Journal of Craniomandibular Function, 04/2017

The main breakthrough characteristic of the new Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), besides the standardized examination, is its dual diagnostic axis protocol. The purpose of this article is to present Axis II of the new DC/TMD in Germany, and to emphasize the importance of screening in cases of TMD. Axis II of the established Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) has not yet found wide acceptance among dentists and orofacial pain specialists in Germany, presumably because of its complexity. The most recent DC/TMD has a totally new approach to Axis II, which could make its use more feasible, even in general practice. It consists of a core of short and easyto- apply screening questions that should be used initially. It also provides several instruments covering a variety of clinical symptoms. The main parts of the DC/TMD Axis II core are: 1. A short anamnestic questionnaire consisting of 14 questions, some of which are integrated into the diagnostic algorithm, in combination with the clinical findings from Axis I, from which a three-question screening for temporomandibular disorder (TMD) pain was developed. 2. Graded chronic pain status (GCPS, version 2.0), consisting of eight questions. 3. Screening for depression and anxiety by use of four questions. 4. A drawing showing the location of pain (face, mouth, and body). 5. The short form of the jaw functional limitation scale (JFLS-8). 6. An oral behavior checklist, comprising 21 questions, for global assessment of parafunctions. As the last two instruments are not yet established, screening for TMD can be adequately achieved by use of a few questions and a pain drawing. If a little time is taken to complete all these instruments and assess the results, the process is compatible with regular routine in dental practice. The regular use of these screening instruments can enable dentists to achieve a better diagnosis of TMD, resulting in timely intervention. Keywords: Diagnostic Criteria for Temporomandibular Disorders, screening, temporomandibular dysfunction, myoarthropathy

Background: The highest evidence level of therapy-related primary studies is allocated to randomized controlled trials (RCTs). In dentistry, a quantitative analysis of RCT articles published in the various dental specialties has been missing to date. Methods: In PubMed, the 10 dental specialties with the greatest number of RCT articles published until December 2016 were identified. For each specialty, the percentage of the RCT articles relative to all articles was calculated. Then, separated for dentistry in general and for the topic "temporomandibular disorders (TMDs)," the distribution of the annual frequencies of published RCT articles was determined, and the further development for 2017 to 2030 was predicted. Results: Altogether, 8540 RCT articles were identified. Preventive dentistry and periodontology rank in the top two places numerically and proportionally, while the field of TMDs is ranked eighth. The trend reveals a visible increase in the annual number of published RCT articles over time. This increase will continue in the future. Conclusion: Dentists should know about the RCT articles with high methodological quality, and consider them for clinical decision making. Keywords: dental disciplines, randomized controlled trial, prediction, PubMed, ing, search strategy

In this study - the Study of TMD Patients in General Dentistry Offices (STING) - data on the treatment of TMD patients were collected by 10 practicing dentists and evaluated retrospectively. The aim of this study was to identify risk factors that could lead to treatment failure. Treatment data from 1,041 TMD patient records were entered into an analytical database, categorized, and statistically analyzed by binary logistic regression using SPSS 23. The variables "gender," "age," "number of complaints," and "duration of symptoms" had no significant effect on the treatment outcome. Likewise, individual complaints such as pain or discomfort in the cheek, neck, and/or ear region as well as tension-type headache and functional toothache had no significant effect on the target variable, which was treatment outcome. Chief complaints of dysfunctional pain (odds ratio [OR] 6.4), multilocular pain (OR 8.2), vertigo (OR 13.2), migraine (OR 4.9), tinnitus (OR 4.1), and occlusal discomfort (OR 3.9) were identified as risk factors that influence treatment outcome. The latter association showed a significant correlation with increased Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II levels, as was also the case for tinnitus, migraine, and vertigo. Keywords: temporomandibular disorder (TMD), risk factors, Axis II score, persistent pain, chronic pain, multilocular pain, occlusal discomfort, occlusal splint