Relationship between cervical spine and skeletal class II in subjects with and without temporomandibular disorders

AIM. To assess changes of cranio-cervical structure and of hyoid bone position in skeletal Class II subjects with and without Temporomandibular disorders (TMD). MATERIAL AND METHODS. The cephalometric analysis of 59 subjects with skeletal Class II were evaluated and compared. The measurements considerated were: ANB as parameter of Class II and C0-C1 distance, C1-C2 distance, cranio-cervical angle and hyoid bone position for the cervical spine analysis. Patients were divided into two subgroups: patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with the Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson and Spearman correlation analysis, with p-value <0,005, were performed. RESULTS. C0-C1 and C1-C2 distance values and hyoid bone position resulted within normal range in the majority of patients examined. Cranio-cervical angle was alterated in 33 patients. The reduction of this angle with the increase of the ANB value resulted statistically significant in the group A, according to Pearson correlation index. No other data was statistically significant. CONCLUSIONS. Significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of cranio-cervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (group A and B). The presence of TMDs as key factor in changes of neck posture could explain the different result between the two groups about relationship between ANB and cranio-cervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the cranio-cervical space or to temporomandibular joints retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture also could be the result of a compensatory/ antalgic mechanism in response to TM

Temporomandibular joint damage in juvenile idiopathic arthritis: Diagnostic validity of diagnostic criteria for temporomandibular disorders

Diagnostic criteria reported in the expanded taxonomy for temporomandibular disorders include a standardised clinical examination and diagnosis (DC/TMD 3.B) of temporomandibular joint (TMJ) damage in patients with juvenile idiopathic arthritis (JIA); however, their validity is unknown

Functional implications of minor mandibular asymmetry: clinical and digital research on a sample of healthy patients

OBJECTIVE.The aim of the study is to evaluate the influence that the mandibular asymmetry could have towards the other components of the Stomathognatic system and to further related structures from a functional point of view. MATERIALS and METHODS. A sample of 18 young asymmetric patients, in healthy status, was investigated with clinical evaluation and questionnaires and digital devices such as Electromiography, Stabilometry, T-scan and Formetric. Descriptive and quantitative statistical analysis were performed. RESULTS. ASIM electromyography index was significant only in a short percentage of the sample. Hypertonia of temporalis muscle in the same side of mandibular deviation and the cross-activation of the contralateral masseter were present. The data of the stabilometric platform showed that only 33% of patients had a load discrepancy between right and left side. All patients presented similar and limited postural anomalies during the Formetric examination. No significant results emerged from statistics . CONCLUSIONS. From the emerging data, mandibular asymmetry does not seem to be considered a potential risk factor for the development of functional anomalies both in the stomatognatic system and in the postural one. The only issue that should be considered is the condylar retrusion of the mandibular shortest side that is a possible destabilizing factor of the TMJ condyle-disc coordination

Functional implications of minor mandibular asymmetry: clinical and digital research on a sample of healthy patients

OBJECTIVE.The aim of the study is to evaluate the influence that the mandibular asymmetry could have towards the other components of the Stomathognatic system and to further related structures from a functional point of view. MATERIALS and METHODS. A sample of 18 young asymmetric patients, in healthy status, was investigated with clinical evaluation and questionnaires and digital devices such as Electromiography, Stabilometry, T-scan and Formetric. Descriptive and quantitative statistical analysis were performed. RESULTS. ASIM electromyography index was significant only in a short percentage of the sample. Hypertonia of temporalis muscle in the same side of mandibular deviation and the cross-activation of the contralateral masseter were present. The data of the stabilometric platform showed that only 33% of patients had a load discrepancy between right and left side. All patients presented similar and limited postural anomalies during the Formetric examination. No significant results emerged from statistics . CONCLUSIONS. From the emerging data, mandibular asymmetry does not seem to be considered a potential risk factor for the development of functional anomalies both in the stomatognatic system and in the postural one. The only issue that should be considered is the condylar retrusion of the mandibular shortest side that is a possible destabilizing factor of the TMJ condyle-disc coordination

Somatosensory abnormalities in Chinese patients with painful temporomandibular disorders

Background: The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines. Methods: A standardized quantitative sensory testing (QST) battery consisting of 13 parameters with a stringent statistical protocol developed by the German Research Network on Neuropathic Pain was performed over the most painful and corresponding contralateral sites as well as the right hand of 40 Chinese patients with TMD and pain classified according to the Diagnostic Criteria for TMD (DC/TMD). The same QST protocol was performed bilaterally over the infraorbital, mental, and hand regions of 70 age-and gender-stratified healthy Chinese controls. Z-scores and loss/gain scores were computed for each TMD patient. Results: For patients, 82.5 % had somatosensory abnormalities in the painful facial region, while 60.0 % had abnormalities confined to the right hand. The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli. The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions. Involving side-to-side differences in the evaluation increased the diagnostic sensitivity by 2.5-25.0 % across different parameters. Conclusions: Somatosensory abnormalities were commonly detected in Chinese TMD pain patients both within and outside the primary painful region, strongly indicating disturbances in the central processing of somatosensory stimuli. The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.Capital Health Research and Development [2011-4025-01]; Peking University School of Stomatology [PKUSS20150207]SCI(E)[email protected]

Frequency of daytime tooth clenching episodes in individuals affected by masticatory muscle pain and pain-free controls during standardized ability tasks

Tooth clenching has been suggested to be related to temporomandibular pain. However, the electromyographic characteristics of daytime clenching episodes have been minimally investigated. This study aimed to analyze the frequency, amplitude, and duration of daytime clenching episodes in patients with masticatory muscle pain and pain-free individuals

Langtidsoppfølging (10 år) av pasienter behandlet med kjeveleddsoperasjon diskektomi- med fokus på radiologiske funn

Denne masteroppgaven vil fokusere på denne lille andelen og spesielt på de resultater som er publisert etter kjeveleddsoperasjonen diskektomi. Oppgaven vil bli todelt. Den første delen er en litteraturstudie på etterundersøkelser av pasienter som har gjennomgått diskektomi og den andre delen tar utgangspunkt i et norsk pasientmateriale som er beskrevet klinisk og publisert (Bjørnland og Larheim 2003). I arbeidet rapporteres de kliniske observasjonene preoperativt og 3 år og 10 år postoperativt. Vi vil i denne Masteroppgaven rapportere (originale) radiologiske observasjoner på den samme pasientgruppen. I tillegg beskrives en enkelt «uselektert» pasient i dette materialet som er blitt henvist til Avd for kjeve- og ansiktsradiologi nærmere 30 år etter bilateral diskektomi

Somatic tinnitus

Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role - although different from case to case - in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients

Perspectives on next steps in classification of oro-facial pain - part 1: role of ontology

The purpose of this study was to review existing principles of oro-facial pain classifications and to specify design recommendations for a new system that would reflect recent insights in biomedical classification systems, terminologies and ontologies. The study was initiated by a symposium organised by the International RDC/TMD Consortium Network in March 2013, to which the present authors contributed. The following areas are addressed: problems with current classification approaches, status of the ontological basis of pain disorders, insufficient diagnostic aids and biomarkers for pain disorders, exploratory nature of current pain terminology and classification systems, and problems with prevailing classification methods from an ontological perspective. Four recommendations for addressing these problems are as follows: (i) develop a hypothesis-driven classification structure built on principles that ensure to our best understanding an accurate description of the relations among all entities involved in oro-facial pain disorders; (ii) take into account the physiology and phenomenology of oro-facial pain disorders to adequately represent both domains including psychosocial entities in a classification system; (iii) plan at the beginning for field-testing at strategic development stages; and (iv) consider how the classification system will be implemented. Implications in relation to the specific domains of psychosocial factors and biomarkers for inclusion into an oro-facial pain classification system are described in two separate papers

Subtyping somatic tinnitus: a cross-sectional UK cohort study of demographic, clinical and audiological characteristics

Somatic tinnitus is the ability to modulate the psychoacoustic features of tinnitus by somatic manoeuvres. The condition is still not fully understood and further identification of this subtype is essential, particularly for the purpose of establishing protocols for both its diagnosis and treatment. This study aimed to investigate the characteristics of somatic tinnitus within a large UK cohort using a largely unselected sample. We believe this to be relatively unique in comparison to current literature on the topic. This was investigated by using a total of 608 participant assessments from a set of recognised tinnitus and audiology measures. Results from a set of chi-square tests of association found that amongst the individuals with somatic tinnitus, a higher proportion had pulsatile tinnitus (different from heartbeat), were under the age of 40, reported variation in the loudness of their tinnitus and reported temporomandibular joint (TMJ) disorder. The same pattern of results was confirmed using a multivariate analysis of the data based on logistic regression. These findings have strong implications towards the profiling of somatic tinnitus as a distinct subtype of general tinnitus