Temporomandibular Joint Disorders' Impact on Pain, Function, and Disability

Overview

Journal J Dent Res

Specialty Dentistry

Date 2015 Jan 10

PMID 25572112

Citations 44

Authors

P Chantaracherd

M T John

J S Hodges

E L Schiffman

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored.

Citing Articles

Axis I diagnosis profile according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): comparison between hospital-based orofacial pain clinic and dental academic-based orofacial pain clinic.

Reiter S, Jazmawi S, Winocur E, Arias O, Kats L, Manor Y J Oral Facial Pain Headache. 2025; 38(4):76-84.

PMID: 39800958 PMC: 11810646. DOI: 10.22514/jofph.2024.040.

Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain.

Ma Z, Wan Q, Qin W, Qin W, Yan J, Zhu Y Int J Oral Sci. 2025; 17(1):3.

PMID: 39762209 PMC: 11704193. DOI: 10.1038/s41368-024-00336-6.

Occlusal interventions for managing temporomandibular disorders.

Singh B, Singh N, Jayaraman S, Kirubakaran R, Joseph S, Muthu M Cochrane Database Syst Rev. 2024; 9:CD012850.

PMID: 39282765 PMC: 11403706. DOI: 10.1002/14651858.CD012850.pub2.

Mechanics- and Behavior-Related Temporomandibular Joint Differences.

Nickel J, Gonzalez Y, Liu Y, Liu H, Gallo L, Iwasaki L J Dent Res. 2024; 103(11):1083-1090.

PMID: 39275985 PMC: 11653271. DOI: 10.1177/00220345241265670.

Arthroscopic Assessment of Temporomandibular Joint Pathologies-Is It Possible for Non-Specialists in Arthroscopy? Analysis of Variability and Reliability of Dental Students' Ratings after a Comprehensive One-Semester Introduction.

Bruning L, Rosner Y, Meisgeier A, Neff A J Clin Med. 2024; 13(14).

PMID: 39064035 PMC: 11277048. DOI: 10.3390/jcm13143995.

References

Bertram S, Rudisch A, Innerhofer K, Pumpel E, Grubwieser G, Emshoff R . Diagnosing TMJ internal derangement and osteoarthritis with magnetic resonance imaging. J Am Dent Assoc. 2001; 132(6):753-61. DOI: 10.14219/jada.archive.2001.0272. View

Emshoff R, Rudisch A, Innerhofer K, Bosch R, Bertram S . Temporomandibular joint internal derangement type III: relationship to magnetic resonance imaging findings of internal derangement and osteoarthrosis. An intraindividual approach. Int J Oral Maxillofac Surg. 2001; 30(5):390-6. DOI: 10.1054/ijom.2001.0068. View

Schiffman E, Velly A, Look J, Hodges J, Swift J, Decker K . Effects of four treatment strategies for temporomandibular joint closed lock. Int J Oral Maxillofac Surg. 2013; 43(2):217-26. PMC: 3946573. DOI: 10.1016/j.ijom.2013.07.744. View

Emshoff R, Brandlmaier I, Gerhard S, Strobl H, Bertram S, Rudisch A . Magnetic resonance imaging predictors of temporomandibular joint pain. J Am Dent Assoc. 2003; 134(6):705-14. DOI: 10.14219/jada.archive.2003.0256. View

Rasmussen O . Description of population and progress of symptoms in a longitudinal study of temporomandibular arthropathy. Scand J Dent Res. 1981; 89(2):196-203. DOI: 10.1111/j.1600-0722.1981.tb01671.x. View

Wilkes C . Internal derangements of the temporomandibular joint. Pathological variations. Arch Otolaryngol Head Neck Surg. 1989; 115(4):469-77. DOI: 10.1001/archotol.1989.01860280067019. View

Westesson P, LUNDH H . Arthrographic and clinical characteristics patients with disk displacement who progressed to closed lock during a 6-month period. Oral Surg Oral Med Oral Pathol. 1989; 67(6):654-7. DOI: 10.1016/0030-4220(89)90003-0. View

Schiffman E, Anderson G, Fricton J, Lindgren B . The relationship between level of mandibular pain and dysfunction and stage of temporomandibular joint internal derangement. J Dent Res. 1992; 71(11):1812-5. DOI: 10.1177/00220345920710110901. View

Von Korff M, Ormel J, Keefe F, Dworkin S . Grading the severity of chronic pain. Pain. 1992; 50(2):133-149. DOI: 10.1016/0304-3959(92)90154-4. View

10.

de Bont L, Stegenga B . Pathology of temporomandibular joint internal derangement and osteoarthrosis. Int J Oral Maxillofac Surg. 1993; 22(2):71-4. DOI: 10.1016/s0901-5027(05)80805-7. View

11.

de Leeuw R, BOERING G, Stegenga B, de Bont L . TMJ articular disc position and configuration 30 years after initial diagnosis of internal derangement. J Oral Maxillofac Surg. 1995; 53(3):234-41; discussion 241-2. DOI: 10.1016/0278-2391(95)90215-5. View

12.

de Leeuw R, BOERING G, Stegenga B, de Bont L . Radiographic signs of temporomandibular joint osteoarthrosis and internal derangement 30 years after nonsurgical treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79(3):382-92. DOI: 10.1016/s1079-2104(05)80233-1. View

13.

BUSH F, Harkins S . Pain-related limitation in activities of daily living in patients with chronic orofacial pain: psychometric properties of a disability index. J Orofac Pain. 1995; 9(1):57-63. View

14.

Zarb G, Carlsson G . Temporomandibular disorders: osteoarthritis. J Orofac Pain. 2000; 13(4):295-306. View

15.

Kurita K, Westesson P, Yuasa H, Toyama M, Machida J, Ogi N . Natural course of untreated symptomatic temporomandibular joint disc displacement without reduction. J Dent Res. 1998; 77(2):361-5. DOI: 10.1177/00220345980770020401. View

16.

Kino K, Sugisaki M, Haketa T, Amemori Y, Ishikawa T, Sato F . The comparison between pains, difficulties in function, and associating factors of patients in subtypes of temporomandibular disorders. J Oral Rehabil. 2005; 32(5):315-25. DOI: 10.1111/j.1365-2842.2004.01439.x. View

17.

Kurita H, Uehara S, Yokochi M, Nakatsuka A, Kobayashi H, Kurashina K . A long-term follow-up study of radiographically evident degenerative changes in the temporomandibular joint with different conditions of disk displacement. Int J Oral Maxillofac Surg. 2005; 35(1):49-54. DOI: 10.1016/j.ijom.2005.04.004. View

18.

Ohlmann B, Rammelsberg P, Henschel V, Kress B, Gabbert O, Schmitter M . Prediction of TMJ arthralgia according to clinical diagnosis and MRI findings. Int J Prosthodont. 2006; 19(4):333-8. View

19.

Reissmann D, John M, Schierz O, Wassell R . Functional and psychosocial impact related to specific temporomandibular disorder diagnoses. J Dent. 2007; 35(8):643-50. DOI: 10.1016/j.jdent.2007.04.010. View

20.

Campos M, Campos P, Cangussu M, Guimaraes R, Line S . Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg. 2008; 37(6):529-34. DOI: 10.1016/j.ijom.2008.02.011. View