Association between CMD signs and symptoms, oral parafunctions, race and sex, in 4–6-year-old African-American and Caucasian children

The associations between oral parafunctions, signs and symptoms of craniomandibular disorders (CMD), race, and sex were analysed in recordings from 203 4-6-year-old African-American and Caucasian children. Significant correlations were found between bruxism, nail biting, thumb sucking and most of the CMD signs and symptoms. There were also significant associations between most of the signs and symptoms and race, while significant association with sex was found only regarding headache, TMJ sounds and chewing pain. Significant associations were found between most CMD signs and TMJ sounds supporting the view that joint sound recordings have diagnostic value. There were also significant associations between the pain variables recorded by questionnaire and those recorded by palpation, which indicates that reliable data can be obtained by interviewing children as young as five. The results of this study support the concept that oral parafunctions have a significant role in the aetiology of CMD. The results also show that race and sex need to be considered when analysing the possible aetiological role of oral parafunctions in CMD. Longitudinal studies, beginning with low age groups are needed to better determine the role of childhood oral parafunctions in CMD aetiology.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75673/1/j.1365-2842.1995.tb00241.x.pd

Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi arabian adolescents: a research report

BACKGROUND: The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunction habits among Saudi adolescents in the permanent dentition stage. METHODS: A total of 385 (230 females and 155 males) school children age 12–16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation. RESULTS: The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5%) followed by restricted opening (4.7%) and opening deviation (3.9%). The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%). Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41%) with females significantly more than males, followed by nail biting (29%). Bruxism and thumb sucking were only 7.4% and 7.8% respectively. CONCLUSION: The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%

The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint.</p> <p>Methods</p> <p>We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database.</p> <p>Results</p> <p>Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavaklı 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion.</p> <p>Conclusion</p> <p>Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening.</p

Maximal mouth opening capacity: percentiles for healthy children 4-17 years of age

BACKGROUND: A reduced mouth opening capacity may be one of the first clinical signs of pathological changes in the masticatory system. The aim of this retrospective cross-sectional study was to create age related percentiles for unassisted maximal mouth opening capacity (MOC) of healthy children. METHODS: All recordings of MOC as measured at the yearly dental examinations of school children in the city of Zurich, Switzerland, between August 2009 and August 2010 were extracted from the database. The program LMSchartMaker Pro Version 2.43, Huiqi Pan and Tim Cole, Medical Research Council, 1997--2010 was used to calculate age and sex related reference centiles. RESULTS: Records from 22[prime]060 dental examinations were found during the study period. In 1286 (5.8%) the maximal interincisal measurement was missing. Another 55 examinations were excluded because of missing data for sex (7), age at examination (11) or because the value was deemed to be pathologically low (37). Thus, a total of 20[prime]719 measurements (10[prime]060 girls, 10[prime]659 boys) were included in the analysis. The median age (range) was 9.9 years (3.3-18.3) for girls and 10.0 years (2.8-18.7) for boys. The mean MOC (range) was 45 mm (25--69) for girls and 45 mm (25--70) for boys. Age related percentiles were created for girls and boys separately, showing the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile from 3 through 18 years of age. CONCLUSIONS: In these 20[prime]719 unselected school children MOC increased with age but showed a wide range within children of the same age

A mandibular advancement device reduces sleep disordered breathing in patients with congestive heart failure

Sleep disordered breathing (SDB) including obstructive and central sleep apnoea/ hypopnoea as well as periodic breathing (PB) is common and is believed to increase risk for mortality in patients with congestive heart failure (CHF). Mandibular advancement device (MAD) has widely been recommended for treatment of obstructive sleep apnoea but the method has never been investigated for treatment of SDB in the patients with CHF. The aim with the present study was to examine the effect of MAD intervention on SDB in patients with CHF. The study included 17 male patients, aged 68.4 +/- 5.7 (mean +/- SD) with stable, mild to moderate CHF due to left ventricular systolic dysfunction and with SDB, expressed as apnoea/hypopnoea index (AHI) >= 10. The SDB was examined during a single night using an unattended, portable polysomnographic device in the patients home, prior to and following intervention with a individually adjusted MAD. The SDB was evaluated by calculating AHI, PB expressed as the percentage of the total registration time, oxygen desaturation index (ODI) and snoring time. The AHI was reduced by MAD intervention from 25.1 +/- 9.4 to 14.7 +/- 9.7 (P = 0.003). ODI reduced fro M 21.1 +/- 9.0 to 10.5 +/- 7.8 (P = 0.007) and snoring time decreased from 53 +/- 111 to 18 47 seconds (P = 0.02). PB was reduced from 55.7 +/- 25.6 to 40.4 +/- 26.4 per cent without statistical significance. In conclusion, the MAD intervention may be a feasible method for reducing SDB in patients with stable, mild to moderate CHF and left ventricular systolic dysfunction

A mandibular advancement device reduces sleep disordered breathing in patients with congestive heart failure

Sleep disordered breathing (SDB) including obstructive and central sleep apnoea/ hypopnoea as well as periodic breathing (PB) is common and is believed to increase risk for mortality in patients with congestive heart failure (CHF). Mandibular advancement device (MAD) has widely been recommended for treatment of obstructive sleep apnoea but the method has never been investigated for treatment of SDB in the patients with CHF. The aim with the present study was to examine the effect of MAD intervention on SDB in patients with CHF. The study included 17 male patients, aged 68.4 +/- 5.7 (mean +/- SD) with stable, mild to moderate CHF due to left ventricular systolic dysfunction and with SDB, expressed as apnoea/hypopnoea index (AHI) >= 10. The SDB was examined during a single night using an unattended, portable polysomnographic device in the patients home, prior to and following intervention with a individually adjusted MAD. The SDB was evaluated by calculating AHI, PB expressed as the percentage of the total registration time, oxygen desaturation index (ODI) and snoring time. The AHI was reduced by MAD intervention from 25.1 +/- 9.4 to 14.7 +/- 9.7 (P = 0.003). ODI reduced fro M 21.1 +/- 9.0 to 10.5 +/- 7.8 (P = 0.007) and snoring time decreased from 53 +/- 111 to 18 47 seconds (P = 0.02). PB was reduced from 55.7 +/- 25.6 to 40.4 +/- 26.4 per cent without statistical significance. In conclusion, the MAD intervention may be a feasible method for reducing SDB in patients with stable, mild to moderate CHF and left ventricular systolic dysfunction

Short-term effect of occlusal adjustment on craniomandibular disorders including headaches

The aim of this study was to assess the short-term effect of occlusal adjustment on craniomandibular disorders. Fifty patients were randomly selected and divided into a treatment (T) and a control (C) group. The initial clinical examination and the follow-up were made by one observer and the occlusal adjustment by another. There were no significant differences between groups with regard to frequency of headaches, facial pain, pain on mandibular function, or duration of headaches and facial pain. Fifty-two percent of the patients in the treatment group and 20% of the patients in the control group reported reduced subjective symptoms overall at follow-up examination. The improvement was statistically significant within the T group and significantly greater than in the C group. There was no significant change within or between groups with regard to frequency of headaches, facial pain, or pain on mandibular movements. There was an almost significant difference between groups after treatment with regard to changes in the number of tender muscles. The results of this study indicate that occlusal adjustment provides a general subjective improvement of craniomandibular disorders