Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry1
Purpose: Temporomandibular disorders (TMD) may occur during or after regular dental treatment. The aim of this study is to suggest management of TMD involved in dental implant treatment. Materials and Methods: We investgated the etiology, site of implantation, symptoms, treatments and improvements with a focus on TMD among patients who complained of TMD symptoms during or after dental implant treatment. Results: A total of 19 patients complained of TMD associated with implant treatment. Thirteen patients complained of masticatory muscle pain, 13 patients complained of temporomandibular joint (TMJ) pain, and 8 patients complained of both masticatory muscle pain and TMJ pain. The patients were treated primarily with counselling, medication and physical therapy, and secondarily with occlusal splint therapy. Six patients received only primary treatment, and their average recovery time was 4.2 months. Four patients received secondary treatment, and their average recovery time was 8.5 months. None of the patients underwent surgical intervention of the TMJ. Conclusion: Patients who have a risk of developing TMD may experience TMD symptoms during or after implant treatment, such as facial pain, masticatory myalgia, TMJ pain and mouth opening limitation. To mitigate these symptoms, we suggest the application of the usual treatment protocols for TMD.
1. Okeson JP. Etiology of functional disturbances in the masticatory system. In: Okeson JP, ed. Management of temporomandibular disorders and occlusion. St. Louis: Elsevier; 2014. p. 111-139.
2. Glaros AG, Tabacchi KN, Glass EG. Effect of parafunctional clenching on TMD pain. J Orofac Pain. 1998; 12: 145-152.
3. Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion: idiopathic condylar resorption. Part II. Am J Orthod Dentofacial Orthop. 1996; 110: 117-127.
4. Arnett GW, Milam SB, Gottesman L. Progressive mandibular retrusion--idiopathic condylar resorption. Part I. Am J Orthod Dentofacial Orthop. 1996; 110: 8-15.
5. Maixner W, Fillingim R, Booker D, et al. Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain. 1995; 63: 341-351.
6. Cha YH, Kim BJ, Lim JH, et al. Analysis of treatment patterns of temporomandibular disorders. J Korean Assoc Oral Maxillofac Surg. 2010; 36: 520-527.
7. Levitt SR, McKinney MW. Validating the TMJ scale in a national sample of 10,000 patients: demographic and epidemiologic characteristics. J Orofac Pain. 1994; 8: 25-35.
8. Halpern LR, Levine M, Dodson TB. Sexual dimorphism and temporomandibular disorders (TMD). Oral Maxillofac Surg Clin NorthAm. 2007; 19: 267-277.
9. Wang J, Chao Y, Wan Q, et al. The possible role of estrogen in the incidence of temporomandibular disorders. Med Hypotheses. 2008; 71: 564-567.
10. Peplau HE. Mid-life crises. Am J Nurs. 1975; 75: 1761-1765, 1794
11. Gungormus Z, Erciyas K. Evaluation of the relationship between anxiety and depression and bruxism. J Int Med Res. 2009; 37: 547-550.
12. Oosterink FM, de Jongh A, Hoogstraten J. Prevalence of dental fear and phobia relative to other fear and phobia subtypes. Eur J Oral Sci. 2009; 117: 135-143.
13. Muehlemann HR, Savdir S, Rateitschak KH. Tooth mobility--its causes and significance. J Periodontol. 1965; 36: 148-153.
14. Parfitt GJ. Measurement of the physiological mobility of individual teeth in an axial direction. J Dent Res. 1960; 39: 608-618.
15. Kim Y, Oh TJ, Misch CE, et al. Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale. Clin Oral Implants Res. 2005; 16: 26-35.
16. Jang KS, Kim YH, Kim YS. Mobility of natural teeth and osseointegrated implants. J Korean Acad Prosthodont. 1995; 33: 144-155.
17. Rinchuse DJ, Rinchuse DJ, Kandasamy S. Evidence-based versus experience-based views on occlusion and TMD. Am J Orthod Dentofacial Orthop. 2005; 127: 249-254
18. Gesch D, Bernhardt O, Kirbschus A. Association of malocclusion and functional occlusion with temporomandibular disorders (TMD) in adults: a systematic review of population-based studies. Quintessence Int. 2004; 35: 211-221
19. Tipton RT, Rinchuse DJ. The relationship between static occlusion and functional occlusion in a dental school population. Angle Orthod. 1991; 61: 57-66.
20. Goldstein BH. Temporomandibular disorders: a review of current understanding. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88: 379-385.
21. Roh CS, Jung YH, Tae IH, et al. The usefulness of cone beam computed tomography in diagnosis of temporomandibular joint osteoarthritis. Korean J Oral Med. 2009; 34: 81-90
22. Nicolakis P, Burak EC, Kollmitzer J, et al. An investigation of the effectiveness of exercise and manual therapy in treating symptoms of TMJ osteoarthritis. Cranio. 2001; 19: 26-32.