedetta Vaienti
- Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123, Catania, Italy
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Ainoosah S, Farghal AE, Alzemei MS, Saini RS, Gurumurthy V, Quadri SA, Okshah A, Mosaddad SA, Heboyan A. Comparative analysis of different types of occlusal splints for the management of sleep bruxism: a systematic review. BMC Oral Health 2024; 24:29. [PMID: 38182999 PMCID: PMC10770907 DOI: 10.1186/s12903-023-03782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/15/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism. METHODS The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle-Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically. RESULTS Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually. CONCLUSIONS This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism.
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Affiliation(s)
- Sultan Ainoosah
- Department of Substitute Dental Science, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Ahmed E Farghal
- Department of Substitute Dental Science, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Marwa Saad Alzemei
- Department of Restorative Dental Sciences, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | | | | | - Abdulmajeed Okshah
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Qasr-E-Dasht Street, Shiraz, Iran.
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
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Campi G, Ricci A, Costa N, Genovesi F, Branca JJV, Paternostro F, Della Posta D. Dynamic Correlations and Disorder in the Masticatory Musculature Network. Life (Basel) 2023; 13:2107. [PMID: 38004247 PMCID: PMC10672239 DOI: 10.3390/life13112107] [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: 09/27/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) disorders, which affect millions of people worldwide, have multiple etiological factors that make an accurate diagnosis and effective treatments difficult. As a consequence, the gold standard diagnostic criteria for TMJ disorders remain elusive and often depend on subjective decisions. AIM In this context, the lack of a non-invasive quantitative methodology capable of assessing the functional physiological state and, consequently, identifying risk indicators for the early diagnosis of TMJ disorders must be tackled and resolved. METHODOLOGY In this work, we have studied the biomechanics and viscoelastic properties of the functional masticatory system by a non-invasive approach involving 52 healthy subjects, analysed by statistical-physics analysis applied to myotonic measurements on specific points of the masticatory system designing a TMJ network composed of 17 nodes and 20 links. RESULTS We find that the muscle tone and viscoelasticity of a specific cycle linking frontal, temporal, and mandibular nodes of the network play a prominent role in the physiological functionality of the system. At the same time, the functional state is characterised by a landscape of nearly degenerated levels of elasticity in all links of the network, making this parameter critically distributed and deviating from normal behaviour. CONCLUSIONS Time evolution and dynamic correlations between biomechanics and viscoelastic parameters measured on the different cycles of the network provide a quantitative framework associated with the functional state of the masticatory system. Our results are expected to contribute to enriching the taxonomy of this system, primarily based on clinical observations, patient symptoms, and expert consensus.
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Affiliation(s)
- Gaetano Campi
- Institute of Crystallography, CNR, Via Salaria Km 29.300, 00015 Monterotondo, Italy;
| | - Alessandro Ricci
- Duferco Corporate Innovation, Via Trevano 2A, 6900 Lugano, Switzerland;
| | - Nicola Costa
- The Anatomical Network APS, Via Fermo 2c, 00182 Rome, Italy; (N.C.); (D.D.P.)
| | | | - Jacopo Junio Valerio Branca
- Department of Experimental and Clinical Medicine, Anatomy and Histology Section, University of Florence, 50134 Florence, Italy;
| | - Ferdinando Paternostro
- Department of Experimental and Clinical Medicine, Anatomy and Histology Section, University of Florence, 50134 Florence, Italy;
| | - Daniele Della Posta
- The Anatomical Network APS, Via Fermo 2c, 00182 Rome, Italy; (N.C.); (D.D.P.)
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Ning R, Chen J, Lu Y, Guo J. Obstructive sleep apnea: a follow-up program in its relation to temporomandibular joint disorder, sleep bruxism and orofacial pain. BMC Oral Health 2023; 23:578. [PMID: 37598191 PMCID: PMC10440039 DOI: 10.1186/s12903-023-03264-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/28/2023] [Indexed: 08/21/2023] Open
Abstract
OBJECTIVE To evaluate the correlation between obstructive sleep apnea (OSA) and temporomandibular joint (TMJ) morphology, tooth wear condition, orofacial pain through a follow-up program. MATERIALS AND METHODS Seventy one OSA patients were divided into three groups according to their (apnea hypopnea index) AHI: mild group (n = 23), moderate group (n = 24), and severe group (n = 24). All patients had OSA therapies around six months after confirm the diagnosis of OSA. The tooth wear score and orofacial pain condition of all patients were recorded via clinical examination. Cone beam computed tomography (CBCT) images were also taken when confirm the diagnosis of OSA (T0), 6 months after the diagnosis (T1), and 6 months after the OSA treatment (T2). Parameters indicating the condylar morphology and joint space were evaluated. The differences of clinical symptoms and TMJ conditions among T0, T1 and T2 time point were detected in the three groups respectively. The changes in T1-T0 and T2-T1 of all descriptions among three groups were also compared. The correlations between AHI and clinical symptoms were detected with Spearman correlation analysis. RESULTS In mild group, there was no difference in all clinical symptoms and TMJ morphology among the three time points. Both in moderate and severe group, the condylar volume, superficial area, wear score, visual analogue scales (VAS), and R value (indicating condyle position) displayed significant differences among the three time points (P < 0.05). From T0 to T1, mild group displayed fewer decreases in the condylar volume and superficial area and fewer increases in wear score than that in moderate and severe group (P < 0.05). From T1 to T2, there was a greatest reduction in severe group for R value, and significant difference in the description of VAS and R value were found among the three groups. AHI was negatively correlated condylar volume and condylar superficial area, and was positively correlated with tooth wear score and VAS (P < 0.05). CONCLUSION Moderate to severe OSA will aggravate orofacial pain and tooth wear, affect TMJ volume and superficial area, even change the location of condyles. Appropriate OSA therapies may be effective ways to alleviate these adverse effects in long-term.
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Affiliation(s)
- Ruoyu Ning
- Department of Orthodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Central South University, 72 Xiangya Road, Changsha, 410000, Hunan, China
- Third Xiangya Hospital & Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Junjie Chen
- Department of Orthodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Central South University, 72 Xiangya Road, Changsha, 410000, Hunan, China
| | - Yanqin Lu
- Department of Orthodontics, Xiangya Stomatological Hospital & Xiangya School of Stomatology, Hunan Clinical Research Center of Oral Major Diseases and Oral Health, Central South University, 72 Xiangya Road, Changsha, 410000, Hunan, China
| | - Jing Guo
- Engineering Laboratory for Biomaterials and Tissue Regeneration, Ningbo Stomatological Hospital, Zhejiang, China.
- Savaid Stomatology School, Hangzhou Medical College, 435 Xinxing Road, Ningbo, 315000, Zhejiang, China.
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Cheeloo College of Medicine, Jinan, China.
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