Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Temporomandibular Joint ; physiopathology ; Temporomandibular Joint Dysfunction Syndrome ; physiopathology ; therapy

Objective: To screen the physical, psychological and behavioral factors related to patients with temporomandibular disorders (TMD) by using Axis Ⅱ assessment instruments of diagnostic criteria for TMD(DC/TMD). And to provide a reference to establish personalized diagnosis and treatment plans for TMD patients so as to prevent TMD and reduce predisposing factors. Methods: A total of 141 TMD patients, who were admitted in the Department of Oral and Maxillofacial Surgery in School and Hospital of Stomatology, Wuhan University from October 2018 to February 2021 were selected. There were 121 females and 20 males, with an average age of 30 years. A total of 90 healthy people were included as controls. A full-time psychologist conducted relevant questionnaire surveys. The questionnaires include general clinical survey forms and TMD symptom questionnaire. In addition, Axis Ⅱ assessment instruments include graded chronic pain scale, jaw functional limitation scale, oral behaviors checklist, patient health questionnaire-9 (depression), generalized anxiety disorder scale, patient health questionnaire-15 (physical symptoms), etc. The main observational indicators include: pain level, pain impact rates, overall classification of chronic pain, limited chewing function score, limited motor function score, limited communication function score, total jaw function restricted score, depression score, anxiety score, somatic symptom score and oral behavior score.The survey data were imported into SPSS 22.0 software for statistical analysis. Results: In the TMD group 60.3% (85/141) patients had various degrees of pain, 24.1% (34/141) of those with pain effect grades from 1 to 3 and 61.0% (86/141) showed chronic pain overall grades from Ⅰ to Ⅳ. The chewing function restricted score was 2.67(1.17, 4.25), motor function restricted score was 4.25(1.75, 6.12), communication function restricted score was 1.13(1.00, 2.25) and total jaw function restricted score was 2.56(1.47, 4.15) respectively. Patients with mild depression or above accounted for 59.6%(84/141), patients with mild anxiety or above accounted for 56.7%(80/141), 46.1%(65/141) patients had somatization symptoms. Statistical differences (P<0.05) were determined between TMD group and control group in various scores of jaw function, oral behavior grading, depression, anxiety, and physical symptoms. Physical symptoms had significantly statistical difference between different diagnostic classification(P<0.05). Meanwhile, among the different chronic pain levels in the TMD group, there were statistical differences in the various scales of mandibular dysfunction, depression, anxiety, and somatization. In the TMD group, other significant differences were noticed between males and females in terms of the average score of mouth opening, verbal and facial communication, the total score of mandibular dysfunction as well as physical symptoms (P<0.05). Conclusions: Compared with the healthy people, patients with TMD had more abnormal oral behaviors, different restriction of the mandibular functional activities. At the same time, depression, anxiety, and somatization were more serious. Patients with osteoarthritis and subluxation of temporomandibular joint were more likely to suffer physical symptoms. TMD patients suffering from pain had more severe mandibular dysfunction and symptoms of depression, anxiety, and somatization.
Adult ; Depression/diagnosis* ; Facial Pain ; Female ; Humans ; Male ; Mandible ; Somatoform Disorders ; Temporomandibular Joint Disorders/diagnosis* ; Temporomandibular Joint Dysfunction Syndrome

OBJECTIVETo study the methodological techniques in measuring the severity of temporomandibulr disorders (TMD) and in evaluating the effectiveness of therapies in clinic.

METHODSBoth Fricton's Craniomandibular Index (CMI) and Helkimo's Clinical Dysfunction Index were calculated from 60 TMD patients. Inter-rater reliability was tested to assess the consistency in use between different examiners. Fricton's CMI was used to assess the clinical improvement after accepting a treatment in 21 TMD patients diagnosed as acute disk displacement without reduction.

RESULTSCorrelation Coefficient for inter-rater reliability in two groups was 0.879 and 0.939 respectively for Fricton's CMI and 0.744 and 0.838 for Helkimo Clinical Dysfunction Index. Fricton's TMJ dysfunction index was decreased from 0.337 to 0.021 (P < 0.001) and Fricton's CMI was decreased from 0.185 to 0.011 (P < 0.001) after the treatment in 21 TMD patients with disk displacement without reduction.

CONCLUSIONSTo avoid using subjective and descriptive report in assessment of the severity of TMD and the effectiveness of therapies, Fricton's CMI is recommended as an objective criteria which is simple in clinical use, and ease in scoring.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Severity of Illness Index ; Temporomandibular Joint ; pathology ; Temporomandibular Joint Disorders ; pathology ; Temporomandibular Joint Dysfunction Syndrome ; pathology

Objective: To observe the different imaging manifestations of condylar sclerosis in temporomandibular joint osteoarthrosis and explore the imaging significance of condylar sclerosis. Methods: From January 2018 to December 2020, 50 patients with temporomandibular joint condylar sclerosis were examined by cone-beam CT (CBCT) and underwent spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 15 males and 35 females aged from 16 to 65 years with age of (42.7±14.5) years. The imaging manifestations of CBCT, spiral CT, MRI and radionuclide bone imaging, joint disc displacement and abnormal bone metabolism of condylar sclerosis were analyzed. And the area of condylar sclerosis was graded according to the image of CBCT. Results: A total of 50 patients were included, including 38 unilateral condylar sclerosis, 12 patients with bilateral condylar sclerosis, the total condylar sclerosis were 66. There was no significant difference between the detection rate of further spiral CT (95.5%, 63/66) and CBCT (100.0%, 66/66) (corrected χ²=1.36,P=0.244). The area of condylar sclerosis was (35.5±4.5) mm², ranged from 1 to 100 mm². In addition, spiral CT showed more clearly condylar sclerosis than CBCT. Sclerosis can occur in all parts of condyle, mainly in the upper middle region (68.2%,45/66) in coronal position and in the upper front region (71.2%,47/66) in sagittal position. Fifty-seven condylar sclerosis were detected by MRI, including 4(4/19) condylar sclerosis less than 4 mm². There was significant difference in the displacement of temporomandibular joint disc between the sclerotic side and the non sclerotic side (χ²=10.09, P=0.006). MRI display the condylar sclerosis showed low signal (56/62), followed by high signal (5/62) and medium signal (1/62). Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism, 34 had abnormal bone metabolism, and 21 patients had concentrated on the non-sclerotic side. Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism and 34 had abnormal bone metabolism. Conclusions: Spiral CT is more accurate than CBCT in terms of condyle sclerosis through different imaging analysis, and the detection rate of both is higher than MRI. Most of condylar sclerosis showed different degrees of low signal on MRI. The condylar sclerosis side is usually manifested by abnormal bone metabolism.
Male ; Female ; Humans ; Mandibular Condyle/diagnostic imaging* ; Sclerosis/diagnostic imaging* ; Temporomandibular Joint/diagnostic imaging* ; Temporomandibular Joint Disorders/etiology* ; Temporomandibular Joint Disc/diagnostic imaging* ; Cone-Beam Computed Tomography ; Temporomandibular Joint Dysfunction Syndrome ; Osteoarthritis/etiology* ; Magnetic Resonance Imaging

OBJECTIVETo investigate the clinical natural course of temporomandibular joint (TMJ) intermittent closed lock (ICL) through 24 months follow-up.

METHODSSixty-eight patients with ICL were included, and 54 patients finished 24 months follow-up. The disease duration, frequency of joint lock and joint pain were recorded at the patient's first visit. Telephone interviews were taken for every month, and the frequency of joint lock and joint pain were recorded. According to the development of ICL, the patients were divided into 3 groups: symptom-worsened group, symptom-disappeared group, symptom-persisted group.

RESULTSThere were 16 patients (30%) whose symptoms worsened into closed lock (disk displacement without reduction), 32 patients (59%) whose symptoms persisted during the 24 months follow-up, and 6 patients' (11%) symptoms disappeared. In symptom-persisted group, the frequency of joint lock decreased in 11/32 (34%), increased in 4/32 (13%), did not change in 17/32 (53%). There was no significant difference in gender, age, frequency of joint lock and joint pain recorded at the first visit among these 3 groups (P > 0.05). The disease duration in the symptom-disappeared group was much shorter than the other 2 groups (P < 0.05).

CONCLUSIONSICL of TMJ was more likely to get worse into closed lock. There seemed no significant relation between the sequelaes of ICL and patients' gender, age, disease duration, frequency of joint lock and joint pain, and larger sample studies were necessary.

Adolescent ; Adult ; Child ; Disease Progression ; Facial Pain ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain Measurement ; Remission, Spontaneous ; Temporomandibular Joint ; pathology ; Temporomandibular Joint Disc ; pathology ; Temporomandibular Joint Dysfunction Syndrome ; physiopathology ; Young Adult

OBJECTIVETo analyze the relationship between pharyngeal paraesthesia and abnormal styloid process, and to evaluate the surgery outcome.

METHODSOne hundred and four patients with styloid process abnormality, especially those with pharyngeal paraesthesia were studied preoperatively and postoperatively.

RESULTSAmong 104 patients who complained about foreign body sensation of the pharynx and a sore throat, after partial removal of styloid process, 71.2% (74/104) cured (symptoms disappeared), 12.5% (13/104) improved, while 16.3% (17/104) had no improvement. The responding rate was 83.7% (87/104).

CONCLUSIONSNot all abnormality of styloid process subjects would have pharyngeal paraesthesia, so for this kind of cases a more comprehensive analysis is necessary. Surgery via mouth is preferable.

Adult ; Aged ; Female ; Humans ; Middle Aged ; Paresthesia ; surgery ; Pharyngeal Diseases ; surgery ; Temporomandibular Joint Dysfunction Syndrome ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo compare clinical therapeutic effects of acupuncture combined with magnetic therapy and simple magnetic therapy on temple-jaw joint dysfunction.

METHODSEighty-two cases were randomly divided into an observation group (n = 52) and a control group (n = 30). The observation group was treated with acupuncture at Xiaguan (ST 7), Jiache (ST 6), Hegu (LI 4), etc. and AL-2 low frequency electromagnetic comprehensive treatment instrument; the control group was treated with AL-2 low frequency electromagnetic comprehensive treatment instrument.

RESULTSThe cured and markedly effective rate of 90.4% in the observation group was significantly better than 66.7% in the control group (P < 0.01), and the total effective rate of 98.1% in the observation group was significantly better than 86.7% in the control group (P < 0.05).

CONCLUSIONThe therapeutic effect of acupuncture combined with magnetic therapy is significantly better than that of the simple magnetic therapy on temple-jaw joint dysfunction.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Magnetic Field Therapy ; instrumentation ; methods ; Male ; Middle Aged ; Temporomandibular Joint ; pathology ; Temporomandibular Joint Dysfunction Syndrome ; pathology ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo search for a better therapy for temporomandibular joint dysfunction syndrome.

METHODSTwo hundred and ten cases of temporomandibular joint dysfunction syndrome were randomly divided into a treatment group, a control group I and a control group II, 70 cases in each group. The treatment group were treated with warming needle moxibustion plus exercise, with Hegu (LI 4), Xiaguan (ST 7), Yifeng (TE 17) and so on selected, in combination with opening and closing the mouth; the control group I were treated with simple filiform needle needling, and the control group II with local blocking therapy. The therapeutic effects of the 3 groups were compared.

RESULTSThe total effective rate was 94.3% in the treatment group, 87.1% in the control group I and 85.7% in the control group II with a significant difference among the 3 groups, the treatment group being better than the two control groups (P < 0.05).

CONCLUSIONWarming needle moxibustion plus exercise has a good therapeutic effect on temporomandibular joint dysfunction syndrome.

Adult ; Exercise Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Moxibustion ; methods ; Temporomandibular Joint Dysfunction Syndrome ; therapy

OBJECTIVE: To investigate the correct diagnosis for styloid process syndrome. METHOD: CT scan and 3D reconstruction was undertaken in 301 cases with foreign body sensation in submandibular angle, pain in pharyngeal, tension feeling and unhealing feeling after tonsillectomy. 263 cases were diagnosed as styloid process syndrome. RESULT: Seventy-two cases were performed with tonsillar styloidectomy. The follow up showed no pre-operative symptoms. CONCLUSION CT scan 3D reconstruction is the best method in diagnosing styloid process syndrome.
Adult ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Temporomandibular Joint Dysfunction Syndrome ; diagnosis ; Tomography, X-Ray Computed ; Young Adult