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J Craniomandib Disord [journal]
- Symptom reporting in temporomandibular joint clicking: some theoretical considerations. [Journal Article]
- J Craniomandib Disord 1992; 6(3):213-9.
Analysis of research on psychological aspects of temporomandibular disorders suggests that self-reports of symptoms do not constitute reliable instruments for the measurement of physiological processes. In TMJ clicking, the actual physiological signal can be measured and compared with self-reports of the sounds. In this article a model is presented to describe perception, interpretation, and reporting of TMJ sounds. Three questionnaires are presented that measure aspects of these psychological processes. Recommendations are made for future research.
- Acute closed lock in a patient with lupus erythematosus: case review. [Case Reports, Journal Article]
- J Craniomandib Disord 1992; 6(3):208-12.
Collagen failure has been shown to result in synovitis, joint adhesions, and internal joint derangement. This case report illustrates the similarities between patients with systemic lupus erythematosus and an internally deranged temporomandibular joint and patients with internal derangement with no lupus erythematosus. If abnormalities in intra-articular collagen tissue lead to adhesion formation and restrict normal mobility during translatory movements, joint mechanics would be compromised. Arthritic changes, vasculitis, and synovitis of systemic lupus erythematosus appear to be contributory factors in this pathophysiologic process. Diagnostic and therapeutic arthroscopic surgery was performed. Acute and chronic signs of synovitis were observed during surgery, and tissue samples were obtained for histologic interpretation.
- Observer variation in functional examination of the temporomandibular joint. [Journal Article]
- J Craniomandib Disord 1992; 6(3):202-7.
Agreement between observers classifying TMJ sounds from data given in records of nonpatient adolescents was almost perfect in this interobserver study. Intraobserver and interobserver agreement in classifying all specific TMJ sounds at palpation and auscultation was acceptable to moderate (kappa value = 0.49 to 0.74). The agreement was considerably more reliable when classifying only one specific TMJ sound. Measurements of linear jaw opening showed small interobserver differences (coefficient of variation = 2.4 to 3.8). The significant difference found in calculating the angular mandibular opening may be the result of difficulties in maintaining maximum passive opening.
- The size and distribution of fiber types in jaw muscles: a review. [Comparative Study, Journal Article, Review]
- J Craniomandib Disord 1992; 6(3):192-201.
Histochemical enzyme reactions and physiological recordings of limb and jaw muscles have independently revealed three to five types of muscle fibers. Surprisingly, type II fibers are smaller than type I fibers in major human jaw muscles. This is the opposite of the situation in limb muscles. Human jaw muscles contain mixed fiber types. Type I fibers predominate in lateral pterygoid and type II fibers in digastric muscles. The masseters in carnivorans and rodents contain mainly type II fibers, whereas those of some herbivorans, including rabbits and bovids, contain mainly type I fibers. Attempts were made to describe the functional significance of some observations.
- Sleep movements in teethgrinders. [Journal Article]
- J Craniomandib Disord 1992; 6(3):184-91.
To investigate the nocturnal motor activity associated with teethgrinding, 12 patients and 12 controls were recorded during sleep with the masseter muscle electromyogram (EMG) and the static charge-sensitive bed movement sensor. The frequency of body movements per hour was 21.4 in the teethgrinders and 14.0 (P less than .05) in the control group. The movement time was 87.4 seconds per hour in the teethgrinders and 55.2 seconds per hour (P less than .01) in the controls. The differences were most obvious in the body movements with temporal association to EMG elevation during the first stage of sleep. The number of isolated EMG elevations showed great interindividual variation and did not differ between groups. The teethgrinders complained more frequently of delayed sleep onset and daytime tiredness. The data suggest that the motor disturbance of teethgrinding is not limited to masticatory muscles but is manifested also as increased general body movement activity.
- Changes in mandibular masticatory movements after insertion of nonworking-side interference. [Journal Article]
- J Craniomandib Disord 1992; 6(3):177-83.
To investigate the influence of nonworking-side interferences on mandibular masticatory movements and signs and symptoms of dysfunction of the masticatory system, an experimental balancing-side interference was introduced in 12 healthy subjects for 1 week. The individual response to the interference varied substantially. However, some of the movement variables were significantly changed immediately after insertion, but an adaptation of the neuromuscular system to the interference was evident at the end of the experimental period.
- Anatomical relationships and superior reinforcement of the TMJ mandibular fossa. [Journal Article]
- J Craniomandib Disord 1992; 6(3):171-5.
Only a few cases of condylar penetration into the middle cranial fossa have been documented in the literature. This study attempts to provide an anatomical explanation for this rare phenomenon. Mandibular (glenoid) fossa position in relation to important endocranial and exocranial structures located in close proximity to the TMJ, and relative condyle-fossa size, were evaluated on a dry skull sample. Additional osseous relationships were observed on cadaver material using dissection and x-ray. The anatomic relationships of the mandibular fossa and superior structures that appear to buttress it are described. It is concluded that the temporal squama that lies superior to the mandibular fossa provides a powerful buffer, which prevents condylar endocranial penetration in cases of an appropriate traumatologic mechanism.
- Predicting response to treatment for temporomandibular disorders. [Journal Article]
- J Craniomandib Disord 1992; 6(3):161-9.
This study examined whether pretreatment psychological characteristics of temporomandibular disorder (TMD) patients were related to the response to treatment in a TMD and facial pain clinic. The care provided to patients was either an evaluation only or an evaluation followed by a course of physical medicine/dental procedures (occlusal appliances, physical therapy, anti-inflammatory medications). Outcomes were assessed in terms of pain levels, jaw function difficulties, and satisfaction with care at 6 months posttreatment by phone and 16 months posttreatment by mail. There were no pretreatment differences between treated and evaluated patients except for higher pretreatment jaw function difficulty scores in the evaluated only patients. Factor analysis of pretreatment scores revealed distrust, pain, anxiety, and somatization. Somatization predicted follow-up pain levels at both follow-ups in the treated patients but only at the 16-month follow-up in the evaluated only patients. Pretreatment pain levels predicted posttreatment pain in both groups only at the 6-month follow-up. Posttreatment jaw function difficulties were related inconsistently to the pretreatment dimensions, while satisfaction was not predicted by pretreatment scores except for a possible connection between this outcome and distrust. It is concluded that an overconcern about bodily functioning appears to decrease the likelihood that patients obtain pain relief from physical medicine care.
- The prevalence of joint noises as related to age and gender. [Comparative Study, Journal Article]
- J Craniomandib Disord 1992; 6(3):157-60.
The interdependence of joint noises on age and gender was studied mixed-longitudinally in orthodontically treated subjects from 7 to 38 years of age. The prevalence of clicking signs and symptoms increased up to 25 years of age and leveled thereafter. Around age 19, a significant gender difference was present in clicking symptoms, with females reporting more clicks. The same pattern, although not significantly, was present for palpated clicks. Since male and female clicking prevalences are the same before and after adolescence, and since girls mature at an earlier age than boys, it is concluded that these noises reflect a maturity level rather than a multifactorial disorder. The prevalence of crepitation continued to increase slowly.
- Suggested curriculum guidelines for the development of continuing education programs in TMD and orofacial pain. [Guideline, Journal Article]
- J Craniomandib Disord 1992; 6(2):137-40.