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The TMJ Association is pleased to partner with Inspire to bring you the TMJ Cafe, a free online support network and discussion community for those with Temporomandibular Disorders (TMD). We invite you to meet others like you, share experiences and tips for getting through the day, and give and receive support.

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.

Overdiagnosis and Unnecessary Therapy

  • Mar 2, 2017

We grateful to Dr. Daniel Laskin, Adjunct Clinical Professor and Chairman Emeritus at Virginia Commonwealth University School of Dentistry, Oral and Maxillofacial Surgery, for summarizing the following article for our readers.
  
Many dental practitioners continue to use radiographic or magnetic resonance imaging (MRI) findings in the temporomandibular joint (TMJ) as the sole means of establishing that there is pathology present that requires treatment. These findings include the position of the intra-articular disc in relation to the mandibular condyle, the location of the condyle relative to the glenoid fossa, the depth of the glenoid fossa, and flattening of the condylar surface. In this study the MRIs of two groups of asymptomatic general population individuals differing in age by 20 years were analyzed for these factors.

In both groups, condylar position was characterized by great variability. Whereas those dentists who use condylar position as a criterion of pathology believe that the condyle should be centered in the glenoid fossa, this study found only 49% of the subjects had condyles in that position and, of these, an absolute centric position was present in less than 4%. In females, a posterior position was present in 52%, while in men, 57% were in a centric position. Neither age nor gender had any influence on location of the condyle.

In three-fourths of the subjects the intra-articular disc, described in textbooks as normally having its posterior band at the twelve o'clock position, was in a more forward position. This anterior location was twice as frequent in females as in males, in conjunction with the more common finding of TMJ clicking in women. The depth of the fossa was decreased in both age groups.

Based on the findings in this study, it is evident that eccentric condylar position is not an indicator of an abnormal TMJ and should not be used as a reason for treatment. Moreover, it is clear that one cannot rely solely on imaging evidence of an anteriorly positioned disc as an indicator of joint pathology and that it must be accompanied by clinical symptoms of TMJ pain and/or limitation of jaw movement for this to be considered. Painless clicking alone is also not an indication for treatment. Although the authors did not specifically study changes in the condylar surface, they do discuss this issue and point out that although loss of normal contour and flattening of the condyle may be an indication of osteoarthritis, it also may represent a normal sign of aging and/or adaptive remodeling and require no treatment.

Disc displacement, eccentric condylar position, osteoarthritis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts. Turp JC, Schlenker A, Schroder J, Schmitter M. BMC Oral Health (2016) 16: 124.  
TMJ Disorders

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