- Email: [email protected]
TMJ and tinnitus
implants in native posterior maxilla, reason for tooth extraction, and narrow versus wide edentulous maxilla crest. None of these were related to higher implant failure rates. Recent Changes.—In addition to the conditions for which several publications were available and data could be assessed, a few more recent studies suggest that modern implants that are moderately rough are exhibiting good results. These achieve similar results whether they are placed in maxillas versus mandibles or in smoking versus nonsmoking patients. Short implants of this type had results similar to implants with longer lengths.
Fig 5.—Bone resorption around a short turned surface implant. €rn Gjelvold.) (Courtesy of Chrcanovic BR, (Courtesy of Dr Bjo Albrektsson T, Wennerberg A: Reasons for failures of oral implants. J Oral Rehab 41:443-476, 2014.)
overdenture attachment, abutment design, immediate/ early/delayed/late loading, and framework. Higher rates of failure were associated with prosthetic rehabilitation with implant-supported overdentures, immediate loading, and implants inserted into fresh extraction sockets. Other Conditions.—Other conditions that were explored for their relationship to implant failure were contamination with prefabricated stainless steel guide versus no guide, control versus immediate orthodontic loading, internal sinus lift without graft material versus
Clinical Significance.—Implants should be able to withstand normal use for several decades, especially since they are being used in young persons. To extend their use, it is important to know what contributes to or causes their failure. Approaches to lengthen implant usefulness can then be designed.
Chrcanovic BR, Albrektsson T, Wennerberg A: Reasons for failures of oral implants. J Oral Rehab 41:443-476, 2014 Reprints available from BR Chrcanovic, Dept of Prosthodontics, Fac€ Univ, Carl Gustafs vo €g 34, SE-205 06 ulty of Odontology, Malmo €, Sweden; e-mail: [email protected]; brunochrc Malmo [email protected]
TMJ TMJ and tinnitus Background.—Tinnitus and temporomandibular disorders (TMDs) often occur together, prompting speculation that the two disorders may be related. The possible association between tinnitus and TMDs was investigated, along with the effects of stomatognathic therapy on tinnitus symptoms. Methods.—The 951 consecutive patients (mean age 54 years, range 8 to 98 years) were seen at the University Medical Center in Regensburg, Germany. Twentyfive patients had TMD and tinnitus. At baseline, all participants underwent a detailed functional analysis, took diagnostic tests for TMJ and masticatory muscle disorder, and completed a tinnitus questionnaire. All participants were prescribed individual dental
322
Dental Abstracts
functional therapy using oral splints or physiotherapy, with the results evaluated 3 to 5 months after beginning treatment. Results.—Eighty-two patients (8.6%) were diagnosed with TMD, 68 (7.2%) with tinnitus, and 30 (3.2%) with both. The relative risk of having tinnitus was 8.37 times higher for persons with TMD than for those without TMD. Men and women experienced tinnitus at similar levels (6.8% and 7.5%, respectively). However, TMD was twice as prevalent among women (11.7%) as among men (5.5%). More women (4.0%) than men (2.3%) had TMD and tinnitus concomitantly. Muscle disorders were noted in 14 patients with concurrent tinnitus, disk displacement
Table 1.—Treatment Outcome of 30 Individuals with TMD and Simultaneous Tinnitus After Dental Functional Therapy Symptoms at Baseline
Pain (27 of 30) Joint sounds (19 of 30) Limited mandibular movements (9 of 30) Tinnitus (30 of 30) Acute tinnitus (10 of 30) Chronic tinnitus (20 of 30)
No. Participants in the Study*
No Change n (%)
Improvement n (%)
Complete Remission n (%)
% Improvement/Complete Remission
22 of 27 16 of 19 6 of 9
4 (18) 5 (31) 3 (50)
9 (41) 5 (31) 3 (50)
9 (41) 6 (38) 0
82 69 50
25 of 30 8 of 10 17 of 20
14 (56) 0 14 (82)
9 (36) 7 (87) 2 (12)
2 (8) 1 (13) 1 (6)
44 100 18
* Five of 30 refused to participate. (Courtesy of Buergers R, Kleinjung T, Behr M, et al: Is there a link between tinnitus and temporomandibular disorders? J Prosthet Dent 111:222-227, 2014.)
was noted in 18 patients, and arthralgia, osteoarthritis, and/ or osteoarthrosis was noted in 10 participants with tinnitus. All patients who had unilateral TMD and tinnitus had both symptoms on the same side, whereas those with bilateral TMD had bilateral tinnitus in 14 of 17 cases and unilateral tinnitus in 3 of 17 cases. Bilateral tinnitus was found with unilateral TMD in 5 participants. Dental functional therapy produced improvement or complete remission of TMD symptoms after 3 to 5 months in 81.8% of those with myofascial pain, 68.8% of those with joint sounds, and 50% of those with limited mandibular movements. Eight percent of those with tinnitus had complete remission of their symptoms, 36% had improvement, and 56% experienced no change. Of the 30 persons with simultaneous tinnitus and TMD, 10 had acute or subacute tinnitus and 20 had chronic tinnitus. Dental functional therapy improved or eliminated tinnitus symptoms for all patients with acute tinnitus, but 82% of those with chronic tinnitus reported no change (Table 1).
participants who did not have physiotherapy had these positive results. Improvement or complete remission of tinnitus occurred significantly more often among person with arthrogenic disorders than among those with myogenic disorders. Discussion.—Tinnitus and TMDs appear to be correlated. Stomatognathic therapy may provide relief of symptoms of the TMJ and masticatory muscle related tinnitus.
Clinical Significance.—It is not possible to conclusively link TMD and tinnitus based on the findings of this study. However, it appears that treatment using splints or physiotherapy may help both disorders.
A distraction splint was used for 14 patients and a Michigan-type splint for 11 patients. The type of splint had no significant effect on the change in tinnitus symptoms.
Buergers R, Kleinjung T, Behr M, et al: Is there a link between tinnitus and temporomandibular disorders? J Prosthet Dent 111:222-227, 2014
Physiotherapy was done for 16 patients who had tinnitus and TMD, and 50% of these patients had improvement or total remission of their symptoms. Only 3 of 9
Reprints available from R Buergers, Dept of Prosthodontics, Univ Medical Ctr Goettingen, 37099 Goettingen, Germany; e-mail: [email protected]
Oral Medicine Bell’s palsy Background.—Idiopathic facial paralysis (Bell’s palsy) is characterized by the sudden onset of unilateral, lower motor neuron weakness of the facial nerve with no discernible
cause. Patients may also experience retroauricular pain extending into the neck and occiput, intolerance of noise, and ipsilateral taste disturbance. Most cases resolve
Volume 59
Issue 6
2014
323
Fig 5.—Bone resorption around a short turned surface implant. €rn Gjelvold.) (Courtesy of Chrcanovic BR, (Courtesy of Dr Bjo Albrektsson T, Wennerberg A: Reasons for failures of oral implants. J Oral Rehab 41:443-476, 2014.)
overdenture attachment, abutment design, immediate/ early/delayed/late loading, and framework. Higher rates of failure were associated with prosthetic rehabilitation with implant-supported overdentures, immediate loading, and implants inserted into fresh extraction sockets. Other Conditions.—Other conditions that were explored for their relationship to implant failure were contamination with prefabricated stainless steel guide versus no guide, control versus immediate orthodontic loading, internal sinus lift without graft material versus
Clinical Significance.—Implants should be able to withstand normal use for several decades, especially since they are being used in young persons. To extend their use, it is important to know what contributes to or causes their failure. Approaches to lengthen implant usefulness can then be designed.
Chrcanovic BR, Albrektsson T, Wennerberg A: Reasons for failures of oral implants. J Oral Rehab 41:443-476, 2014 Reprints available from BR Chrcanovic, Dept of Prosthodontics, Fac€ Univ, Carl Gustafs vo €g 34, SE-205 06 ulty of Odontology, Malmo €, Sweden; e-mail: [email protected]; brunochrc Malmo [email protected]
TMJ TMJ and tinnitus Background.—Tinnitus and temporomandibular disorders (TMDs) often occur together, prompting speculation that the two disorders may be related. The possible association between tinnitus and TMDs was investigated, along with the effects of stomatognathic therapy on tinnitus symptoms. Methods.—The 951 consecutive patients (mean age 54 years, range 8 to 98 years) were seen at the University Medical Center in Regensburg, Germany. Twentyfive patients had TMD and tinnitus. At baseline, all participants underwent a detailed functional analysis, took diagnostic tests for TMJ and masticatory muscle disorder, and completed a tinnitus questionnaire. All participants were prescribed individual dental
322
Dental Abstracts
functional therapy using oral splints or physiotherapy, with the results evaluated 3 to 5 months after beginning treatment. Results.—Eighty-two patients (8.6%) were diagnosed with TMD, 68 (7.2%) with tinnitus, and 30 (3.2%) with both. The relative risk of having tinnitus was 8.37 times higher for persons with TMD than for those without TMD. Men and women experienced tinnitus at similar levels (6.8% and 7.5%, respectively). However, TMD was twice as prevalent among women (11.7%) as among men (5.5%). More women (4.0%) than men (2.3%) had TMD and tinnitus concomitantly. Muscle disorders were noted in 14 patients with concurrent tinnitus, disk displacement
Table 1.—Treatment Outcome of 30 Individuals with TMD and Simultaneous Tinnitus After Dental Functional Therapy Symptoms at Baseline
Pain (27 of 30) Joint sounds (19 of 30) Limited mandibular movements (9 of 30) Tinnitus (30 of 30) Acute tinnitus (10 of 30) Chronic tinnitus (20 of 30)
No. Participants in the Study*
No Change n (%)
Improvement n (%)
Complete Remission n (%)
% Improvement/Complete Remission
22 of 27 16 of 19 6 of 9
4 (18) 5 (31) 3 (50)
9 (41) 5 (31) 3 (50)
9 (41) 6 (38) 0
82 69 50
25 of 30 8 of 10 17 of 20
14 (56) 0 14 (82)
9 (36) 7 (87) 2 (12)
2 (8) 1 (13) 1 (6)
44 100 18
* Five of 30 refused to participate. (Courtesy of Buergers R, Kleinjung T, Behr M, et al: Is there a link between tinnitus and temporomandibular disorders? J Prosthet Dent 111:222-227, 2014.)
was noted in 18 patients, and arthralgia, osteoarthritis, and/ or osteoarthrosis was noted in 10 participants with tinnitus. All patients who had unilateral TMD and tinnitus had both symptoms on the same side, whereas those with bilateral TMD had bilateral tinnitus in 14 of 17 cases and unilateral tinnitus in 3 of 17 cases. Bilateral tinnitus was found with unilateral TMD in 5 participants. Dental functional therapy produced improvement or complete remission of TMD symptoms after 3 to 5 months in 81.8% of those with myofascial pain, 68.8% of those with joint sounds, and 50% of those with limited mandibular movements. Eight percent of those with tinnitus had complete remission of their symptoms, 36% had improvement, and 56% experienced no change. Of the 30 persons with simultaneous tinnitus and TMD, 10 had acute or subacute tinnitus and 20 had chronic tinnitus. Dental functional therapy improved or eliminated tinnitus symptoms for all patients with acute tinnitus, but 82% of those with chronic tinnitus reported no change (Table 1).
participants who did not have physiotherapy had these positive results. Improvement or complete remission of tinnitus occurred significantly more often among person with arthrogenic disorders than among those with myogenic disorders. Discussion.—Tinnitus and TMDs appear to be correlated. Stomatognathic therapy may provide relief of symptoms of the TMJ and masticatory muscle related tinnitus.
Clinical Significance.—It is not possible to conclusively link TMD and tinnitus based on the findings of this study. However, it appears that treatment using splints or physiotherapy may help both disorders.
A distraction splint was used for 14 patients and a Michigan-type splint for 11 patients. The type of splint had no significant effect on the change in tinnitus symptoms.
Buergers R, Kleinjung T, Behr M, et al: Is there a link between tinnitus and temporomandibular disorders? J Prosthet Dent 111:222-227, 2014
Physiotherapy was done for 16 patients who had tinnitus and TMD, and 50% of these patients had improvement or total remission of their symptoms. Only 3 of 9
Reprints available from R Buergers, Dept of Prosthodontics, Univ Medical Ctr Goettingen, 37099 Goettingen, Germany; e-mail: [email protected]
Oral Medicine Bell’s palsy Background.—Idiopathic facial paralysis (Bell’s palsy) is characterized by the sudden onset of unilateral, lower motor neuron weakness of the facial nerve with no discernible
cause. Patients may also experience retroauricular pain extending into the neck and occiput, intolerance of noise, and ipsilateral taste disturbance. Most cases resolve
Volume 59
Issue 6
2014
323