BACKGROUND Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.

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Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study

Association Between Polymorphisms in the Genes of Estrogen Receptors and the Presence of Temporomandibular Disorders and Chronic Arthralgia.

Aim: To determine the relationship between estrogen levels in females and prevalence of temporomandibular joint disorders (TMDs) in Aseer region of Saudi Arabia. Context: TMDs were considered to be the most common musculoskeletal disorders that cause orofacial pain. The complex chronic nature of TMDs may affect the quality of life negatively. Studies have shown different prevalence of TMDs among different populations which could be related to variations in methodologies, diagnostic criteria, or classifications. Females are affected more commonly than males with the highest prevalence reported during the reproductive years. One possible explanation, although debatable, is related to female reproductive hormones, especially estrogen. Estrogen could have influence on the structural development, metabolism, and physiologic pain perception of temporomandibular joints. Methodology: After theApproval taken from the Scientific Research Committee, College of dentistry, King Khalid University, Abha. A written informed consent was drawn from subjects and total of 227 Saudi and NonSaudi female subjects were selected randomly and were examined. Research Diagnostic Criteria for TMDs (RDC/TMD) Axes I and II were used for diagnosing the most common TMDs and for assessing the psychosocial and behavioral factors, respectively. Procedures followed were in accordance with the ethical standards given in the Declaration of Helsinki of 1975, as revised in 2000. Estrogen test results were retrieved from the latest hormonal analysis of estradiol (E2) blood tests and statistical analysis was done using SPSS Version 16.0. Kolmogorov-Smirnov, Mann-Whitney U, and Kruskal-Wallis tests. Results: The prevalence of TMDs in females in Aseer region is 26%. Myofascial pain is the most common diagnosis based on RDC/TMD diagnostic criteria, with 22% myofascial pain only and 4% myofascial pain with limited opening. 19.8% reproducible clicking and 9.7% clicking and catching. There was no significant difference of the estrogen levels reported. The mean value of estrogen levels reached its highest in 41-50 age groups. Conclusions: No significant association found between the tested demographic parameters and TMDs diagnosis or Estrogen levels. TMDs cases showed significantly lower Estrogen levels in comparison to normal cases which are consistent with some published studies but should be interpreted carefully. Further Investigations are needed to assess the relationship of Estrogen levels and TMDs.

http://www.journal.atmph-specialissues.org/uploads/179/8518_pdf.pdf

Prevalence of Temporomandibular Disorders (TMDs) in Relation to Estrogen Levels among Females in Aseer Region, Saudi Arabia

Molecular genetics and epigenetics of temporomandibular disorder

Temporomandibular Joint Disorders During Pregnancy and the Postpartum Period

Aim: The aim of the present study is to investigate the role of female reproductive hormones estrogen and progesterone in temporomandibular disorder (TMD) in female patients. Materials and Methods: Serum estrogen and progesterone levels of 200 female participants who had varying grades of TMD were measured by enzyme immunoassay competition method in the luteal phase of menstrual cycle. Results: Mean serum concentration of estrogen was 302.1 ± 3.16 pg/mL, and the mean serum concentration of progesterone was 1.68 ± 38.3 ng/mL. Mean serum levels of estrogen and progesterone increased with increasing severity of TMD. Conclusion: Increased serum levels of estrogen and progesterone with increased grade of severity of TMD suggest role of these hormones as etiological factors for TMD.

Satish Chuggani

Papers

Role of female reproductive hormones estrogen and progesterone in temporomandibular disorder in female patients