Temporomandibular joint anterior disc displacement with reduction in a young population: Prevalence and risk indicators

Background: Temporomandibular joint (TMJ) anterior disc displacements with reduction (ADDR) are commonly found in the young population and often found to be associated with biomechanical and anatomical factors. Until now, most knowledge on ADDR among children and adolescents comes from studies performed on Caucasian subjects. Aims: To assess the clinically determined prevalence rates of ADDR among the young Indonesian population and to evaluate its risk indicators. Design: In this cross-sectional study, 1562 pupils and students of 7-21 years old completed a questionnaire and underwent a clinical examination. Results: The prevalence rates of ADDR were 7.0% among children (7-12 years), 14.4% among adolescents (13-18 years), and 12.3% among young adults (19-21 years). Logistic regression analyses revealed that increasing age and lip biting were associated with ADDR in children, whereas pen biting was associated with ADDR in the adolescent population. None of the included factors were found to be associated with ADDR in the young adult population. Conclusions: The present findings indicate that prevalence of ADDR increases with age, with a peak during the years of adolescence. Biomechanical factors seem to play a significant role in ADDR development

Effectiveness of botulinum toxin type A treatment of neck pain related to nocturnal bruxism: a case report

OBJECTIVE: This case report describes a patient with nocturnal bruxism and related neck pain treated with botulinum toxin type A (BTX-A). CLINICAL FEATURES: The patient was a 27-year-old man with nocturnal bruxism and difficulty in active mouth opening and chewing and neck pain at rest. His numeric pain score was 7 of 10. Surface electromyography of the temporalis and masseter muscles showed typical signs of hyperactivity, characterized by compound muscle action potential amplitude alterations. INTERVENTION AND OUTCOME: After clinical evaluation, he was treated with BTX-A to reduce masseter and temporalis muscle hyperactivity. After 3 days of treatment with BTX-A, with each masseter muscle injected with a dose of about 40 mouse units with a dilution of 1 mL and with temporal muscle bilaterally injected with 25 mouse units with the same dilution, a decrease in bruxism symptoms was reported. Neck pain also decreased after the first treatment (visual analog scale of 2/10) and then resolved completely. After 4 weeks, electromyography showed the reduction of muscle hyperactivity with a decrease in the amplitude of the motor action potential. The same reduction in signs and symptoms was still present at assessment 3 months posttreatment. CONCLUSION: These findings suggest that BTX-A may be a therapeutic option for the treatment of bruxism and related disorders