• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.43 no.6
• /
• pp.363-367
• /
• 2017

Headaches are one of the most common conditions associated with temporomandibular disorder (TMD). In the present paper, we evaluated the relationship between headache and TMD, determined whether headache influences the symptoms of TMD, and reported two cases of TMD accompanied by headache. Our practical experience and a review of the literature suggested that headache increases the frequency and intensity of pain parameters, thus complicating dysfunctional diseases in both diagnostic and treatment phases. Therefore, early and multidisciplinary treatment of TMD is necessary to avoid the overlap of painful events that could result in pain chronicity.

• Journal of Oral Medicine and Pain
• /
• v.40 no.4
• /
• pp.155-162
• /
• 2015

Purpose: The association between pain and sleep is described as a vicious cycle and psychological distress is well known as comorbid condition in the patients with pain and sleep problems. The aim of the study was to evaluate the prevalence of self-reported sleep disturbance and its relationship to clinical and psychological profiles in temporomandibular disorder (TMD) patients. Methods: The sample consisted of 123 TMD patients (90 women and 33 men), with a mean age of $39.9{\pm}15.4years$. Self-report measures of sleep quality, pain and psychological profile were conducted via the Pittsburgh Sleep Quality Index (PSQI), the Brief Pain Inventory and the Symptom Checklist-90-Revision at the initial visit. The primary diagnosis of TMD were categorized as TMD with internal derangement without pain, TMD with joint pain, TMD with muscle pain and TMD with joint-muscle combined pain. The chi-square test, independent t-test, oneway ANOVA and multiple linear regression analysis were used for statistics. Results: The patients was grouped as good sleepers (n=32, scores of 5 and lower) and poor sleepers (n=91, scores of 6 and higher) according to the recommended cutoff point of the global PSQI score (>5). TMD patients with pain showed poor sleep quality than TMD patients with internal derangement without pain. Poor sleepers had high pain interference and elevated psychological distress. Among them, pain interference and depression were significant predictors to sleep quality. Conclusions: The results suggest that sleep disturbance is a prevalent complaint in TMD patients, and sleep problems in TMD patients are associated with pain and psychological distress.

• Journal of Korean Dental Science
• /
• v.11 no.1
• /
• pp.21-31
• /
• 2018

Occlusion may change spontaneously but dental treatment or trauma in the patients with temporomandibular disorders (TMDs) may also alter occlusion. This report presents three cases displaying occlusal changes. Review of literature emphasizes the significance of TMD treatment. Conservative treatment modalities such as counseling, medication, physical therapy and splint therapy may be selected as initial treatment options. Irreversible or invasive treatment, such as orthodontic, prosthodontic, and occlusal adjustment should not be attempted early. In case there is no response to conservative treatment, joint injection, muscle injection, arthrocentesis or arthroscopic surgery might be performed.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.22 no.1
• /
• pp.29-36
• /
• 2006

As migraine pain represents a substantial personal and social burden worldwide, there has been a great deal of effort in developing a screening instrument for migraine. Lipton et al(2003) developed and validated the ID Migraine questionnaire, which is a self-administered screener for migraine in primary care, and it is brief and easy to use for a primary care provider. The aim of this study was to determine if the ID Migraine questionnaire could be applied successfully to assess the headache patients with temporomandibular disorders(TMD) and orofacial pain. This study found that nausea, photophobia and headache-related disability had the highest individual sensitivities and specificities, and the performance of the three-item screener was equivalent to that reported in a previous study. Although the sensitivity of the three-item screener in this study (0.58) was lower than in a previous study (0.81), the specificity (0.98) was higher and the positive predictive value was 93.9%. This suggest that the ID Migraine questionnaire is very efficient in this setting. In conclusion, the ID Migraine questionnaire, which is a three-item screener consisting of nausea, photophobia and headache-related disability, is effective as a self-administered report for detecting migraine headaches in patients with temporomandibular disorders(TMD) and orofacial pain.

• Journal of Technologic Dentistry
• /
• v.42 no.3
• /
• pp.254-261
• /
• 2020

Purpose: This study aimed to investigate the effect of stress and oral parafunctional habits on temporomandibular joint disorders (TMD) in college students. Methods: An online survey comprising 354 questionnaires was conducted from May 23, 2020, to June 21, 2020. The collected data were analyzed using Student's t-test, one-way analysis of variance, correlation tests, and multiple regression analysis. Results: The stress symptom score was higher in females than in males. The symptoms of physical stress were significantly higher among students from the Department of Public Health, whereas those of psychological stress were higher among students from the Department of Physical Education. Both TMDs and oral parafunctional habits were higher among females, students of the Departments of Arts and Physical Education, and seniors. The higher the stress symptom level, the higher the scores for TMD and oral parafunctional habits. TMD and oral parafunctional habits were found to be most affected by physical stress. Conclusion: These findings indicate that a reduction in physical stress is required to decrease the prevalence of oral parafunctional habits and TMDs among college students. This can be achieved by the incorporation of physical activity programs, which may aid in reducing the symptoms of physical stress.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.18 no.2
• /
• pp.31-42
• /
• 2023

Objectives This study aimed to conduct a systematic review evaluating the effectiveness of muscle energy technique(MET) in temporomandibular joint disorders (TMD). Methods Searches were conducted in 11 electronic databases until October 2023. Randomized controlled trials(RCT) comparing the effect of MET for TMD were included. All studies were evaluated using the Cochrane Risk of Bias tool. Results Nine documents that fulfilled all the criteria were obtained for analysis. All studies showed some concerns in high risk of bias, but showed a significant improvement in pain and maximum mouth opening compared to baseline of MET or control group. MET was not better than extracorporeal shock wave therapy or myofascial release in some outcomes. Conclusions MET seems to be an effective treatment for TMD in some regards, however, can be considered as an adjunct therapy which has weak evidence. Further studies are required due to the inconclusive data and poor homogeneity found in this review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.6
• /
• pp.326-331
• /
• 2012

Objectives: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. Materials and Methods: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. Results: The high-risk group (PWI-SF${\geq}27$, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. Conclusion: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.38 no.5
• /
• pp.284-294
• /
• 2012

Objectives: The anterior open bite with temporomandibular disorders (TMD) is one of the most challenging cases both orthodontically and surgically. We introduce an intermaxillary traction treatment for patients with anterior open bite and TMD using a skeletal anchorage system (SAS). Materials and Methods: This study was comprised of 52 patients with anterior open bite and TMD. A total of four mini-screws were inserted, two screws each into the maxilla and mandible, to obtain a class II pattern of elastic application with 120-200 g force. Adjunctive muscle relaxation treatments, such as splint therapy, medication, and botulinum toxin injection were applied during or before intermaxillary traction. At least one treatment among adjunctive muscle relaxation treatment, mentioned above, was applied to 96.2% of patients. We evaluated the clinical characteristics of patients, TMD symptom changes, amount of open bite improved. The degree of open bite improvement was compared between the open bite-reduced group (21 patients) and not-reduced group (5 patients). Results: TMD symptoms (muscle/joint pain, joint sound, mouth opening) remained or improved in most patients, and worsened in about 10% of patients for each items. Anterior open bite was improved by a mean of 1.75 mm (P<0.01) during treatment. The open bite-reduced group exhibited a significant open bite improvement compared to the not-reduced group (P<0.05), with 37% of open bite improvement occurring during the first 3 months of treatment. Conclusion: The intermaxillary traction technique using SAS is a valid modality for correction of anterior open bite and improvement of TMD symptoms.

• Journal of Oral Medicine and Pain
• /
• v.40 no.2
• /
• pp.47-54
• /
• 2015

Purpose: Besides depression and anxiety, recently pain catastrophizing has been emphasized for an important psychological factor explaining pain response in various pain conditions including temporomandibular disorders (TMDs). The aims of this study were to evaluate pain catastrophizing of TMD patients and to investigate how the level of pain catastrophizing related with clinical variables and psychometric morbidity. Methods: Inclusion criterion was all new TMD patients ${\geq}18$ years old attending the Department of Orofacial Pain and Oral Medicine of Dankook University Dental Hospital (Cheonan, Korea) over three-month period in 2014, who completed questionnaires. The questionnaires included the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Symptom Check List- 90-Revised (SCL-90-R). All of them were examined clinically and diagnosed. Results: One hundred fifty five patients diagnosed as TMDs were participated in this study (mean age of $38.7{\pm}15.2$ years, male:female=1:2.5). Mean PCS score of the patients was 17.3 with standard deviation of 12.6. By the median of the PCS score (i.e., 15), the subjects were categorized into the high (${\geq}15$) and low catastrophizers (<15). Increased pain severity and interference and increased score of psychological features of SCL-90-R were found in the TMD patients with higher level of catastrophizing (p<0.001) and there was weak to moderate correlation between those factors (p<0.05). Difference in catastrophizing level was not found for other variables such as age, gender, duration of pain, education level and types of TMDs. Conclusions: Conclusively, pain catastrophizing of TMD patients relates positively to pain severity and pain interference. In addition to depression and anxiety, pain catastrophizing is positively correlated with variable other psychological morbidity such as somatization, obsessive- compulsive, interpersonal sensitivity, paranoid ideation and psychoticism. Types of TMD diagnosis do not seem to affect catastrophizing level. The results of this study suggest that pain catastrophizing should be emphasized and assessed in the TMD patients.

• Physical Therapy Rehabilitation Science
• /
• v.9 no.4
• /
• pp.244-251
• /
• 2020

Objective: Physical therapy techniques are required for patients with temporomandibular joint disorder (TMD), but the effects of treatment have not been compared. Therefore, effects of transcutaneous electrical nerve stimulation (TENS) and low level laser (LLL), which are most commonly used interventions, were compared. Design: Randomized controlled trial. Methods: Thirty-six participants with pain in the temporomandibular joint were enrolled, and 12 participants were randomly assigned to either the TENS group, LLL group, or placebo group. Each intervention was performed for a total of 6 sessions for 2 weeks. For the evaluation of the participants, the mouth opening (MO), pressure pain threshold (PPT), and stress were measured at three time periods: baseline, post-test, and follow-up at 2 weeks. Results: Significant interaction between groups according to each evaluation point was found only in PPT-masseter (p<0.05). The evaluation time point at which a significant difference appeared was at the post-test and follow-up at 2 weeks time periods. As a result of the post-test, the LLL group showed a significant improvement compared to the TENS group (p<0.05), and at 2 weeks follow-up, the TENS group showed a significant improvement compared to the placebo group (p<0.05). Conclusions: In this study, an experiment was conducted to compare the treatment effects when TENS, LLL, and placebo were given to patients with TMD. In addition, by quantitatively presenting the effect size of each treatment, this study suggests clinical use of TENS and LLL treatment for TMD.