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Sustained and Repeated Mouth Opening Leads to Development of Painful Temporomandibular Disorders Involving Macrophage/Microglia Activation in Mice

Temporomandibular disorder (TMD) is a set of heterogeneous musculoskeletal conditions involving the temporomandibular joint (TMJ) and/or the masticatory muscles. Up to 33% of the population has had at least one symptom of TMD with 5-10% of them requiring treatment. Common symptoms include limited jaw movement, joint sound, and pain in the orofacial area. Once TMD becomes chronic, it can be debilitating with comorbidities that greatly reduce one's overall quality of life. However, the underlying mechanism of TMD is unclear due to the multicausative nature of the disease.

Prevalence of TMD in Sjӧgren Syndrome Patients

Sjӧgren's Syndrome seems to play a role in temporomandibular joint disorders.

Early Molecular Response and Microanatomical Changes in the Masseter Muscle and Mandibular Head After Botulinum Toxin Intervention in Adult Mice

The Botox-injected masseters had greatly increased expression of genes involved in muscle atrophy at the 1 week time point compared to the control side muscles. At the end of the study, 2 weeks after injection, the Botox-injected masseters were about 20% smaller than the control side masseters, and the Botox-side condyles had lost about 40% of relative bone area compared to the control side condyles.

Centralized Pain in TMD: Is It All in the Head?

We are pleased to introduce Sophia Stone, a new contributor to The TMJ Association, whose passion is to separate TMD fact from TMD fiction. Sophia has a background in medicine and research and can draw on her personal experience as a TMD patient.

Good News...Exercise Improves Disc Displacement

  • Jul 27, 2017

A recent study conducted at the Tokyo Medical and Dental University found that therapeutic exercise brings earlier recovery of jaw function compared with splints!

Randomized Clinical Trial of Treatment for TMJ Disc Displacement

Abstract:

Of the various conservative treatment modalities available for temporomandibular disorders, we believe that therapeutic exercise has a good prognosis, especially for anterior disc displacement without reduction. Since its effectiveness has not been extensively evaluated, we conducted a comparative study to verify the hypothesis that treatment efficacy would not differ for exercise and occlusal splints. Fifty-two individuals with anterior disc displacement without reduction were randomly assigned to a splint or a joint mobilization self-exercise treatment group. Four outcome variables were evaluated: (i) maximum mouth-opening range without and (ii) with pain, (iii) current maximum daily pain intensity, and (iv) limitation of daily functions. All outcome variables significantly improved after 8 weeks of treatment in both groups. In particular, the mouth opening range increased more in the exercise group than in the splint group. This result demonstrates that therapeutic exercise brings earlier recovery of jaw function compared with splints.

Treatment Procedures:

All participants received a verbal explanation of their pathological conditions regarding jaw function based on x-ray and MRI findings, and a general self-care protocol such as good posture, soft diet, teeth apart, etc. 

Participants in the splint group wore a maxillary stabilization appliance while sleeping at night. The splint was 1.5-mm-thick hard, clear acrylic sheet that was vacuum-adapted to the maxillary cast. The splint was adjusted to ensure occlusal contact of all mandibular teeth in centric relation and mandibular canine guidance in eccentric movement.

In the exercise group, participants performed manual jaw-opening exercises by themselves, according to the following protocol: As a warm-up, the individual repeated small mouth-opening and closing movements several times. Then, the individual placed his/her fingertips on the edge of the mandibular anterior teeth and slowly pulled the mandible down until pain occurred on the TMJ-affected side. This mouth-opening position was held for 30 sec. Three cycles of this stretching movement were defined as a single set. The participant performed 4 sets per day, one after each meal and one while bathing.

All participants in both groups were prescribed a non-steroidal anti-inflammatory drug (Amfenac sodiu, Fenazox, Meiji Sika Co., Tokyo, Japan; 150 mg) 3 times every day, and were followed up at 4 and 8 weeks after the start of treatment. No significant adverse effect was reported resulting from either treatment.

TMJ Disorders

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