Effect of duration of preoperative pain on outcomes of total temporomandibular joint replacement.

The purpose of the study was to determine whether the duration of preoperative pain affects outcomes of temporomandibular joint replacement (TMJR). Twenty-seven patients who underwent primary TMJR between 1 July 2020 and 31 October 2022 were retrospectively assessed for duration of preoperative pain, level of preoperative and postoperative pain on a visual analogue scale (VAS; 0, none; 10, severe), preoperative and postoperative range of motion (ROM), and net change in quality of life (much better, better, same, worse, much worse), reporting the longest available follow up for each patient. Surgical success was defined as postoperative pain of ≤4 and postoperative ROM of ≥30 mm, or net change (Δ) in ROM of ≥10 mm. Regression analyses evaluated associations between independent variables and postoperative pain and ROM. At a mean follow-up of 17.8 (SD: 6.8, range 3-32) months , pain (5.1, SD: 2.2, p < 0.001) and ROM (9.3 mm, SD: 8.0, p<0.001) significantly improved. Quality of life was much better in 16 patients, better in eight, the same in one, and worse in two. Longer duration of preoperative pain tended to be negatively associated with postoperative ROM (ß = -0.27; 95% CI -0.6 to 0.0; p = 0.078) but was not associated with severity of postoperative pain. Surgical success was achieved in 23/27 patients. The successful group tended to have lower pain on VAS preoperatively (5.9, SD: 1.9) vs 7.5, SD: 1.3) and postoperatively (0.4, SD: 0.8 vs 4.8, SD: 2.6), and greater improvement in quality of life (much better: 14/23 vs 2/4). In conclusion, longer duration of preoperative pain tended to be associated with worse postoperative ROM following TMJR. Higher preoperative pain may be a predictor for unsuccessful surgery.

A comparison of work environment, job insecurity, and health between marginal part-time workers and full-time workers in Denmark using pooled register data.

OBJECTIVES: This study aimed to evaluate characteristics of the work environment, job insecurity, and health of marginal part-time workers (8.0-14.9 hours/week) compared with full-time workers (32.0-40.0 hours/week). METHODS: The study population included employees in the survey Work Environment and Health in Denmark (WEHD) in 2012, 2014, or 2016 (n = 34 960). Survey information from WEHD on work environment and health was linked with register-based information of exposure based on working hours 3 months prior to the survey, obtained from the register Labour Market Account. Associations between marginal part-time work and work environment and health were assessed using logistic regression models. RESULTS: Marginal part-time workers reported less quantitative job demands, lower levels of influence at work, poorer support from colleagues and leaders, less job satisfaction and poorer safety, as well as more job insecurity. Results on negative social relations in the workplace and physical workload were more ambiguous. Marginal part-time workers were more likely to report poorer self-rated health, treatment-requiring illness, and depressive symptoms compared with full-time workers. Adjusting for characteristics of the work environment showed an indication of altered odds ratios for self-rated health and depressive symptoms, whereas job insecurity did not. CONCLUSIONS: This study finds that marginal part-time workers experience a poorer psychosocial work environment and safety, higher job insecurity, and poorer health than full-time workers. Work environment characteristics may confound or mediate the association between marginal part-time work and health. However, prospective studies are needed to determine the causal direction of the revealed associations.

[Temporomandibular joint prostheses]. / Prothèses d'articulation temporo-mandibulaire.

Temporomandibular joint prosthesis. The temporomandibular joint can be affected by end-stage pathology such as arthritic disease, trauma, ankylosis. The main debilitating symptoms results in limited mouth opening and pain. TMJ prosthesis is recommended for disease resulting in an anatomical modification and aims at restoring joint function with pain relief. Despite its initial history of health scandals, prosthetic replacement for end-stage TMJ disease is gradually becoming a common procedure because of good functional results and low morbidity. Significant advances have been made in the design of the temporomandibular joint prostheses during the last decades, specially thanks to the use of 3D printing. The indications should be further clarified and extended.

Prothèses d'articulation temporo-mandibulaire. L'articulation temporo-mandibulaire peut être le siège de pathologies telles que l'arthrose, les séquelles de trau¬matisme ou l'ankylose. Les principaux symptômes inva¬lidants sont la limitation de l'ouverture buccale et la douleur. La prothèse d'articulation temporo-mandibulaire s'adresse aux pathologies entraînant une modification anatomique. Son but premier est de restaurer la fonction de l'articulation en soulageant la douleur. Malgré son histoire initialement émaillée de scandales sanitaires, le remplacement prothétique pour les pathologies avancées de l'articulation temporo-mandibulaire est progressive¬ment devenu une intervention courante, grâce à de bons résultats fonctionnels et une morbidité faible. D'impor¬tantes avancées ont été réalisées dans la conception des prothèses durant les dernières décennies, notamment grâce à l'apport de l'impression 3D. Ses indications doivent encore être précisées et étendues.