Correlation between Temporomandibular Disorders (TMD) and Posture Evaluated trough the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): A Systematic Review with Meta-Analysis

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Introduction: While Temporomandibular disorders (TMDs) are not typically considered a primary symptom of Parkinson disease (PD), recent studies have documented a correlation between ageing and TMDs, a cluster of conditions affecting the temporomandibular joint and surrounding musculature, thereby underscoring the potential for an increased frequency of TMDs in the ageing PD population. Objective: The purpose of this review is to systematically evaluate the existing literature on the topic and provide a comprehensive overview of the prevalence of TMDs in patients with PD. Methods: To determine eligibility, we utilised the Population (human subjects), Exposure (PD), Comparator (PD vs non-PD subjects), and Outcomes (TMD) (PECO) model. To conduct this systematic review, we searched for articles published in PubMed, Web of Science and Lilacs from the beginning until April 15, 2023.Results: Three studies were selected. All together they comprised a total of 55 828 subjects, out of which 12 629 were affected by PD or Parkinsonism, and the remaining 43 199 were non-PD subjects matched for age and sex. The study aimed to evaluate the prevalence of TMDs in subjects affected by PD. The results showed that 193/12629 (1.53%) of PD individuals presented with TMD symptoms or were diagnosed with TMD, while 260/43199 (0.6%) of non-PD subjects were diagnosed with the same. The meta-analysis showed that there was a higher TMD prevalence in PD subjects compared to non-PD subjects (RR 1.57; 95% CI: 1.30-1.89). Conclusion:The studies reviewed suggest a possible association between TMD and PD. Further research is needed to clarify the relationship between TMD and PD and to identify possible mechanisms and treatment strategies.

Section: Discussionmentioning

confidence: 99%

Prevalence of temporomandibular disorders in subjects affected by Parkinson disease: A systematic review and metanalysis

Franco

Minervini

Ronsivalle

et al. 2023

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“…The most common clinical manifestations of TMD are pain, joint noises, tenderness, dysfunction and functional limitation in the articular movement; furthermore, TMD patients may also suffer from headaches, earaches, tinnitus, dizziness, posture impairment, and neck and shoulder pain. 3,5,6,48 Indeed, recent evidence showed that TMD could negatively influence quality of life, suggesting a prompt and adequate rehabilitation of TMD pain. 10,12,13,49 Viscosupplementation with HA has been widely used in TMJ pathological changes considering that HA is a glycosaminoglycan naturally found in the synovial fluid.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic acid injections for pain relief and functional improvement in patients with temporomandibular disorders: An umbrella review of systematic reviews

Agostini,

Ferrillo,

Bernetti

et al. 2023

BackgroundTemporomandibular disorders (TMD) are the main cause of chronic facial pain, and intra‐articular (IA) injections of hyaluronic acid (HA) are commonly performed.ObjectivesThis umbrella review of systematic reviews aimed at analysing the effectiveness of HA injections on pain and functional outcomes in patients affected by TMD.MethodsPubMed, Cochrane Library and PEDro were systematically searched from inception until 17 January 2023 to identify systematic reviews evaluating the effects on pain and functional outcomes of HA IA injections. PROSPERO registration number: CRD42022382586.ResultsOut of 316 papers suitable for title/abstract screening, 18 articles were included in the umbrella review. Thirteen studies included only randomized controlled clinical trials (RCTs). The included systematic reviews reported no statistically significant differences between HA and corticosteroids, whereas platelet derivates seem to have good results in pain relief. The literature did not show severe adverse events, except for mild pain in the site of injection. Concerning the quality assessment of the 18 systematic reviews, 2 (11.11%) had a high quality, 3 (16.67%) a moderate quality, 7 (38.89%) a low quality and 6 (33.33%) a critically low quality.ConclusionsTaken together, findings of this umbrella review showed intriguing effects of IA HA injections in terms of reduction of pain intensity and improvement of functioning in patients affected by TMD. Furthermore, there is no agreement on the effectiveness of a combination of arthrocentesis or arthroscopy with IA HA injections. Although the literature showed these positive results after IA HA injections, the overlapping of primary studies in the systematic reviews included might have affect our results, such as the very low quality of the papers. Thus, further RCTs are needed to confirm the efficacy of IA injections of HA on pain relief in patients with TMD.

“…In order to manage TMD, it is important to reduce stress. 26,27 This can include relaxation techniques, such as deep breathing, yoga and meditation. 26 It is also important to avoid activities that may cause further strain on the TMJ, such as chewing gum, nail-biting and clenching or grinding of the teeth.…”

Section: Introductionmentioning

confidence: 99%

Post‐traumatic stress, prevalence of temporomandibular disorders in war veterans: Systematic review with meta‐analysis

Franco

Minervini

Fiorillo

et al. 2023

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IntroductionThe physical and psychological effects of war are not always easy to detect, but they can be far‐reaching and long‐lasting. One of the physical effects that may result from war stress is temporomandibular disorder (TMD).ObjectiveTo evaluate the prevalence of TMD sign and symptoms among war veterans diagnosed with PTSD.MethodsWe systematically searched in Web of Science, PubMed and Lilacs for articles published from the inception until 30 December 2022. All documents were assessed for eligibility based on the following Population, Exposure, Comparator and Outcomes (PECO) model: (P) Participants consisted of human subjects. (E) The Exposure consisted of exposition to war. (C) The Comparison was between war veterans (subjects exposed to war) and subjects not exposed to war. (O) The Outcome consisted of presence of temporomandibular disorders sign or symptoms (we considered pain to muscle palpation in war veterans).ResultsForty studies were identified at the end of the research. We chose only four study to draw up the present systematic study. The included subjects were 596. Among them, 274 were exposed to war, whereas the remaining 322 were not exposed to war stress. Among those exposed to war, 154 presented sign/symptoms of TMD (56.2%) whereas only 65 of those not exposed to war (20.18%). The overall effect revealed that subjects exposed to war and diagnosed with PTSD had a higher prevalence of TMD signs (pain at muscle palpation) than controls (RR 2.21; 95% CI: 1.13–4.34), showing an association PTSD war‐related and TMD.ConclusionsWar can cause lasting physical and psychological damage that can lead to chronic diseases. Our results clearly demonstrated that war exposure, directly or indirectly, increases the risk of developing TMJ dysfunction and TMD sign/symptoms.