Search Results (169)

Background: Temporomandibular joint (TMJ) injections and arthrocentesis are commonly used minimally invasive methods for treating temporomandibular disorders (TMDs). Although considered safe, they can cause neurological complications. The aim of this systematic review was to synthesize all identified evidence for neurological adverse events following intra-articular TMJ interventions. Methods: This review was based on a systematic search with BASE, DOAJ, PubMed, SciELO, and Semantic Scholar on 28 May 2025. It included primary studies involving patients diagnosed with TMDs who underwent intra-articular injections into the TMJ or were treated with arthrocentesis, and in whom neurological adverse effects associated with the intra-articular intervention were reported. Studies reporting non-specific symptoms or unrelated systemic conditions were excluded. The risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tools. Results were presented in summary tables. Results: The search yielded five eligible studies comprising 319 patients, of whom 320 neurological adverse events were reported. Included studies comprised a randomized controlled trial, two retrospective studies, and two case reports. Four studies had a low risk of bias, and one had a moderate risk of bias according to the Joanna Briggs Institute appraisal tools. The proportion of patients affected ranged from 14% to 65% depending on the study design and intervention type. The most common adverse event was transient facial nerve (cranial nerve VII) paralysis, mainly involving the temporal and zygomatic branches. Less commonly reported complications involved the trigeminal nerve branches (V1, V3). There is also a single case of epidural hematoma with palsy of the oculomotor nerve (III). Most symptoms resolved spontaneously within a few hours to a few days. The use of local anesthesia and large volumes of irrigation (60 mL) during arthrocentesis increases the risk of complications. Attempts to explain the mechanisms of complications include local anesthetic diffusion, compression neuropraxia due to lavage fluid leakage, and corticosteroid neurotoxicity. One of the limitations of the study is the scarcity of data. Conclusions: Although most adverse events are mild and reversible, these findings highlight that precise, real-time guided injection and careful control of lavage volumes can minimize extra-articular spread of anesthetics or fluids, thereby reducing the likelihood of neurological complications. This study received no funding. PROSPERO ID number: CRD420251088170. Full article

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. Objective: To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. Methods: In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD–based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ² tests and t-tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). Results: A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; p = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; p = 0.0013), JFLS (32.5 vs. 18.0; p < 0.001), PHQ-9 (6.43 vs. 5.16; p = 0.048), and OBC (13.9 vs. 9.7; p = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; p < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all p < 0.001). Conclusions: Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population. Full article

Background/Objectives: Complications of edentulism include bone resorption, muscular dysfunction, temporomandibular joint disorders (TMJ), and stomatognathic system dysfunctional syndrome (SSDS). The objectives of the study were as follows: to analyze the distribution of edentulism complications related to sociodemographic and clinical parameters and to quantify the strength of relationships between edentulism complications and these socio-demographic or clinical variables. Materials and Methods: This cross-sectional study investigated 150 edentulous subjects (mean age 61.54 +/− 8.99 years) scheduled for hybrid prosthetic therapy. The distribution of edentulism complications was assessed in relation to sex-specific and age-specific patterns, edentulism location (maxillary vs. mandibular), edentulism extension (partial reduced, partial extended, subtotal, complete edentulism), and Kennedy classification (class I vs. class II vs. class IV). Cramér’s V was used to measure the strength of the association between edentulism complications and sociodemographic and clinical factors. Results: The most prevalent complications were more frequent in males—bone resorption (74.2% vs. 40.9%), malocclusion (97.5% vs. 84.9%), TMJ disorders (74.2% vs. 57.0%), muscular disorders (62.5% vs. 31.2%), dyshomeostasis (64.2% vs. 31.2%), and SSDS (79.2% vs. 53.8%). The most relevant associations were found between age group and clinical variables such as irregular ridge (Cramer’s V = 0.737), long/thick frenum (0.711), and SSDS (0.544), while edentulism category was strongly associated with irregular ridge (0.585), TMJ disorders (0.493), and bone resorption (0.492). Conclusions: The type and stage of edentulism emerged as key determinants of complication severity, with complete and subtotal edentulism being associated with the highest rates of muscular and temporomandibular joint dysfunctions. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are a group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and related anatomical structures. Although magnetic resonance imaging (MRI) is considered a noninvasive and highly informative imaging modality for assessing TMJ soft tissues, few studies have examined how TMJ structural features observed on MRI findings relate to oral function and craniofacial morphology in female patients with malocclusion. To investigate the associations among TMJ structural features, oral function, and craniofacial morphology in female patients with malocclusion, using MRI findings interpreted in conjunction with a preliminary assessment based on selected components of the DC/TMDs Axis I protocol. Methods: A total of 120 female patients (mean age: 27.3 ± 10.9 years) underwent clinical examination based on DC/TMDs Axis I and MRI-based structural characterization of the TMJ. Based on the structural features identified by MRI, patients were classified into four groups for comparison: osteoarthritis (OA), bilateral disk displacement (BDD), unilateral disk displacement (UDD), and a group with Osseous Change/Disk Displacement negative (OC/DD (−)). Occlusal contact area, occlusal force, masticatory efficiency, tongue pressure, and lip pressure were measured. Lateral cephalometric analysis assessed skeletal and dental patterns. Results: OA group exhibited significantly reduced occlusal contact area (p < 0.0083, η² = 0.12) and occlusal force (p < 0.0083, η² = 0.14) compared to the OC/DD (−) group. Cephalometric analysis revealed that both OA and BDD groups had significantly larger ANB angles (OA: 5.7°, BDD: 5.2°, OC/DD (−): 3.7°; p < 0.0083, η² = 0.21) and FMA angles (OA: 32.4°, BDD: 31.8°, OC/DD (−): 29.0°; p < 0.0083, η² = 0.17) compared to the OC/DD (−) group. No significant differences were observed in masticatory efficiency, tongue pressure, or lip pressure. Conclusions: TMJ structural abnormalities detected via MRI, especially osteoarthritis, are associated with diminished oral function and skeletal Class II and high-angle features in female patients with malocclusion. Although orthodontic treatment is not intended to manage TMDs, MRI-based structural characterization—when clinically appropriate—may aid in treatment planning by identifying underlying joint conditions. Full article

Introduction: Total temporomandibular joint replacement (TMJR) is a well-established surgical solution for patients with severe TMJ disorders. It aims to relieve chronic pain, restore jaw mobility, and significantly enhance quality of life. This systematic review evaluates QoL outcomes following TMJR, analyzes complication profiles, compares custom versus stock prostheses, explores pediatric applications, and highlights technological innovations shaping the future of TMJ reconstruction. Methods: A systematic search of PubMed, Embase, and the Cochrane Library was conducted throughout April 2025 in accordance with PRISMA 2020 guidelines. Sixty-four studies were included, comprising 2387 patients. Results: Primary outcomes assessed were QoL improvement, pain reduction, and functional gains such as maximum interincisal opening (MIO). Secondary outcomes included complication rates and technological integration. TMJR consistently led to significant pain reduction (75–87%), average MIO increases of 26–36 mm, and measurable QoL improvements across physical, social, and psychological domains. Custom prostheses were particularly beneficial in anatomically complex or revision cases, while stock devices generally performed well for standard anatomical conditions. Pediatric TMJR demonstrated functional and airway benefits with no clear evidence of growth inhibition over short- to medium-term follow-up. Complications such as heterotopic ossification (~20%, reduced to <5% with fat grafting), infection (3–4.9%), and chronic postoperative pain (~20–30%) were reported but were largely preventable or manageable. Recent advancements, including CAD/CAM planning, 3D-printed prostheses, augmented-reality-assisted surgery, and biofilm-resistant materials, are enhancing personalization, precision, and implant longevity. Conclusions: TMJR is a safe and transformative treatment that consistently improves QoL in patients with end-stage TMJ disease. Future directions include long-term registry tracking, growth-accommodating prosthesis design, and biologically integrated smart implants. Full article

Temporomandibular disorders (TMDs) impact quality of life and present diagnostic and treatment challenges. Biomarkers may serve as an additional tool to support diagnosis and monitor disease progression, offering supplementary information for treatment strategies in specific and selected patients. This systematic review aimed to assess the role of biomarkers in diagnosing TMD and guiding personalized treatment. It also examined key biomarkers linked to chronic temporomandibular joint (TMJ) pain and how therapies affect biomarker levels and clinical outcomes. A comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify observational and interventional studies assessing the role of biomarkers in synovial fluid/tissue, saliva, and blood. The research was registered in PROSPERO, adhered to PRISMA guidelines, and employed Cochrane Risk of Bias tools. To assess the effect, only studies examining biomarker levels were considered. A total of forty-six studies met the inclusion criteria: three randomized controlled trials were rated as having some concerns, as were most of the observational studies. Elevated levels of interleukins (1ß and 6), tumour necrosis factor alpha, and prostaglandin E2 in synovial fluid were correlated with temporomandibular joint (TMJ) inflammation. Increased matrix metalloproteinases (2, 7, and 9) indicated cartilage deterioration, while oxidative stress markers such as malondialdehyde were higher in TMD patients. Treatments including hyaluronic acid, platelet-rich plasma, and low-level laser therapy effectively reduced inflammatory biomarkers and improved symptoms. Biomarkers show potential to contribute to the understanding of pathophysiological mechanisms in TMD and may support future diagnostic and therapeutic strategies for selected patients. After high-quality studies confirm these findings, this approach will enable personalized medicine by tailoring treatments to individual patient profiles, ultimately leading to improved outcomes and quality of life. Full article

Background/Objectives: Temporomandibular joint disorders (TMDs) affect the temporomandibular joint and associated structures of the stomatognathic system. Joint Vibration Analysis (JVA) is a non-invasive method used to assess TMJ dysfunction through vibration frequencies. This study aimed to explore how age and gender influence TMJ vibration characteristics, hypothesizing that these factors may affect diagnostic accuracy in TMJ evaluations. Methods: This cross-sectional study includes 251 participants (143 females and 108 males) aged 10 to 30 years. TMJ evaluation used JVA to assess range of motion, integral values, and frequency distributions over and under 300 Hz. Participants with a history of TMJ disorders or significant maxillofacial trauma were excluded. Statistical analysis was conducted using employing Kolmogorov–Smirnov tests for data distribution, Kruskal–Wallis test for group comparisons, and Pearson correlation test for variable relationships. Results: Significant gender differences in range of motion (ROM) were observed, with males exhibiting higher values (p = 0.005). Age notably influenced vibration frequencies, particularly in total integral values (TIL and TIR) and frequency distributions around 300 Hz, suggesting links to degenerative changes. Females showed more pronounced age-related effects on vibration parameters. However, gender did not greatly affect vibration characteristics across all frequency bands, indicating that other factors also impact TMJ function. Conclusions: Age and gender significantly influence TMJ vibrations and the interpretation of JVA in clinical settings. Personalized approaches considering these demographic factors may enhance the accuracy of TMJ dysfunction diagnoses. Full article

Background: The primary objective of our preliminary study was to estimate the prevalence of temporomandibular disorders (TMDs) in people with multiple sclerosis (MS). Furthermore, we aimed to investigate whether there is a correlation between the presence of TMDs and the level of MS-related disability. Methods: The study was conducted at two centers in Poland dealing with the treatment of MS between March 2025 and April 2025. The study used an original survey questionnaire, the European Academy of Craniomandibular Diseases (EACD) questionnaire and the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). The study group included people with multiple sclerosis, while the control group consisted of healthy people without neurological deficits. The study group was examined using the following methods: the McDonald criteria and the Expanded Disability Status Scale (EDSS). Results: The study involved 90 people (45 in both groups). The majority of the study participants were women (80.0%), aged 20–30 years (51.1%) and people living in small towns (51.1%). The largest number of patients with MS were noted with RRMS (75.5%). The duration of the disease was on average 3.3 ± 2.4, and the EDSS score was on average 2.5 ± 1.5. People from the study group significantly (p ≤ 0.05; ES = 0.52–0.86) reported TMDs more frequently based on EACD (pain on opening the mouth: 86.7%; facial pain: 57.8%; joint locking: 28.9%; headaches: 75.3%). The diagnosis of TMDs was confirmed in 40.0% of people with MS and 11.1% of healthy volunteers (p ≤ 0.05). Patients most frequently reported muscle pain and disk displacement with reduction (p ≤ 0.05). The disability score in the MS group did not exhibit differences in the occurrence of TMDs (p > 0.05). Conclusions: The study showed that TMDs are more common in people with multiple sclerosis. The degree of disability did not differentiate the occurrence of TMDs. The authors intend to expand research on the influence of potential risk factors on the occurrence of TMDs in people with multiple sclerosis. Full article

Background/Objectives: Temporomandibular disorders (TMDs) are the most common cause of non-dental pain in the orofacial region. Due to the complex and multifactorial nature of TMD, a multidisciplinary approach is often required. The objective of this narrative review is to evaluate the effectiveness of multimodal therapies in the management of TMD. Methods: A literature search was performed using a combination of keywords: “TMD”, “TMJ”, “disorders”, “manual therapy”, “physical therapy”, “dry needling”, “botulinum toxin”, “Botox”, “splint”, and “psychotherapy”. The search was conducted in the PubMed, Google Scholar, and Scopus databases, focusing on studies involving human subjects. Results: The included studies reported that the use of multimodal approaches—such as physiotherapy, botulinum toxin injections, occlusal splints, and/or psychotherapy—led to symptom improvement or complete resolution in patients with TMD. Conclusions: Temporomandibular disorders are complex conditions with a multifactorial etiology involving both somatic and psychological components. Given the wide range of symptoms and the functional connections of the temporomandibular joint with the nervous, muscular, and skeletal systems—including the cervical spine—effective treatment of TMD requires a multidisciplinary strategy. Full article

Introduction: This study aimed to evaluate the submental and masticatory muscles in patients of different age groups using magnetic resonance imaging (MRI) and computed tomography (CT) methods, and investigate potential associations between muscle morphology, temporomandibular joint (TMJ) structures, and disc displacement. Materials and Methods: A total of 185 MRI scans were retrospectively analyzed to assess the thickness of the digastric, geniohyoid, mylohyoid, medial pterygoid, masseter, and lateral pterygoid muscles bilaterally. TMJ hard tissue changes were classified using computed tomography (CT). Correlations between muscle thickness and TMJ structures were analyzed using Pearson correlation coefficients, with statistical significance set at p < 0.05. Results: The study population included 110 females and 75 males, with a mean age of 50.08 ± 20.15 years. The largest age group was 51–75 years (41%), followed by 18–35 years (28%). Significant correlations were observed between muscle thickness and TMJ structures as follows: Right digastric muscle showed a significant association with right disc–condyle position (p = 0.02). Right mylohyoid muscle exhibited a strong correlation with right disc–condyle position (p = 0.004). Left medial pterygoid muscle was significantly correlated with left condyle pathology (p = 0.02). Left masseter muscle showed a significant correlation with left condyle pathology (p = 0.014). Condylar flattening was the most frequent pathology, observed in 58% of right condyles and 53% of left condyles. Disc displacement was present in 41% of right TMJs and 34% of left TMJs. Conclusions: This study highlights the important associations between masticatory and submental muscle morphology and TMJ structures, suggesting that muscle function may play a role in condylar positioning and disc alignment. These findings emphasize the need for comprehensive muscle evaluation in TMJ disorder (TMD) diagnosis and treatment planning. Full article

Malocclusion can arise due to various causes and may impact not only temporomandibular joint (TMJ) disorders but also overall systemic health. This study aimed to evaluate the association of individual occlusal characteristics with sleep quality and stress levels in female college students. Occlusal analysis was conducted using T-Scan III on 84 participants (age: 21.7 ± 2.09), while sleep quality and stress levels were assessed using the Korean version of the Pittsburgh Sleep Quality Index and self-reported stress questionnaires, respectively. Sleep quality was categorized as “good sleeper” (≤5 points) or “poor sleeper” (>5 points). Stress levels were classified as Normal (≤13), Initial stress (14–16), Moderate stress (17–18), or Severe stress (≥19). The results indicated no significant differences in sleep quality based on occlusal characteristics. However, participants with Type A occlusion (posterior contact without anterior contact) exhibited higher stress scores than those with Type B occlusion. Correlation analysis showed a weak negative association between stress scores and occlusion type, but no significant relationship was found between occlusal characteristics, sleep quality, and stress levels. In conclusion, individual occlusal characteristics have limited explanatory power regarding their effects on sleep quality and stress. Full article

Naked mole-rats are extremely long-living rodents with a maximum lifespan of 37 years, and their cellular aging and tissue aging are almost nonexistent. Therefore, in this study, we aim to analyze the extracellular matrix of the temporomandibular joint (TMJ) of naked mole-rats at the molecular level and explore the molecules involved in anti-aging and their localization. Micro-computed tomography (CT) scans revealed increased mineral density and wear of the mandibular condyle in aged mice. Conversely, CT scans did not reveal wear of the mandibular condyle in naked mole-rats, and histological analysis did not reveal wear of the articular disk. Using various spectroscopies and artificial intelligence (AI), we found that the articular disk of naked mole-rats is composed of a cartilage-like layer with hyaluronic acid and collagen fibers with varying orientations, which is thought to have relieved mechanical stress and have protected the mandibular condyle. These results suggest that not only the amount, but also the spatial distribution of the extracellular matrix is important for the anti-aging properties of the TMJ, and may contribute to elucidating the pathology of TMJ disorders and other degenerative conditions and developing therapeutic drugs. Full article

Background/Objectives: Intra-articular injections of hyaluronic acid (HA) or platelet-rich plasma (PRP) have been used in the treatment of temporomandibular joint (TMJ) arthrocentesis to improve lubricative properties and influence regenerative processes. This study aimed to evaluate the potential clinical benefits of complementary bioviscosupplementation with hyaluronic acid (HA) and platelet-rich plasma (PRP) in patients undergoing double-portal TMJ arthrocentesis. Methods: A total of forty-six patients (33 females, 13 males; mean age of 45.83 ± 20.62 years) with arthrogenous temporomandibular disorders, identified through clinical and imaging examinations, were randomized into HA+PRP (23 patients) or HA-alone (23 patients) groups. The primary outcome variable was TMJ arthralgia; the secondary outcome was maximum mouth opening (MMO). All the outcome variables were assessed preoperatively (T0) and at several follow-ups (T1—1 month, T2—3 months, T3—6 months, T4—12 months follow-up). Results: The HA+PRP group presents lower TMJ arthralgia levels than the HA group at every follow-up moment (p < 0.05, r ≈ 0.3). At T3 and T4, the HA+PRP group presented a higher MMO average than the HA group (p = 0.03 and p = 0.02; r ≈ 0.3). At T4, the HA group’s success rate was lower than the HA+PRP group (65% vs. 96%), and a higher number of postoperative reinterventions were observed (35% vs. 4%). Conclusions: In this study, complementary intra-articular bioviscosupplementation (HA+PRP) following double-portal TMJ arthrocentesis was associated with better clinical outcomes regarding TMJ arthralgia reduction, MMO improvement, and reduced risk of future TMJ reintervention. Full article

Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic–pituitary–adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p < 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support. Full article

Background/Objectives: Arthroscopy and arthrocentesis are routinely performed for temporomandibular joint (TMJ) disorders, but high-quality evidence regarding their efficacy relative to each other is scarce. The current study, as part of an ongoing randomized controlled trial, aimed to compare office-based arthroscopic lysis and lavage with arthrocentesis for TMJ pain and dysfunction. Methods: Adults (≥18 years old) referred to a tertiary care hospital with TMJ arthralgia were included. The exclusion criteria comprised systemic rheumatic disease, connective tissue disease, bony ankylosis, congenital or acquired dentofacial deformities, a history of significant jaw trauma, or systemic illnesses. The primary outcome was joint pain during mandibular movement/function (visual analog scale (VAS); 0–100 mm). The secondary outcomes included pain at rest (VAS), maximum mouth opening (mm), maximum mouth opening without increased pain (mm), protrusive and lateral movements (mm), joint noises (absent/present), and mandibular function (mandibular function impairment questionnaire score). The outcomes were registered at baseline and 3-, 6-, and 12-month follow-ups. Linear mixed models and mixed-effects logistic regressions were utilized to evaluate the effects of interventions on the repeated outcome measurements. Results: Twenty subjects were randomly allocated to office-based arthroscopic lysis and lavage (n = 10) or arthrocentesis (n = 10). Multivariable mixed-effects models showed significantly higher pain scores during mandibular movement/function in the arthrocentesis group compared with arthroscopy (22.42 mm (95% CI: 5.28 to 39.57); p = 0.011). The secondary outcomes were not significantly different between the interventions. Conclusions: The preliminary results show the superiority of office-based arthroscopy over arthrocentesis in reducing pain during mandibular movement/function over a follow-up period of 1 year while showing no differences between interventions regarding other study outcomes. Full article