Temporomandibular disorder treatment algorithm for otolaryngologists

Lee, Esther; Crowder, Hannah R.; Tummala, Neelima; Goodman, Joseph; Abbott, Jeremy; Zapanta, Philip E.

doi:10.1016/j.amjoto.2021.103155

Cited by 11 publications

(7 citation statements)

References 72 publications

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“…Temporomandibular disorders (TMD) describe a group of diseases with the same clinical symptoms, but its etiology remains unknown [ 1 ]. Its main clinical symptoms include pain in the temporomandibular joint and/or masticatory muscles, joint ringing, murmur and fragmentation, and abnormal mandibular movement [ 2 ]. Epidemiological studies demonstrate that the prevalence of TMD is about 40%, and the annual incidence rate is about 3.9%.…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

Shao

Deng

2022

Computational and Mathematical Methods in Medicine

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Objective. To survey the clinical manifestations and imaging features of temporomandibular disorders (TMD) and analyze the risk factors for pathogenesis/prognosis through a case-control study based on psychogenic factors of patients. Methods. According to the inclusion criteria, 200 adult patients were randomly enrolled from the maxillofacial department of our hospital from January 2020 to May 2021, including 100 patients with TMD as the study group and 100 healthy patients as the control group. The study group can be assigned into four subgroups according to their clinical manifestations: (1) articular area or/and masticatory muscle pain group, (2) mandibular movement abnormality group, (3) joint murmur group, and (4) two or more symptom groups. Based on the study of psychogenic factors of patients, the clinical manifestations and imaging features of TMD were determined, and the risk factors for pathogenesis/prognosis were analyzed. Results. The distribution of psychological status in the TMD group was higher than that in the control group ( P < 0.05 ). The distribution of anxiety, depression, and somatic symptoms in the TMD group was significantly different from that in the control group ( P < 0.05 ). Anxiety, depression, and somatic symptoms were the risk factors for TMD. Compared with the control group, the incidence of abnormal MRI images in patients with temporomandibular disorders was significantly different ( P < 0.05 ). There were significant differences in psychological status (anxiety, depression, and somatic symptoms) among the three groups ( P < 0.05 ). Anxiety, depression, and somatic symptoms were the risk factors for abnormal mandibular movement and joint tremor and murmur ( P < 0.05 ). Somatic symptoms were the risk factors for various clinical symptoms of TMD ( P < 0.05 ). Depression was the risk factor for pain ( P < 0.05 ). Conclusion. In patients with TMD, MRI can early identify disc abnormalities and other related imaging features, which is helpful for more comprehensive clinical evaluation and treatment of TMD patients. There exhibits no significant difference in psychological status (anxiety, depression, and somatic symptoms) of patients with different clinical symptoms, and abnormal psychological status may be one of the risk factors leading to different clinical symptoms and development of different types of TMD patients.

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Section: Introductionmentioning

confidence: 99%

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

Shao

Deng

2022

Computational and Mathematical Methods in Medicine

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“…Although it may be helpful in patients whose dysfunction is due to severe bruxism or nocturnal clenching, its indications for treating myofascial pain in the head and neck region are unclear. 3,13 There are a variety of splint designs that generally work by unloading stress to the condyle and providing protection to the articular disk, leading to relaxation of the TMJ muscles. Moreover, it has been reported to protect teeth wear in patients with bruxism.…”

Section: Initial Approachmentioning

confidence: 99%

“…1,16 Physical therapy, manual therapy, and electro-physical and electro-analgesic treatments have been proven helpful in alleviating pain and TMJ dysfunction symptoms. 3,9 However, patients with myofascial pain who fail conservative management after a minimum of 2 to 3 weeks may benefit from additional therapies. Some minimally invasive alternatives include trigger point injections with steroids, neuromodulators or hyaluronic acid, and acupuncture.…”

Section: Acute Conditionsmentioning

confidence: 99%

“…Patient relaxation techniques, muscle relaxants, or botulinum toxin injections may be beneficial in patients experiencing TMJ/ myofascial pain as a result of bruxism and/or clenching when refractory to dental device use. 3 In addition to nocturnal clenching or grinding, other contributory parafunctional habits may include biting on straws/pens/etc., chewing on ice, and intentionally making joint pop or click when there is an underlying internal derangement.…”

Section: Degenerative Joint Processesmentioning

confidence: 99%

“…In the absence of visible bite deformity (malocclusion), clinical signs of infection, limited mobility, neurologic findings, history of recent trauma, or another clear underlying disorder, patients should typically undergo conservative treatment measures without further imaging. 3 Research studies have shown that 70% to 80% of FACE 4 (2) patients presenting with TMJ dysfunction without the aforementioned symptoms will experience pain relief after applying conservative management strategies. 4,5 Conservative measures are variable, and the least invasive option should be considered the first treatment choice.…”

Section: Initial Approachmentioning

confidence: 99%

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The temporomandibular joint (TMJ) has a complex and unique anatomy. When disarranged, it may produce a constellation of symptoms and dysfunction, leading to morbidity. The causes of TMJ dysfunction are numerous but often present with similar clinical signs and symptoms. In this series, we included a review of normal anatomy and a review of the pathophysiology with assessment of the most common TMJ dysfunctions, including myofascial pain, internal derangements of the articular disk, osteoarthrosis, among others. The authors present the last of a 3-part educational series on the TMJ, addressing treatment strategies for these disorders.

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Occlusal interventions for managing temporomandibular disorders

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et al. 2024

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Temporomandibular disorder treatment algorithm for otolaryngologists

Cited by 11 publications

References 72 publications

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients

A Plastic Surgeons Guide to the Temporomandibular Joint: Part III, Treatment

Occlusal interventions for managing temporomandibular disorders

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