Of the various conservative treatment modalities available for temporomandibular disorders, we believe that therapeutic exercise has a good prognosis, especially for anterior disc displacement without reduction. Since its effectiveness has not been extensively evaluated, we conducted a comparative study to verify the hypothesis that treatment efficacy would not differ for exercise and occlusal splints. Fifty-two individuals with anterior disc displacement without reduction were randomly assigned to a splint or a joint mobilization self-exercise treatment group. Four outcome variables were evaluated: (i) maximum mouth-opening range without and (ii) with pain, (iii) current maximum daily pain intensity, and (iv) limitation of daily functions. All outcome variables significantly improved after 8 weeks of treatment in both groups. In particular, the mouth opening range increased more in the exercise group than in the splint group. This result demonstrates that therapeutic exercise brings earlier recovery of jaw function compared with splints.

The aim of this study was to compare the multidimensional properties among subtypes of painful temporomandibular disorders (TMD): myofascial pain (group I), disc displacement (group II), arthralgia (group IIIa) and osteoarthritis (group IIIb). A total of 511 patients answered a battery of questionnaires, which included questions relating to intensity and duration of pain, the Japanese version of the McGill Pain Questionnaire, limitation of daily functions, the Hospital Anxiety and Depression Scale, the Eysenck Personality Questionnaire short-form and 34 items of behavioural contributing factors. Group IIIb showed significantly the highest age in all subtypes. Those in group I had higher depression scores than those in group II (P = 0.005). Group IIIa had a lower women's ratio than in group II (P = 0.001) and the patients showed a shorter pain duration than those in groups I (P = 0.000) and II (P = 0.001). Group IIIa patients also showed lower visual analogue scale (VAS) ratings for pain descriptors 'heavy' (P = 0.002) and 'tiring' (P = 0.004) than those of group I, and 'dull' (P = 0.005), 'heavy' (P = 0.001) and 'tiring' (P = 0.005) than those of group II. Group IIIa showed lower ratios of contributing factors of 'an awareness of grinding/clenching during sleep' (P = 0.000) and 'an awareness of clenching sensation when waking up at night' (P = 0.002) than those of group I, and also showed a higher ratio of 'a liking for a hard food' (P = 0.000) and lower ratio of 'talking for a long time on the telephone' (P = 0.001) than those of group II. In conclusion, although several properties were different between subtypes, the majority of them were similar in the four subtypes of TMD.

Background: The symptoms of temporomandibular disorders (TMD) are directly influenced by numerous factors, and it is thought that additional factors exert indirect influences. However, the relationships between TMD-related symptoms (TRS) and these contributing factors are largely unknown. Thus, the goal of the present study was to investigate influences on TRS in a working population by determining the prevalence of TRS, analyzing contributing factors, and determining their relative influences on TRS.Materials and Methods: The study subjects were 2203 adults who worked for a single company. Subjects completed a questionnaire assessing TRS, psychosocial factors (stress, anxiety, depressed mood, and chronic fatigue), tooth-contacting habit, and sleep bruxism-related morning symptoms, using a 5-point numeric rating scale. Our analysis proceeded in 2 phases. First, all variables of the descriptor were divided into parts by using an exploratory factor analysis. Second, this factorial structure was verified by using a confirmatory factor analysis with structural equation modeling.Results: Of 2203 employees, 362 reported experiencing TRS (16.4%). Structural equation modeling generated a final model with a goodness of fit index of 0.991, an adjusted goodness of fit index of 0.984, and a root mean square error of approximately 0.021. These indices indicate a strong structural model. The standardized path coefficients for “habitual behavioral factors and TRS,” “psychosocial factors and habitual behavioral factors,” “psychosocial factors and TRS,” and “gender and habitual behavior factors” were 0.48, 0.38, 0.14, and 0.18, respectively.Conclusions: Habitual behavioral factors exert a stronger effect on TRS than do psychosocial factors.

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