Marzia Segu

Distribution of diagnoses in a population of patients with temporomandibular disorders.

OBJECTIVES The objective of this study was to describe the frequency of TMD diagnoses in a patient population for comparison with the available literature. METHODS Five hundred twenty consecutive patients seeking TMD treatment underwent a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) assessment. The prevalence and age distribution of the different RDC/TMD axis I and II diagnoses were described. RESULTS Muscle disorders, disk displacements, and other joint disorders were diagnosed respectively in 56.4%, 42.0%, and 57.5% of patients. Sixty percent of patients had depression symptoms, 76.6% had somatization, and 21.8% presented high levels of pain-related impairment. Disk displacements were more frequently diagnosed in the younger-aged, other joint disorders in the older-aged, and muscle disorders in the middle-aged subjects (ANOVA for mean age comparison, F = 3.355; P = .002). CONCLUSIONS These distribution frequencies of TMD diagnoses provide insight into the epidemiology of this disease.

Temporomandibular Joint Disorders in Patients With Different Facial Morphology. A Systematic Review of the Literature

PURPOSE The present article aimed to review systematically the literature on the relation between facial skeletal structures and temporomandibular joint (TMJ) disorders. MATERIALS AND METHODS A systematic search in the dental and medical literature was performed to identify all studies of humans assessing the relation between TMJ disorders and facial morphology. Articles were included based on study design, irrespective of TMJ disorder (eg, disc displacement, osteoarthrosis, or unspecified), skeletal features, diagnostic strategies (e.g., imaging techniques or clinical assessment), and population (eg, demographic features of participants) under investigation. The selected articles were assessed according to a format based on patients, problem, and population, intervention, comparison, and outcome and quality was evaluated based on the Newcastle-Ottawa Scale. RESULTS Thirty-four articles were included in the review, 27 of which concerned adult samples and 7 concerned adolescent samples. Quality was generally moderate. The articles dealt with the relation between facial morphology and the following TMJ disorders, assessed clinically or by magnetic resonance (MR): disc displacement (n = 20), osteoarthritis or osteoarthrosis (n = 8), and temporomandibular disorder signs and symptoms (n = 6). The different approaches featuring the various investigations and the presence of some potential methodologic biases complicated a summary of the findings. Most studies reported that some features related to the vertical dimension of the face might help distinguish patients with potential TMJ disc displacement or MR-detected signs of osteoarthrosis from those without TMJ disorders. CONCLUSIONS The quality of the available literature is not adequate to provide an evidence base on the topic. Despite the heterogeneity of design and findings of the reviewed articles, it seems reasonable to suggest that skeletal Class II profiles and hyperdivergent growth patterns are likely associated with an increased frequency of TMJ disc displacement and degenerative disorders.