Journal of Craniomandibular Function, 04/2015

Playing a musical instrument that loads the masticatory system, such as the violin or oboe, has been suggested to be part of the group of etiological factors for temporomandibular disorders (TMDs). In 2014, a review of literature was published that explicitly focused on the possible association between playing a musical instrument and TMDs. However, though published in 2014, the literature search was performed in 2012, and covered only one search engine, namely PubMed. Therefore, a new comprehensive search of literature was conducted to explore what is mentioned in the English medical literature about the relationship between playing a musical instrument and the presence of TMDs. A PubMed search yielded 23 articles, 15 of which were included in this review. In addition, an extensive search was performed on Google Scholar, which yielded 9 more articles. Of the 24 articles, 11 had a comparative observational study design, and 1 had a pretest-posttest design. These articles were analyzed according to the PICO (patient problem or population, intervention, comparison, and outcome) system. The remaining 12 articles consisted of case reports/case series, literature surveys (2 of which included a case series), and literature reviews, and were only tabulated as brief summaries. While no conclusions could be drawn from these 12 articles, conclusions based on the comparative observational design studies seem to suggest that TMDs and playing a musical instrument are associated. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMDs, or whether it is associated only in combination with other factors. More and better research on this topic is needed to better enable counseling, and possibly better treatment, of musicians with TMD complaints. Keywords: musical instrument, literature review, risk, temporomandibular disorders

The main aim of this study was to quantify certain dentoalveolar compensations in a group of individuals with severe tooth wear. A sample of 53 adult individuals was created from the Nubian series in Mirgissa (ca 2180 to 1552 BC). Various methods were used to quantify wear on the molars (M1 and M2) and the maxillary central incisors (I1). To quantify dentoalveolar compensations, different craniometric and cephalometric measurements were carried out on two groups, one with moderate wear (MW), and one with advanced wear (AW). Craniometric results revealed that dental arch length was significantly less in the AW group, whereas dental arch width did not differ between the two groups. Vertical dimensions also did not differ significantly between the MW and AW groups. Cephalometric results showed that the I1 axis was significantly more vertical in the AW group than in the MW group. Dentoalveolar compensations such as mesial drift, continuous eruption, and maxillary incisor posterior tipping were found in the Mirgissa sample. These indicate that functional occlusion and an effective level of masticatory function were maintained, despite the progress of tooth wear. Keywords: cephalometry, continuous eruption, dental anthropology, dentoalveolar compensations, mesial drift, occlusal vertical dimension, tooth wear

Only very few structured studies from clinical practice in general dentistry offices are available on the prevalence of temporomandibular disorder (TMD) symptoms. The majority of studies are population-based or representative of the structures of patient populations in university treatment centers. To bridge this gap, a study design was developed within the framework of the study group Functional Analysis of the German Federal States' Dental Chambers (BZÄK) that enables the systematic evaluation of data collected from dental practices. The goal of this retrospective study of TMD symptoms in general dentistry offices (STING) is to assess postulated differences between the patient populations in dental treatment centers and practices. During the preparation phase, criteria were defined, a documentation form developed, and the technical feasibility assessed. The described concept serves as a preliminary study for implementation on a larger scale at a later date. The aim of the study is to describe subjective symptoms, objective findings, diagnoses, and different treatment levels, as well as to evaluate the successful treatment outcome of TMD patients treated in dental offices specializing in functional therapy. In contrast to other studies, with a female-male ratio of 2.3:1, the gender distribution was less overrepresented than is reported in the literature. Of TMD patients, 67% were diagnosed with bruxism, as opposed to a prevalence in the population of 8% to 16%. The percentage of patients with orofacial pain of non-dental origin was 17%. Keywords: TMD disorders, TMD therapy, Axis II stress, therapeutic success, pain disease, bite splint therapy, occlusal therapy

The aim of this study was to evaluate possible factors that predict response to treatment in subjects with temporomandibular joint (TMJ) disc displacement without reduction (DDwoR). A treatment algorithm with disc manipulation, a protrusive splint or, if unsuccessful, a stabilization splint used fulltime for 2 to 10 weeks was introduced to a consecutive series of 50 patients with TMJ DDwoR. The splint treatment non-responders were offered surgery. At the end of the splint period/after surgery, the patients rated their response to treatment on preset alternatives, according to which they were classified as responders or non-responders. In total, 44 patients were responders, ie, were completely free from symptoms or had minor discomfort on rare occasions. The remaining 6 patients still suffered moderate to severe pain. The non-responders were all women. The only statistically significant difference in baseline case-history information between the two groups was a longer duration of symptoms in the non-responder group; mean 6 years vs 2 years for the responders. All other case-history information parameters were non-significant. Conclusively, duration of symptoms was a factor of significance in predicting response to treatment. Keywords: predictor of treatment outcome, splints, TMD, TMJ disc displacement without reduction