Evaluation of Psychological Factors in Temporomandibular Joint Pain Dysfunction Syndrome: A report of 3 cases and review of the literature

Objective: This study reports the findings from the psychological assessment of temporomandibular pain dysfunction syndrome (TMJPDS) patients and the treatment outcome following a multidisciplinary team management of this condition. Methods: Three patients suffering from TMJPDS were administered the following psychological assessment questionnaires: Eysenck Personality Questionnaire (EPQ), Symptom Distress Checklist ­ 90 (SCL - 90), Spielberger's State-Trait Anxiety Inventory (STAI), Index of self Esteem (ISE) and Chronic Pain Grade (CPG). The completed questionnaires by the patients were analyzed by a Clinical Psychologist. Case Reports: Case 1 was a 32 years old male. Psychological assessment showed that he manifested high peak position to being anxious and high feeling of tension associated with dental treatment. He also showed an increased pain perception and disability caused by TMJPDS. Case 2 was a 61 years old female. Psychological test showed that despite her high level of trait anxiety, the feeling of tension associated with dental treatment was low. She perceived her abnormal pain and disability caused by the disease to be low. Case 3 was a 39 years old female. Psychological assessment revealed that her predisposition to being anxious was high; however, her anxiety related to dental care was low. She also reported a reduced pain perception and disability caused by the disease condition. Conclusion: This study shows that TMJPDS is often associated with psychological problems, such as anxiety, with or without tension related to dental care, abnormal pain perception and psychological disability. A multidisciplinary team approach including dentists and mental health experts in the management of patients suffering from TMJPDS is recommended

Management of long standing temporomandibular dysfunction in an edentulous patient with gunning type splint: a clinical case report

Objective: The aetiology of temporomandibular dysfunction (TMD) is multifactorial and controversial. It is associated with pain, clicking sounds and structural derangement within the joints. TMDs are believed to be a complex interaction between the temporomandibular joint (TMJ), the masticatory muscles, and possibly the occlusion of the teeth. The prevalence of TMDs in edentulous populations is similar to that in the dentate population. The objective of this study was to observe the effect of altering occlusal vertical dimension on the course of TMD and the overall rehabilitation of an edentulous patient. Clinical Case Report: This work reports a treatment protocol on a single edentulous woman with TMD. It was carried out at a tertiary centre in Kano, Nigeria. A misdiagnosed, and wrongly treated patient was referred to the prosthodontic clinic at this centre. Clinical and radiological assessments suggested a diagnosis of TMJ arthrosis secondary to neglected TMD. Gunning type splints were used to reduce pressure on the TMJs. Thereafter, conventional complete dentures were prescribed. The symptoms of TMD began to reduce after about 4 weeks and were self-reported to have completely disappeared after 12 weeks of treatment. Treatment with splint therapy was effective and patient was successfully rehabilitated. Conclusion: In this study, success was achieved with the use of splint therapy in the treatment of TMD. Gunning type splints are a viable option for splint therapy in the edentulous