Temporomandibular disorders—review of evidence-based management and a proposed multidisciplinary care pathway

Patel, Kamala D.; Eley, Karen A.; Cascarini, Luke; SR, Watt-Smith; M, Larkin; Lloyd, Tracey; Maddocks, Clare; McLaren, Elenor; Stovell, Rachel; RS, McMillan

doi:10.1016/j.oooo.2023.02.001

“…48 Therefore, developing multidisciplinary teams may be a promising approach to bridging the dental-medical divide and benefiting lowincome patients. 49,50 There were also some other findings in this study. In patients with TMD, the female gender was significantly positively associated with both anxiety and impaired jaw function, suggesting that gender may be a common cause of both.…”

Section: Discussionsupporting

confidence: 81%

“…Furthermore, low‐income patients may face significant barriers to referral for psychological interventions due to mental illness stigma, 47 the cost of travel to multiple providers, 9 and insurance issues associated with referrals 48 . Therefore, developing multidisciplinary teams may be a promising approach to bridging the dental‐medical divide and benefiting low‐income patients 49,50 …”

Section: Discussionmentioning

confidence: 99%

Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders

Zheng,

Zhou,

Huang

et al. 2023

J of Oral Rehabilitation

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ObjectiveThe association between jaw function and income in patients with temporomandibular disorders (TMDs) remain unclear. The aim of this study was to explore this association and its relationship with anxiety and depression.Subjects and MethodsA total of 451 TMD patients, including 361 males and 90 females, participated in this study. The sociodemographic information of patients and their questionnaires including the Generalised Anxiety Disorder 7‐item (GAD‐7), Patient Health Questionnaire 9‐item (PHQ‐9), and Jaw Functional Limitation Scale‐8 (JFLS‐8) were collected. Patients were divided into the high‐income and low‐income groups based on a household per capita income of 6000 RMB per month. Multiple regression and mediation analysis were used to explore the association between variables. The bootstrap method was applied to estimate confidence intervals (CIs).ResultsHigher JFLS‐8 scores were significantly correlated with higher GAD‐7 scores (r = 0.361, p < .001), PHQ‐9 scores (r = 0.339, p < .001). Females and patients with low income had statistically higher JFLS‐8 scores (p < .01, p < .001). Mediation analysis with 10 000 bootstrap simulations revealed a significant direct association between JFLS‐8 scores and income (−2.920, 95% CI [−4.757, −1.044], p = .002). A significant indirect association of JFLS‐8 scores with income via GAD‐7 scores and PHQ‐9 scores was also observed (−0.889, 95% CI [−1.728, −0.164], p = .025), accounting for 23.3% of the total association.ConclusionsLow income is associated with impaired jaw function via anxiety and depression in patients with TMD. Clinicians may need to pay more attention to the psychological status of low‐income TMD patients in clinical practice.

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“…The TMJ prosthesis is indicated for diseases that result in anatomical changes and aims to restore joint function with pain relief. Significant advances have been made in the design of TMJ prostheses due to 3D printing [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…In this context, temporomandibular disorder (TMD) configures TMJ diseases that may be related to the joints, muscles, ligaments, bones, teeth, and psychological aspects. However, TMD can be divided into two large subgroups: those originating from joint problems, that is, those in which the signs and symptoms are related to the TMJ, and those of muscular origin, where their relationship is associated with the structures of the stomatognathic system [3][4][5]. Furthermore, patients with TMD often suffer from chronic pain, but severe pain can lead to a reduced quality of life.…”

Section: Introductionmentioning

confidence: 99%

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Gubert,

Mercante,

Polidoro

et al. 2024

MedNEXT

0

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Introduction: The temporomandibular joint (TMJ) can be affected by end-stage pathologies, such as arthritic disease, trauma, and ankylosis. Around 70% of the general population has suffered at least one symptom of temporomandibular disorder (TMD), which constitutes TMJ disease that may be related to the joints, muscles, ligaments, bones, teeth, and psychological aspects. As a treatment, the implantation of a total alloplastic TMJ prosthesis is an innovative approach. Objective: It was to present the main considerations and outcomes of clinical studies on the treatments of temporomandibular disorders using customized or prefabricated prostheses. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found, 40 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=57.8%>50%. It was concluded that stock and CAD/CAM prostheses suggested great improvements in mouth opening and pain reduction as a result of the rehabilitation of TMJ function. The results showed comparable data for both types of prosthesis design at 6 months postoperatively. However, the additional advantages of custom prosthetics, along with increasing access to digital technology, will likely result in custom devices dominating the market in TMJ total joint replacement systems. The custom-made combined prosthesis with custom design and 3D printing fabrication represents a safe and reliable implantable reconstruction method for combined TMJ-skull base injuries.

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“…The TMJ prosthesis is indicated for diseases that result in anatomical changes and aims to restore joint function with pain relief. Significant advances have been made in the design of TMJ prostheses due to 3D printing [3,4].…”

Section: Introductionmentioning

confidence: 99%

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Gubert,

Mercante,

Polidoro

et al. 2024

MedNEXT

0

View full text Add to dashboard Cite

Introduction: The temporomandibular joint (TMJ) can be affected by end-stage pathologies, such as arthritic disease, trauma, and ankylosis. Around 70% of the general population has suffered at least one symptom of temporomandibular disorder (TMD), which constitutes TMJ disease that may be related to the joints, muscles, ligaments, bones, teeth, and psychological aspects. As a treatment, the implantation of a total alloplastic TMJ prosthesis is an innovative approach. Objective: It was to present the main considerations and outcomes of clinical studies on the treatments of temporomandibular disorders using customized or prefabricated prostheses. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from February to April 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found, 40 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 10 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=57.8%>50%. It was concluded that stock and CAD/CAM prostheses suggested great improvements in mouth opening and pain reduction as a result of the rehabilitation of TMJ function. The results showed comparable data for both types of prosthesis design at 6 months postoperatively. However, the additional advantages of custom prosthetics, along with increasing access to digital technology, will likely result in custom devices dominating the market in TMJ total joint replacement systems. The custom-made combined prosthesis with custom design and 3D printing fabrication represents a safe and reliable implantable reconstruction method for combined TMJ-skull base injuries.

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Temporomandibular disorders—review of evidence-based management and a proposed multidisciplinary care pathway

Cited by 5 publications

References 100 publications

Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders

Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

Major considerations and outcomes of clinical studies on the treatment of temporomandibular disorders using prostheses: a systematic review

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