Study of temporomandibular joint disorder in older patients by magnetic resonance imaging

Jagomägi

Proceedings of Singapore Healthcare

et al. 2017

Background: To assess the prevalence of the symptoms and signs of temporomandibular disorders (TMDs) and determine the prevalence of TMDs among elderly Vietnamese aged 65-74 years old. Methods: A cross-sectional study was conducted among 258 participants aged 65-74 years old (128 females and 130 males) using two strategies for TMD diagnosis: a clinical examination of the temporomandibular joint and its associated structures using the Diagnostic Criteria for Temporomandibular Disorders Axis I; and a set of 14 questions regarding TMD symptoms to obtain anamnestic data. Results: The prevalence of TMD symptoms was: headache 49.6%; temporomandibular joint noise 28.0%; orofacial pain 25.2%; jaw locking 3.1%; 62.5% of participants had at least one TMD symptom. Headaches were more prevalent in females than males (p=0.009) and rural than urban residents (p<0.001). The most frequent signs were temporomandibular joint crepitus (50.4%), clicking (48.1%) and mouth-opening deviation (37.6%). Temporomandibular joint crepitus and mouthopening deviation were more frequent among rural than urban (p=0.024 and p<0.001, respectively). TMD was found in 56.6% of the total sample. Of the TMD sufferers, 37.6% were diagnosed with disc displacement, 34.9% with degenerative joint disease, 3.5% with myalgia and 1.2% with arthralgia. Conclusions: More than half of elderly Vietnamese have at least one TMD symptom. TMD sounds were the most common clinical sign of TMD. There were no differences between the genders or place of residence and TMD diagnosis. Disc displacement and degenerative joint disease were most prevalent among elderly Vietnamese.

Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Symptoms and signs of temporomandibular disorders among elderly Vietnamese

Jagomägi

Proceedings of Singapore Healthcare

et al. 2017

J of Oral Rehabilitation

“…However, some of the discs were significantly more anterior and had abnormal shape and therefore constitute a subgroup that should be followed prospectively. Degrees of anteriorly located discs in normals is described on MRIs in 20–34% and is considered a variant of normal in those cross‐sectional studies. Disc positions up to +15 degrees on medial tomograms and +30 degrees on lateral tomograms have been regarded as normal variations .…”

Section: Does Condyle–fossa Position Define the Disc Shape?mentioning

confidence: 99%

Establishing better biological models to understand occlusion. I: TM joint anatomic relationships

Pullinger¹

2013

Belief in and rejection of a relationship of occlusion and temporomandibular joint (TMJ) condyle-fossa position with normal and abnormal function are still contentious issues. Clinical opinions can be strong, but support in most published data (mostly univariate) is problematic. Distribution overlap, low sensitivity and specificity are a common basis to reject any useful prediction value. Notwithstanding, a relationship of form with function is a basic tenet of biology. These are multifactor problems, but the questions mostly have not been analysed as such. This review moves the question forward by focusing on TM joint anatomic organisation as the multifactor system it is expected to be in a closed system like a synovial joint. Multifactor analysis allows the data to speak for itself and reduces bias. Classification tree analysis revealed useful prediction values and usable clinical models which are illustrated, backed up by stepwise logistic regression. Explained variance, R(2), predicting normals from pooled TMJ patients was 32·6%, sensitivity 67·9%, specificity 85·7%; 37% versus disc displacement with reduction; and 28·8% versus disc displacement without reduction. Significant osseous organisational differences between TM joints with clicking and locking suggest that this is not necessarily a single disease continuum. However, a subset of joints with clicking contained characteristics of joints with locking that might contribute to symptom progression versus resistance. Moderately strong models confirm there is a relationship between TMJ osseous organisation and function, but it should not be overstated. More than one model of normals and of TM derangement organisation is revealed. The implications to clinical decision-making are discussed.

“…However, awareness of such symptoms tends to decrease with age (2). Badel et al classified patients as older (≥ 60 years) and younger (< 60 years) and noted a high level of anxiety in both patient groups, regardless of the shorter duration of pain in older patients (20). Older patients may present earlier with TMD symptoms because they have more time to go to the hospital.…”

Section: Figmentioning

confidence: 99%

Age-related associations between psychological characteristics and pain intensity among Japanese patients with temporomandibular disorder

et al. 2014

We investigated the relationship between pain intensity and psychosocial characteristics in patients with temporomandibular disorder (TMD).Participants with painful TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD), were recruited from our clinic and classified into six age groups: 15 to 24, 25 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 to 85 years (Groups A through F, respectively). Self-reported present pain intensity and worst pain intensity during the past 6 months were ascertained using a numeric rating scale (0 to 10). Depression and somatization scores were evaluated using the RDC/ TMD axis II questionnaire. Among women, worst pain intensity was significantly lower in Groups E and F than in Groups B and C (P < 0.05). In Groups A, C, and D, depression scores were significantly higher in women than in men (P < 0.05). Among women, depression score was significantly lower in Group F than in Groups A through C (P < 0.05). In Groups A through D, somatization scores were significantly higher for women than for men (P < 0.05). Depression score and TMD symptom severity appear to decrease with age in women. (J Oral Sci 56, 221-225, 2014)