OBJECTIVE: To compare the prevalence of tinnitus in temporomandibular disorder (TMD) patients affected by either jaw muscle pain, temporomandibular joint (TMJ) internal derangements, or TMJ arthrosis. METHODS: The presence of self-reported tinnitus was assessed in 250 consecutive TMD patients and correlation analysis was performed with clinical TMD signs and symptoms. RESULTS: Tinnitus prevalence in the TMD population was 30.4%. Any significant patterns of correlation were shown for the overall study group, despite a higher tinnitus prevalence in patients with (32.8%) than without masseter pain (24.8%; p = 0.176) as well as in those with (33.7%) than without TMJ arthrosis (26.1%; p = 0.082). Age-stratified analysis showed correlations with masseter pain in older patients (48.3% vs 16; p < 0.05), and with arthrosis in younger patients (57.1% vs 22.2%; p < 0.05). CONCLUSIONS: Any correlation patterns were shown between tinnitus and TMD. Age-stratified analysis suggested possible hypotheses for a symptom-specific clinical correlation that should be assessed with future research.
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.
Objective. To characterize the closed-mouth temporomandibular joint (TMJ) disc-condyle relationship in a population of individuals who sought hospital services for temporomandibular disorders (TMD). Methods. Two hundred and twenty-four TMJ magnetic resonance images (MRIs) of 112 patients were assessed in all spatial planes to classify disc position with respect to the condyle in a closed-mouth position. Results. Disc displacement (DD) was present in 62.1 and superior disc position in 29.9 of the patients. Position could not be determined in 8 of the cases. Among DD, pure anteriorized position was the most common condition (34.4), with different combined translational and rotational displacements in all the other joints (27.7). Conclusion. There is a wide biological variability in disc position in closed mouth among patients seeking for TMD advice. Getting deeper into the correlation with clinical symptoms is recommended to refine the potential relevance of any diagnostic and management strategies based on the imaging evaluation of TMJ disc position.