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Background: The reduction in joint load is a potential beneficial factor in managing osteoarthritis of the temporomandibular joint (TMJ). This paper aims to compare the effectiveness of the intramuscular injection of botulinum toxin (BTX-A) as an adjunct to TMJ arthrocentesis plus viscosupplementation with arthrocentesis plus viscosupplementation alone in the management of TMJ osteoarthritis. Methods: A pilot clinical retrospective study examined TMJ osteoarthritis treatments. Patients were divided into two groups: Group A received BTX-A injections and arthrocentesis with viscosupplementation, while Group B received only arthrocentesis with viscosupplementation. The study assessed outcomes based on mouth opening (MO), pain at rest (PR), pain at mastication (PF), and masticatory efficiency (ME) at various time points (baseline (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4)) up to 2 months after treatment. Results: The study included two groups, each with five patients. Group A received five weekly sessions of arthrocentesis plus viscosupplementation and a single BTX-A injection during the first arthrocentesis appointment. Group B underwent the five-session protocol of arthrocentesis plus viscosupplementation alone. MO, PF, PR, and ME improved quickly in T2 in both groups, but the improvement was of greater importance over the following weeks and lasted longer in Group A. Conclusions: Arthrocentesis with viscosupplementation associated with BTX-A was found to be more effective than arthrocentesis alone in improving clinical outcomes. This suggests that patients with TMJ osteoarthritis and myofascial pain may benefit from reduced muscle tone and joint load. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to show the anatomical and histological features of the displaced temporomandibular joint (TMJ) disc in joints with degenerative disease. Methods: This study was performed on a total of 30 TMJ discs extracted from 22 patients, who underwent surgical discectomy after failure of conservative non‐surgical treatment regimens to control pain and/or limited range of motion. All joints had imaging signs of an anteriorized disc position and degenerative joint disease. Samples of the extracted discs were stored in formalin, cut into 3 micron‐thick sections imbedded in paraffin and processed with hematoxylin‐eosin. Result: All the samples present irreversible morphologic and histological alterations. The macroscopical evaluation showed that 14 discs were worn and fragmented in several parts, and one disc was perforated. Morphological alterations with deformation and degenerative signs were shown in all discs, which were all severely worn and compromised. Histologically, various alterations were found, such as pre‐fibrous sclerosis with myxoid degeneration and collagen deposits (N = 25), an increase in fibro‐hyaline and fibrous tissues, with loss of elasticity (N = 25), scattered calcifications (N = 15), and synovial inflammation with microvascular proliferation and increased cellularity, presence of lymphocytes, histiocytes and plasma cells (N = 18). After the intervention, all patients reported decreased pain levels and showed improved function at 6 months. Conclusion: These observations suggest that degenerative joint disease is accompanied by a anteriorized discs featuring abnormal macroscopical and histological changes. From a clinical viewpoint, this may suggest that, when treatment escalation leads to consider TMJ surgery, total discectomy is the most reasonable approach. [ABSTRACT FROM AUTHOR]

Background. Temporomandibular joint (TMJ) arthritis is a degenerative pathology that may cause pain and dysfunction. Nonsurgical therapy is the traditional treatment of TMJ diseases but if ineffective, TMJ surgery can be performed and may include arthroplasty with interposition of autograft. The encouraging results reported with the use of human amniotic membrane (HAM) in different surgical fields have highlighted its potential, but approaches providing the positioning of HAM within the intra-articular space of arthritic TMJs have never been investigated. Case Presentation. A 48-year-old woman was presented with limited mouth opening and pain with palpation at the left joint. A severe TMJ degeneration was diagnosed, and a surgical treatment was necessary. In the present case report, the authors describe the application of a cryopreserved HAM patch within the joint space as a disc-replacing film during major surgeries for discectomy and arthroplasty. Three months after the intervention, the patient reported an overall improvement in chewing efficiency as well as the absence of pain. Conclusions. According to the regenerative effects of HAM, the design of trials on the topic should be encouraged for its possible inclusion within the field of TMJ disease practice. [ABSTRACT FROM AUTHOR]

Objectives: This study investigates the psychological impact of COVID‐19 on burning mouth syndrome (BMS) patients. It focuses on comparing post‐traumatic stress symptoms (PTSS), post‐traumatic growth (PTG), and resilience between BMS patients and Controls. Methods: A total of 100 BMS patients and 100 Controls from five Italian centers participated in this observational cross‐sectional study. They completed several assessments, including the General Health Questionnaire, Depression Anxiety and Stress Scale, Insomnia Severity Index, National Stressful Events Survey Short Scale, Impact of Event Scale‐Revised, Post Traumatic Growth Inventory Short Form, and Connor‐Davidson Resilience Scale. Results: BMS patients had significantly higher stress, anxiety, and depression (DASS‐21 score) and post‐traumatic stress symptoms (IES‐R‐6 score), particularly in terms of intrusive thoughts. They showed lower post‐traumatic growth (PTGI‐SF score) compared to Controls. The resilience scale (CDRS‐10) was a key predictor of PTG in both groups, explaining a significant variance in PTGI‐SF scores. Conclusions: BMS patients experienced heightened post‐traumatic stress, stress, anxiety, and depression during the COVID‐19 pandemic, with reduced post‐traumatic growth. This highlights the need to prioritize their psychological well‐being, focusing on stress management and fostering post‐traumatic growth in challenging times. [ABSTRACT FROM AUTHOR]

Objectives Materials and Methods Results Conclusions To compare masticatory muscles' recruitment in patients with temporomandibular disorders and asymptomatic control subjects. To evaluate if the masticatory muscles' recruitment pattern may predict symptoms' improvement after temporomandibular disorders treatment.Standardized surface electromyography of anterior temporalis and superficial masseters muscles were recorded and compared at baseline in 26 patients with arthrogenous temporomandibular disorders (study group) and 26 asymptomatic subjects (control group). The study group was treated pharmacologically and by means of five arthrocentesis sessions. Pre‐, during‐, and post‐treatment pain and mandibular function were assessed and compared among timepoints. Clinical improvement in terms of pain and mandibular function was correlated with pre‐treatment standardized surface electromyography values.Temporomandibular disorders patients showed improved maximum mouth opening and pain during and after treatment with arthrocentesis compared to baseline (T‐test p < 0.01). Standardized surface electromyography values were significantly different in temporomandibular disorders subjects compared to controls (T‐test p < 0.05). Improvement in pain at rest after treatment was inversely correlated with pre‐treatment masseters standardized surface electromyography symmetry (R‐coefficient 0.3936; p < 0.05).Temporomandibular disorders patients showed a different muscular recruitment pattern compared to controls. The lesser the pre‐treatment masseters symmetry, the greater the improvement of pain at rest after treatment. [ABSTRACT FROM AUTHOR]

Background. Lockdown restrictions during the COVID-19 pandemic exerted a strong impact on people's quality of life and increased loneliness. This study evaluates the effect of the pandemic on loneliness in patients with burning mouth syndrome (BMS) compared with the general population. Methods. 100 BMS patients versus 100 healthy controls (HC) were recruited in five Italian centers. The 12-Item General Health Questionnaire (GHQ-12), the Depression Anxiety Stress Scales-21 (DASS-21), the Insomnia Severity Index (ISI), the short-form UCLA Loneliness Scale-8 (ULS-8), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Suicidal Ideation Attribute Scale (SIDAS) were administered. Results. BMS patients and HC showed high scores (16 [14-20.25] and 16 [14-18]) in the ULS-8. Statistically significant differences have been found considering the BMS patients lived with fewer relatives during the lockdown compared with the HC (2 [2-3] and 3 [2-4]; p : 0.012) with a lower level of satisfaction in relationships with relatives (4 [1.75-5] and 5 [4-5]; p < 0.001) and also in the DASS-21 total scores between the BMS patients and HC (16 [10-24.2] and 10 [4-17]; p < 0.001). The multivariate logistic regression revealed that age, education, DASS-21, and MSPSS were the most predictive variables and could explain 34.68% of the variance in the ULS-8 score (p < 0.001) in the BMS group. However, only the DASS-21 was significant in the HC group, explaining 10.11% of the variance of the ULS-8 (p : 0.033). Conclusions. Both the patients and controls experienced deep loneliness during the pandemic. However, in the BMS group, loneliness was significantly correlated with age, a higher level of education and stress, and a lower level of satisfaction in relationships with relatives and social support perceived compared with the controls. [ABSTRACT FROM AUTHOR]

A response by Daniele Manfredini and colleagues to a letter to the editor about their article "Surface Electromyography Findings in Unilateral Myofascial Pain Patients: Comparison of Painful vs Non Painful Sides" in the 2013 issue is presented.

Background: The aim of this paper is to provide a systematic review of the literature regarding the clinical use of botulinum toxin (BTX) to treat various orofacial neuropathic pain disorders (NP). Methods: A comprehensive literature search was conducted using Medline, Web of Science, and the Cochrane Library databases. Only randomized clinical trials (RCT) published between 2003 and the end of June 2023, investigating the use of BTX to treat NP, were selected. PICO guidelines were used to select and tabulate the articles. Results: A total of 6 RCTs were selected. Five articles used BTX injections to treat classical trigeminal neuralgia, and one to treat post-herpetic neuralgia. A total of 795 patients received BTX injections. The selected studies utilised different doses and methods of injections and doses. All the selected studies concluded superiority of BTX injections over placebo for reducing pain levels, and 5 out 6 of them highlighted an improvement in the patient's quality of life. Most of the studies reported transient and mild side effects. Conclusion: There is evidence of the efficacy of BTX injections in orofacial pain management. However, improved study protocols are required to provide direction for the clinical use of BTX to treat various orofacial neuropathic pain disorders. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "An Assessment of the Usefulness of Jaw Kinesiography in Monitoring Temporomandibular Disorders: Correlation of Treatment-Related Kinesiographic and Pain Changes in Patients Receiving Temporomandibular Joint Injections," by D. Manfredini and colleagues published in a 2013 issue of the "Journal of the American Medical Dental Association."

Background: Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest.. Study Objectives: The aim of this study was to investigate the correlation between SB‐related masseter muscle activity (MMA) and apnea–hypopnea events as well as to assess their temporal sequence. Methods: Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea–hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea–hypopnea index (AHI) and SB index (SBI). A 5‐s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA. Results: On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10). Conclusions: Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea–hypopnea events and bruxism activities. [ABSTRACT FROM AUTHOR]

A smartphone‐based ecological momentary assessment (EMA) strategy was used to assess the frequency of awake bruxism behaviours, based on the report of five oral conditions (ie relaxed jaw muscles, teeth contact, mandible bracing, teeth clenching and teeth grinding). One hundred and fifty‐three (N = 153) healthy young adults (mean ± SD age = 22.9 ± 3.2 years), recruited in two different Italian Universities, used a dedicated smartphone application that sent 20 alerts/day at random times for seven days. Upon alert receipt, the subjects had to report in real‐time one of the above five possible oral conditions. Individual data were used to calculate an average frequency of the study population for each day. For each condition, a coefficient of variation (CV) of frequency data was calculated as the ratio between SD and mean values over the seven recording days. Average frequency of the different behaviours over the seven days was as follows: relaxed jaw muscle, 76.4%; teeth contact, 13.6%; mandible bracing, 7.0%; teeth clenching, 2.5%; and teeth grinding, 0.5%. No significant differences were found in frequency data between the two University samples. The relaxed jaw muscles condition was more frequent in males (80.7 ± 17.7) than in females (73.4 ± 22.2). The frequency of relaxed jaw muscles condition over the period of observation had a very low coefficient of variation (0.27), while for the different awake bruxism behaviours, CV was in a range between 1.5 (teeth contact) and 4.3 (teeth grinding). Teeth contact was the most prevalent behaviour (57.5–69.7). Findings from this investigation suggest that the average frequency of AB behaviours over one week, investigated using EMA‐approach, is around 23.6%. [ABSTRACT FROM AUTHOR]

The giant cell tumour (GCT) is a benign, locally invasive lesion that accounts for about 20% of benign bone tumours. Approximately 2% of all GCTs arise in the head and neck region. Giant cell lesions in the craniofacial skeleton other than the jaws are uncommon; the majority of them occur in the sphenoid, ethmoid and temporal bones. GCT of the maxilla has seldom been described. We present the case of an 83-year-old patient with an advanced GCT of the left maxilla who underwent en bloc resection through maxillectomy. Reconstruction of the orbitary frame and maxilla was performed with autologous calvaria and a temporalis muscle pedicled flap. Our successful maxillary reconstruction based on the association between autologous calvarial bone sticks bent with titanium miniplates and a temporalis muscle pedicled flap allowed the involvement of only one donor area for both hard and soft tissues. At 1-year follow-up, our patient showed no evidence of recurrent GCT, with satisfactory aesthetic results. [ABSTRACT FROM AUTHOR]

Objective: A smartphone-based ecological momentary assessment (EMA) strategy to collect real time data on awake bruxism (AB) has been recently introduced. The aim of this study was to assess the compliance with its use over 1 week in a sample of healthy young adults. Method: Sixty (N = 60) healthy young adults (mean age 24.2 ± 4.1 years) used a dedicated smartphone application that sent 20 alerts at random times throughout the day. Upon alert receipt, the subjects had to report in real time their condition among five possible options: relaxed jaw muscles, teeth contact, teeth clenching, teeth grinding, and mandible bracing. Compliance rate with the app was assessed at the individual and group level in terms of percentage of answered alerts as well as number of days that were needed to reach the targeted observation period of 7 days with a compliance of at least 60%. Results: The mean compliance recorded with the smartphone application was 67.8% of the total alerts. On average, 9.8 ± 3.2 days (range 7–19) have been necessary to achieve the targeted goal of 7 days with a minimum of 60% alerts/day. No gender differences were detected in any compliance data. Response rate was not different during weekdays or weekends. Conclusions: This investigation is the first attempt to assess individual compliance with EMA for reporting awake bruxism. Results suggest that a smartphone-based strategy can have interesting potential. The compliance rate reported in this study will serve as a comparison standpoint for future investigations. Clinical significance: Based on the recent multidisciplinary focus on the study of awake bruxism, EMA has emerged as a potential approach for use in the clinical and research settings. This investigation suggests that compliance with such strategy is good, thus making it worthy of adoption for the assessment of AB and its clinical implications. [ABSTRACT FROM AUTHOR]

Summary: Background: Several studies have described high levels of psychosocial disorders in patients with temporomandibular disorders (TMD), but an estimate of their prevalence in populations of TMD patients has never been assessed systematically. Objective: To conduct a systematic review of the literature on the prevalence of research diagnostic criteria for TMD (RDC/TMD) Axis II findings in TMD patients. Methods: Search for articles was carried out by two independent researchers to retrieve papers published after 1992. Inclusion was reserved to observational studies with a minimum sample size of 100 individuals, which used RDC/TMD diagnostic protocol. Quality assessment was performed with the adoption of the methodological evaluation of observational research (MORE). Results: A total of 1186 citations were obtained from search strategy, but only 14 filled the inclusion criteria. Included papers reported somatisation, depression and/or pain‐related disability prevalence or scores from populations of 12 different countries. A broad range in the prevalence of moderate‐to‐severe somatisation in patients with TMD was observed, ranging from 28.5% to 76.6%. Similar results were found for depression, with moderate‐to‐severe levels in 21.4%‐60.1% of patients. Finally, most patients were rated as grade I or II of the Graded Chronic Pain Scale, whereas high pain‐related impairment was present in 2.6% to 24% of the individuals. Conclusion: The prevalence of severe‐to‐moderate somatisation and depression was high in TMD patients, while severe physical impairment was not commonly reported. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this investigation was to assess the association of magnetic resonance imaging (MRI)-diagnosed temporomandibular joint (TMJ) disorders [i.e., disc displacement with reduction, disc displacement without reduction (DDNR), osseous changes (OC), joint effusion] on the same side as well as in the joints of the two sides of the same individual. Materials and methods: A total of 199 patients undergoing bilateral MRI of the TMJs were included in the study. A single variable correlation matrix was created to assess the within- and between-side correlation of single diagnoses. Then, based on 12 possible combinations of diagnoses per each side, a contingency table was created to assess the chi-square values of the differences between the observed and expected frequencies of the different cross-combinations. Multiple variable permutation test was performed to assess the null hypothesis that the diagnoses in the right and left joints are not related. Results: Within the signs of the same side, DDNR was positively correlated with OC. As for combination of diagnoses, the presence of a specific combination of signs on one side implied the same combination of signs on the other side. The global multivariate permutation test with Tippett combination was significant at p < 0.001, showing that the null hypothesis of independence between diagnoses of the two sides was rejected. Conclusions: It can be suggested that disc displacement without reduction is associated with osseous changes of the same joint and that joints of the two sides are likely to be affected by the same combinations of MRI signs. Clinical relevance: This investigation supports the concept that the two temporomandibular joints work as a unit. [ABSTRACT FROM AUTHOR]

Objectives To answer the clinical research question: in patients with myofascial pain, are there any differences in the surface electromyography (sEMG) activity of muscles of the painful and nonpainful sides that can be detected by commercially available devices? Methods The study sample (N = 39; 64%F, mean age 35.7 ± 15 years) consisted of patients seeking for temporomandibular disorders Temporomandibular Disorders (TMD) treatment and meeting Research Diagnostic Criteria for TMD ( RDC/ TMD) diagnosis of myofascial pain, with pain referred only in muscles on one side. They underwent sEMG of jaw muscles to record levels of standardized sEMG activity at rest, as well as during maximum clenching on teeth for the four investigated muscles, viz., bilateral masseter and temporalis. The existence of differences between sEMG values of muscles of the painful and nonpainful sides during the standardization test (i.e., clenching on cotton rolls) at rest and during clenching on teeth was assessed. Results At the study population level, differences between the sEMG values of muscles of the painful and nonpainful sides were not significant in any conditions, viz., either at rest or during clenching tasks. At the individual level, the difference between the sEMG activity of painful and nonpainful sides was very variable. Conclusions The above findings were not supportive of the existence of any detectable difference in sEMG activity between jaw muscles of the painful and nonpainful sides in patients with unilateral myofascial pain. Centrally mediated mechanism for pain adaptation may explain these findings, and the role of sEMG as a diagnostic tool for muscle pain needs to be carefully reconceptualized. [ABSTRACT FROM AUTHOR]

Background. The authors conducted a study in patients with temporomandibular joint (TMJ) osteoarthritis to assess whether treatment- related changes in pain levels and chewing ability coincide with a change in jaw kinesiographic (KG) parameters. Methods. The authors selected 34 patients with a diagnosis of TMJ osteoarthritis that met Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) to undergo a cycle of five weekly arthrocentesis procedures with injections of 1 milliliter hyaluronic acid. They performed a permutation test to assess the correlation between changes across time (from baseline to end of treatment) in two clinical outcome parameters-pain level and chewing ability-and changes across time in the KG outcome parameters. Results. The authors observed improvement across time in both chewing ability (F = 8.328; P = .005) and pain level (F = 10.903; P = .002). The authors observed no significant changes in any KG variables. With minor exceptions, no significant correlations were shown between changes in the clinical and KG parameters during the treatment period. Conclusions. Treatment-related changes in pain levels and chewing ability in patients with TMJ osteoarthritis do not coincide with changes in KG parameters. Practical Implications. If one assumes pain variables to be the primary outcome measures in assessing treatment of TMJ osteoarthritis, KG recordings of the jaw are not useful for monitoring TMJ osteoarthritis in the clinical setting. [ABSTRACT FROM AUTHOR]

As part of an ongoing multicenter investigation involving four highly specialized tertiary clinics for temporomandibular disorders (TMD) treatment, retrospective analysis of Research Diagnostic Criteria for TMD (RDC/TMD) axis I and axis II data gathered on clinic and community cases were assessed with a twofold aim: (1) to search for a correlation between axis I diagnoses and axis II pain-related disability, and (2) to identify clinical (axis I) and psychosocial (axis II) predictors of high pain-related disability. Two samples of patients seeking treatment for TMD (clinic cases, N = 1,312) and a sample of general population subjects (community cases, N = 211) underwent a thorough assessment in accordance with the RDC/TMD version 1.0 [] guidelines to receive both axis I and axis II diagnoses. Spearman's test was performed to assess the level of correlation between axis I diagnoses and Graded Chronic Pain Scale (GCPS) pain-related disability. A stepwise multiple logistic regression model was used to identify the significant associations between 12 clinical and psychosocial predictors and the presence of high pain-related disability. Axis I findings were related with pain-related impairment (GCPS scores) in the overall study sample including both clinic community cases (Spearman correlation = 0.129, p = 0.000), but the results of the correlation analyses performed on the clinic sample alone were not significant (Spearman correlation = −0.018, p = 0.618). Predictors for high disability were related to axis II findings (severe depression and somatization) or psychosocial aspects related to the pain experience (pain lasting from more than 6 months; treatment-seeking behavior), while none of the axis I diagnoses remained in the final logistic regression model. The final model predicted the level of pain-related impairment at a fair level ( R = 26.7%). The correlation between axis I diagnoses and pain-related impairment is not significant in the patients populations. Treatment-seeking behavior and other factors related with the pain experience are likely to be more important than the physical findings to determine the degree of psychosocial impairment. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The relationship between the rate of chronic pain-related disability and depression and somatization levels as well as the influence of pain duration on Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis II findings were assessed in a three centre investigation. Methods: The study sample (N =1149; F:M 4.1:1, m.a. 38.6 years) consisted of patients seeking for TMD treatment and undergoing RDC/TMD axis II psychosocial assessment to be rated in chronic pain-related disability (Graded Chronic Pain Scale, GCPS), depression (Symptoms Checklist-90[SCL-90] scale for depression, DEP) and somatization levels (SCL-90 scale for non-specific physical symptoms, SOM). The null hypotheses to be tested were that (1) no correlation existed between GCPS categories and DEP and SOM scores, and (2) no differences emerged between patients with pain from more or less than 6 months as for the prevalence of the different degrees of pain-related impairment, depression, and somatization. Results: In the overall sample, the prevalence of high pain-related disability (GCPS grades III or IV), severe depression and somatization was 16.9%, 21.4%, and 28.5%, respectively. A correlation was shown between GCPS and both DEP and SOM categories (Spearman''s correlation test, p <0.001). A significant association between pain lasting from more than 6 months and high GCPS scores was shown (χ 2, p <0.001), while no association was found between DEP and SOM scores and pain duration in the overall sample (χ 2, p =0.742 and p =0.364, respectively). Conclusions: Pain-related disability was found to be strongly related with depression and somatization levels as well as associated with pain duration. Depression and somatization scores were not associated with pain duration. [Copyright &y& Elsevier]

Aims: To evaluate the prevalence of different Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses in a population of patients seeking for TMD treatment at a tertiary clinic in Northern Italy; to evaluate the pattern of age distribution of RDC/TMD diagnoses and to compare data with those from similar studies in the literature. Materials and Methods: Two-hundred-forty-three (N=243) consecutive patients seeking TMD treatment at the TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy, during the period from July 1st to December 31st, 2008, underwent a RDC/TMD axis I assessment by the use of a systematically translated Italian version of the RDC/TMD guidelines. Results: One-hundred-ninety-nine (N=199) patients (female:male ratio 5:1, mean age 39.7+/-17.1 years, range 18-80) satisfied the RDC/TMD consortium inclusion criteria. Group I disorders (muscle disorders) were diagnosed in 49.7% of patients, group II disorders (disc displacements) in 57.3%, and group III disorders (arthralgia, osteoarthritis, and osteoarthrosis) in 81.4%. The majority of patients (64.3%) received RDC/TMD diagnoses of more than one group. On the basis of the age distribution of RDC/TMD diagnoses, two main distinct groups of TMD patients could be identified: a first group of patients showing disc displacement in the absence of degenerative disorders (any group II diagnoses alone or combined with group I diagnoses of muscle disorders and/or group IIIa diagnosis of arthralgia), and a second group of patients with signs and symptoms of inflammatory-degenerative joint disorders (group IIIb diagnosis of osteoarthritis and/or group IIIc diagnosis of osteoarthrosis). The former comprised 107 patients (20 males, 18.7%; 87 females, 81.3%) with a mean age of 32.7+/-14.5 years, while the latter comprised 46 patients (4 males, 8.7%; 42 females, 91.3%) with a mean age of 54.2+/-15.1 years, thus accounting for about 80% of the study population and being characterized by a significantly different age peak. Conclusions: Along with descriptive relative frequencies of the RDC/TMD diagnoses, which have been compared with other similar studies in the literature, the main findings of the present investigation were that at least two distinct age peaks are identifiable within this population of patients seeking for TMD treatment. These data might be useful to gather data on the specific epidemiologic features of each single RDC/TMD diagnoses. These findings have to be confirmed by means of multicenter studies involving many calibrated investigators. [ABSTRACT FROM AUTHOR]

Aims: The aim of this work was to evaluate the agreement between temporomandibular joint click sound and MR diagnoses of different disk positions. Methods: One hundred ninety-four (N=194) patients seeking treatment for temporomandibular disorders at the TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Italy, underwent a bilateral magnetic resonance of the temporomandibular joints. The presence of click sounds was clinically assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and put into relation with different magnetic resonance (MR) diagnoses of disk-condyle position by means of permutation tests. Results: The proportion of joints with reducing and non-reducing disk displacement which provided a click sound during the clinical assessment was similar (45.6% vs. 48.9%, respectively), while the prevalence of the two MR diagnoses in joints with click sound were strongly different (25.3% vs. 40.1%, respectively. Thus, the MR diagnosis which appears to be more positively associated with click sounds is disk displacement without reduction. Conclusion: There is a weak form of dependence between click and MR diagnosis, and the MR diagnosis of DDNR seems to be more positively associated with the presence of click sounds than the other categories, which did not show significant positive associations with click (i.e. there is negative association between click presence and normal disk position and no association between click presence and DDR joints. [ABSTRACT FROM AUTHOR]