Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.

El dolor, los ruidos articulares, las desviaciones mandibulares y el daño en la función masticatoria son las quejas más comunes por las cuales se consulta al especialista. Los desórdenes temporomandibulares (DTM) son alteraciones que deben evaluarse en los pacientes que buscan tratamiento de ortodon...

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Autores:
Bernal Fuentes, Jorge Mario
Restrepo Fernández, Rodrigo Alberto
Tipo de recurso:
Article of investigation
Fecha de publicación:
2021
Institución:
Universidad Cooperativa de Colombia
Repositorio:
Repositorio UCC
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OAI Identifier:
oai:repository.ucc.edu.co:20.500.12494/33296
Acceso en línea:
https://hdl.handle.net/20.500.12494/33296
Palabra clave:
TMD (temporomandibular disorders)
Maloclussion
Orthodontics
TMJD
Craniomandibular disorders
osteoarthritis
TG 2021 EOF
Maloclussion
Osteoarthritis
TMD
Temporomandibular disorders
Orthodontics
TMJD
craniomandibular disorders
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closedAccess
License
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dc.title.spa.fl_str_mv Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
title Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
spellingShingle Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
TMD (temporomandibular disorders)
Maloclussion
Orthodontics
TMJD
Craniomandibular disorders
osteoarthritis
TG 2021 EOF
Maloclussion
Osteoarthritis
TMD
Temporomandibular disorders
Orthodontics
TMJD
craniomandibular disorders
title_short Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
title_full Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
title_fullStr Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
title_full_unstemmed Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
title_sort Desórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.
dc.creator.fl_str_mv Bernal Fuentes, Jorge Mario
Restrepo Fernández, Rodrigo Alberto
dc.contributor.advisor.none.fl_str_mv Restrepo Fernández, Rodrigo Alberto
dc.contributor.author.none.fl_str_mv Bernal Fuentes, Jorge Mario
Restrepo Fernández, Rodrigo Alberto
dc.subject.spa.fl_str_mv TMD (temporomandibular disorders)
Maloclussion
Orthodontics
TMJD
Craniomandibular disorders
osteoarthritis
topic TMD (temporomandibular disorders)
Maloclussion
Orthodontics
TMJD
Craniomandibular disorders
osteoarthritis
TG 2021 EOF
Maloclussion
Osteoarthritis
TMD
Temporomandibular disorders
Orthodontics
TMJD
craniomandibular disorders
dc.subject.classification.spa.fl_str_mv TG 2021 EOF
dc.subject.other.spa.fl_str_mv Maloclussion
Osteoarthritis
TMD
Temporomandibular disorders
Orthodontics
TMJD
craniomandibular disorders
description El dolor, los ruidos articulares, las desviaciones mandibulares y el daño en la función masticatoria son las quejas más comunes por las cuales se consulta al especialista. Los desórdenes temporomandibulares (DTM) son alteraciones que deben evaluarse en los pacientes que buscan tratamiento de ortodoncia, debido a la relación anatómica que presentan la articulación temporomandibular(ATM) y la oclusión. estos desórdenes pueden explicar estos cambios dinámicos (alteraciones estructurales, funcionales y psicológicas). El objetivo de esta revisión es definir la asociación entre DTM y maloclusión, además de estructurar un protocolo de manejo ortodóncico basado en la evidencia. Materiales y métodos: Se realizó la búsqueda en las bases de datos (PubMed, Scopus y google scholar) de 2010 a 2019 con términos MeSH tales como “TMD” (temporomandibular disorders), “maloclussion”, “orthodontics”, “TMJD”,” craniomandibular disorders” y “osteoarthritis” además de operadores booleanos. Fueron seleccionados 166 artículos, 36 duplicados y 130 artículos se localizaron. 23 artículos se seleccionaron para la presente revisión. Resultados: Los DTM afectan al paciente desde etapas tempranas hasta la edad adulta, siendo un factor etológico de maloclusión en los tres planos del espacio. Conclusión: las maloclusiones agudas y crónicas son el resultado de alteración muscular, enfermedad degenerativa condilar y trauma. El ortodoncista debe conocer el protocolo para tratar estas alteraciones oclusales. Una adecuada anamnesis en la consulta inicial, un examen físico y recopilación de los signos clínicos pueden ser el gold standard para realizar un correcto diagnóstico y un tratamiento exitoso.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-02-09T23:34:06Z
dc.date.available.none.fl_str_mv 2021-02-09T23:34:06Z
dc.date.issued.none.fl_str_mv 2021-01-29
dc.type.none.fl_str_mv Artículos Científicos
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dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12494/33296
dc.identifier.bibliographicCitation.spa.fl_str_mv Bernal Fuentes, J.M., Restrepo Fernández, R.A. (2021). Desórdenes temporomandibulares como factor etiológico de maloclusiones. Revisión sistemática., 1-19. (Trabajo de posgrado, Universidad Cooperativa de Colombia) Repositorio Institucional UCC.
url https://hdl.handle.net/20.500.12494/33296
identifier_str_mv Bernal Fuentes, J.M., Restrepo Fernández, R.A. (2021). Desórdenes temporomandibulares como factor etiológico de maloclusiones. Revisión sistemática., 1-19. (Trabajo de posgrado, Universidad Cooperativa de Colombia) Repositorio Institucional UCC.
dc.relation.references.spa.fl_str_mv Schiffman E, Look J, Anderson G, Goldberg LJ, Haythornthwaite JA, Hollender L, et al. diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical research applications: recomendations of the international RDC/TMD consortium network and orofacial pain special interest group. 2014;28(1):6–27.
Racich MJ. Occlusion , temporomandibular disorders , and orofacial pain : An evidence-based overview and update with recommendations. J Prosthet Dent [Internet]. 2015;(October):1–8. Available from: https://doi.org/10.1016/j.prosdent.2018.01.033
Manfredini D. O ral Rehabilitation Temporomandibular disorders and dental occlusion . A systematic review of association studies : end of an era ? 2017;(5):908–23.
National Institute of Dental and Craniofacial Research. [7/28/2013]. Facial Pain. http:// www.nidcr.nih.gov/DataStatistics/FindDataByTopic/FacialPain/.
Sena MF De, Santos FRR, Silva FWGP, Serrano KVD. Prevalence of temporomandibular dysfunction in children and adolescents. 2013;31(4):538–45.
Mcnamara JA, Arbor A. Orthodontic treatment and temporomandibular disorders. 1997;107–17.
Nassif NJ. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males. 2003;(i):944–50.
Hiltunen K, Schmidt-kaunisaho K, Nevalainen J, Närhi T, Hiltunen K, Schmidt-kaunisaho K, et al. Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki , Finland Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki , Finland. 2009;6357(March 2016).
Okeson JP. O ral Rehabilitation Does altering the occlusal vertical dimension produce temporomandibular disorders ? A literature review. 2015;
Okeson JP. disorder in orthodontics : Past , present , and future. Am J Orthod Dentofac Orthop [Internet]. 2015;147(5):S216–23. Available from: http://dx.doi.org/10.1016/j.ajodo.2015.02.007
Mtaya M, Brudvik P AA. Prevalence of malocclusion and its relationship with socio‑demographic factors, dental caries, and oral hygiene in 12‑ to 14‑year‑old Tanzanian school children.le. Eur J Orthod. 2009;31:467–76.
Karaiskos N, Wiltshire WA, Odlum O, Brothwell D HT. Preventive and interceptive orthodontic treatment needs of an inner‑city group of 6‑ and 9‑year‑old Canadian children. J Can Dent Assoc. 2005;71:649.
Marques LS, Pordeus IA, Ramos‑Jorge ML, Filogônio CA F, CB, Pereira LJ et al. Factors associated with the desire for orthodontic treatment among Brazilian adolescents and their parents. BMC Oral Health. 2009;9:34.
Silva RG, Kang DS. Prevalence of malocclusion among Latino adolescents. 2004;313–5.
Caldas W, Cláudia A, Ferreira DC, Janson G, César P, Conti R. Occlusal changes secondary to temporomandibular joint conditions : a critical review and implications for clinical practice. :411–9.
Melvin L Moss RMR. the role of the functional matrix in mandibular growth. Columbia; 1968. p. 95–102.
Chouinard A, Peacock ZS. A c q u i red Ab n o r m a l i t i e s o f t h e Te m p o rom a n d i b u l a r Joint. Oral Maxillofac Surg Clin NA [Internet]. 2018;30(1):83–96. Available from: https://doi.org/10.1016/j.coms.2017.08.005
Prevalence of Temporomandibular Dysfunction and its Association with Malocclusion in Children: An Epidemiologic Study. 2017;41(2):161–6.
Bindayel NA. Occurrence of Malocclusion in Patients with Orofacial Pain and Temporomandibular Disorders. 2018;19(May):477–82.
Aboalnaga AA, Amer NM, Elnahas MO, Fayed MMS, Lumpur K, Soliman SA, et al. Malocclusion and Temporomandibular Disorders: Verification of the Controversy. 2019;33(4).
Petty RE, Southwood TR, Manners P, Baum J, Glass DN, He X, et al. rs on m e Co r ig ht rig s International League of Associations for Rheumatology Classification of Juvenile Idiopathic Arthritis : Second Revision , Edmonton , 2001 se. 2004;31(2).
Gäre BA. Juvenile arthritis - Who gets it , where and when ? A review of current data on incidence and prevalence. 1999;
Stoll ML, Sharpe T, Beukelman T, Good J, Young D, Cron RQ, et al. Idiopathic Arthritis Risk Factors for Temporomandibular Joint Arthritis in Children with Juvenile Idiopathic Arthritis. 2012;39(9).
Palmer AJR, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ. Seminar Osteoarthritis. 2015;386.
Chen Y, Dent M, Shih TT, Wang J. ORAL AND MAXILLOFACIAL RADIOLOGY Editor : Allan G . Farman Magnetic resonance images of the temporomandibular joints of patients with acquired open bite. 2005;99(6):734–42.
Chatzigianni A, Kyprianou C, Papadopoulos MA, Sidiropoulou S. Dentoalveolar characteristics in children with juvenile idiopathic arthritis. 2018;
Sarver DM, Janyavula S, Cron RQ. Condylar Degeneration and Diseases — Local and Systemic Etiologies. YSODO [Internet]. 2013;19(2):89–96. Available from: http://dx.doi.org/10.1053/j.sodo.2012.11.008
Wang M, He J, Chen C, Widmalm SE, He J, Chen C, et al. A Preliminary Anatomical Study On the Association of Condylar and Occlusal Asymmetry. 2016;9634(July).
Kasimoglu Y, Tuna EB, Rahimi B, Marsan G, Gencay K. Condylar asymmetry in different occlusion types. 2014;1–5.
Duy T, Duong T, Jinnavanich S, Chen M, Ko EW, Chen Y, et al. “Are signs of degenerative joint associated with chin deviation?” [Internet]. Journal of Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons; 2020. Available from: https://doi.org/10.1016/j.joms.2020.03.019
Veldhuis EC, Veldhuis AH, Koudstaal MJ. Treatment management of children with juvenile idiopathic arthritis with temporomandibular joint involvement : a systematic review. OOOO [Internet]. 2014;117(5):581–589.e2. Available from: http://dx.doi.org/10.1016/j.oooo.2014.01.226
Krisjane Z, Urtane I, Krumina G, Neimane L, The IR. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities : a cone-beam CT study. Int J Oral Maxillofac Surg [Internet]. 2012;41(6):690–5. Available from: http://dx.doi.org/10.1016/j.ijom.2012.03.006
Elgazzar RF, Abdelhady AI, Saad KA, Elshaal MA, Hussain MM. Treatment modalities of TMJ ankylosis : experience in Delta. Int J Oral Maxillofac Surg [Internet]. 2010;39(4):333–42. Available from: http://dx.doi.org/10.1016/j.ijom.2010.01.005
Gayle EA, Young SM, Mckenna SJ, Mcnaughton CD. Septic arthritis of the temporomandibular joint: case reports and riview of the literature. J Emerg Med [Internet]. 2013;(November 2012):1–5. Available from: http://dx.doi.org/10.1016/j.jemermed.2013.01.034
Chin R, Cheong T, Kassam K, Eccles S, Hensher R. Case Report Congenital Temporomandibular Joint Ankylosis : Case Report and Literature Review. 2016;2016(May 2011):2010–4.
Ali Ghasemzadeh, B.S., Gerhard S. Mundinger, M.D., Edward W. Swanson, M.D. AFU. treatment of pediatric condylar fractures: a 20-year experience. 2016;136(6):1279–88.
Becking G. Management of Posttraumatic Malocclusion Caused by Condylar Fractures. 1998;1370–4.
Kommers C, Bergh B Van Den, Boffano P, Verweij KP, Forouzanfar T. Dysocclusion after maxillofacial trauma : A 42 year analysis. 2013;2011–4.
Harvey NC. Epidemiology of fractures in the United Kingdom 1988–2012: Variation with age, sex, geography, ethnicity and socioeconomic status. Bone [Internet]. 2016; Available from: http://dx.doi.org/10.1016/j.bone.2016.03.006
Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil : A 5-year prospective study. 2004;28–34.
Rudisch A, Ulmer H. Cranio-maxillofacial trauma : a 10 year review of 9543 cases with 21 067 injuries. 2003;5182:51–61.
Handelman CS, Greene CS. Progressive / Idiopathic Condylar Resorption : An Orthodontic Perspective. YSODO [Internet]. 2013;19(2):55–70. Available from: http://dx.doi.org/10.1053/j.sodo.2012.11.004
FERRI. J NR. Condylar resorptions and orthodontic- surgical treatment: State of the art. 2016;223:1–25.
Kajii TS, Fujita T, Sakaguchi Y, Shimada K. Osseous changes of the mandibular condyle affect backward-rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption of the temporomandibular joint. CRANIO® [Internet]. 2018;9634:1–8. Available from: http://doi.org/10.1080/08869634.2017.1421446
Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil. 2010;37(8):411–29.
Kamble V, Rawat J, Kulkarni A, Pajnigara N, Dhok A. Osteochondroma of Bilateral Mandibular Condyle with Review of Literature. 2016;10(8):2–3.
Luo E, Du W, Li J, Zhu S, Li J, Hu J. Guideline for the Treatment of Condylar Osteochondroma Combined With Secondary Dentofacial Deformities. 2016;27(5):1156–61.
Wolford LM, Movahed R, Perez DE. Classification System for Conditions Causing Condylar Hyperplasia. J Oral Maxillofac Surg [Internet]. 2014;72(3):567–95. Available from: http://dx.doi.org/10.1016/j.joms.2013.09.002
Dari M. Condylar Hyperlasia : Diagnosis and Treatment , a review Condylar Hyperlasia : Diagnosis and Treatment , a review. webmed Cent Orthod. 2017;44–6.
Almeida LE. Condylar hyperplasia : An updated review of the literature. 2015;333–40.
Olate S, Netto HD, Rodriguez-chessa J, Alister JP, De J. Mandible condylar hyperplasia : a review of diagnosis and treatment protocol. 2013;6(9):727–37.
Mauro G. Temporomandibular disorders , a review of current diagnosis and treatment. 2018;86(5):364–75.
Okeson JP. Tratamiento de oclusión y afecciones temporomandibulares. 7th ed. elsevier, editor. españa; 2013. 198-199 p.
Ngan P, Fields HW. Open bite: a review of etiology and management. Pediatr Dent [Internet]. 1997;19(2):91–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9106869
Kurodaa ETEYTIS, A. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage. 2012;144–54.
Sang-Woon Haa ; Jin-Young Choib ; Seung-Hak Baek. Correction of unilateral condylar hyperplasia and posterior open bite with proportional condylectomy and fixed orthodontic treatment. Angle Orthod. 2020;90(1):144–58.
Kuroyanagi F, Tome W, Jogaki C, Kitai N. ScienceDirect Treatment of a patient with mandibular deviation and dentofacial various problems on alignment and multidirectional relationships. Orthod Waves [Internet]. 2017;1–8. Available from: http://dx.doi.org/10.1016/j.odw.2017.08.001
Machado M, Oliveira AS De. durante a mastigação Muscle activation time during chewing in temporomandibular disorder patients Tempo de ativação muscular em portadoras de disfunção temporomandibular durante a mastigação. 2014;(February 2016).
Martini M, Pecora CN, Ortensi L, Pietravalle G, Paolo C Di. Variation of Occlusal Contacts and Activity of Masticatory Muscles , In Relation to Increasing the Capacity of Movement of the Cervical Spine after Thrust Maneuver. 2017;(November 2016).
Aliko A, Ciancaglini R, Alushi A, Tafaj A, Temporomandibular DR. Temporomandibular joint involvement in rheumatoid arthritis , systemic lupus erythematosus and systemic sclerosis. Int J Oral Maxillofac Surg [Internet]. 2011;40(7):704–9. Available from: http://dx.doi.org/10.1016/j.ijom.2011.02.026
Mehra P, Wolford LM. Single-Stage Comprehensive Surgical Treatment of the Rheumatoid Arthritis Temporomandibular Joint Patient. YJOMS [Internet]. 2009;67(9):1859–72. Available from: http://dx.doi.org/10.1016/j.joms.2009.04.035
Symmons DPM, Barrett EM, Bankhead CR, Silman AJ. THE INCIDENCE OF RHEUMATOID ARTHRITIS IN THE UNITED KINGDOM : RESULTS FROM THE NORFOLK ARTHRITIS REGISTER. 1994;(d):735–9.
Cordeiro PCF, Guimaraes JP, Souza VA De. TEMPOROMANDIBULAR JOINT INVOLVEMENT IN RHEUMATOID ARTHRITIS PATIENTS : ASSOCIATION BETWEEN CLINICAL AND TOMOGRAPHIC DATA. 2016;29:219–24.
Sonnesen L, Bakke M, Solow B. Temporomandibular disorders in relation to craniofacial dimensions , head posture and bite force in children selected for orthodontic treatment. 2001;23:179–92.
Custodio W, Guimarães S, Gomes F, Faot F, Cunha R, Rodrigues M, et al. PDVWLFDWRU \ PXVFOHV DQG PDQGLEXODU ÀH [ XUH RI subjects with different facial types. :343–9.
Han UK, Vig KWL, Orth D, Eng F, Welntraub JA, Vig PS, et al. Consistency of orthodontic treatment decisions relative to diagnostic records. (1).
Martinez JE, Grassi DC, Marques LG. Analysis of the applicability of diff erent pain questionnaires in three hospital settings : outpatient clinic , ward and emergency unit. 2011;51(4):299–304.
Maydana AV, Tesch RDS, Vitor O, Denardin P. Possible etiological factors in temporomandibular disorders of articular origin with implications for diagnosis and treatment. 2010;15(3):78–86.
Köhler AA, Helkimo AN, Magnusson T, Hugoson A. Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents . A cross-sectional epidemiological investigation covering two decades. 2009;10.
Torii K. Longitudinal course of temporomandibular joint sounds in Japanese children and adolescents. 2011;1–5.
Akhter R, Murray A, Hassan N, Wickham J. Temporomandibular Disorder Symptoms and their Association with Anxiety and Depression Among University Students. 2019;10(3):96–100
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spelling Restrepo Fernández, Rodrigo AlbertoBernal Fuentes, Jorge MarioRestrepo Fernández, Rodrigo Alberto2021-02-09T23:34:06Z2021-02-09T23:34:06Z2021-01-29https://hdl.handle.net/20.500.12494/33296Bernal Fuentes, J.M., Restrepo Fernández, R.A. (2021). Desórdenes temporomandibulares como factor etiológico de maloclusiones. Revisión sistemática., 1-19. (Trabajo de posgrado, Universidad Cooperativa de Colombia) Repositorio Institucional UCC.El dolor, los ruidos articulares, las desviaciones mandibulares y el daño en la función masticatoria son las quejas más comunes por las cuales se consulta al especialista. Los desórdenes temporomandibulares (DTM) son alteraciones que deben evaluarse en los pacientes que buscan tratamiento de ortodoncia, debido a la relación anatómica que presentan la articulación temporomandibular(ATM) y la oclusión. estos desórdenes pueden explicar estos cambios dinámicos (alteraciones estructurales, funcionales y psicológicas). El objetivo de esta revisión es definir la asociación entre DTM y maloclusión, además de estructurar un protocolo de manejo ortodóncico basado en la evidencia. Materiales y métodos: Se realizó la búsqueda en las bases de datos (PubMed, Scopus y google scholar) de 2010 a 2019 con términos MeSH tales como “TMD” (temporomandibular disorders), “maloclussion”, “orthodontics”, “TMJD”,” craniomandibular disorders” y “osteoarthritis” además de operadores booleanos. Fueron seleccionados 166 artículos, 36 duplicados y 130 artículos se localizaron. 23 artículos se seleccionaron para la presente revisión. Resultados: Los DTM afectan al paciente desde etapas tempranas hasta la edad adulta, siendo un factor etológico de maloclusión en los tres planos del espacio. Conclusión: las maloclusiones agudas y crónicas son el resultado de alteración muscular, enfermedad degenerativa condilar y trauma. El ortodoncista debe conocer el protocolo para tratar estas alteraciones oclusales. Una adecuada anamnesis en la consulta inicial, un examen físico y recopilación de los signos clínicos pueden ser el gold standard para realizar un correcto diagnóstico y un tratamiento exitoso.Pain, temporomandibular joint noises, mandibular deviations and damage to masticatory function are the most common complaints for which the specialist is consulted. Temporomandibular disorders (TMD) are alterations that should be evaluated in patients seeking orthodontic treatment, due to the anatomical relationship between the temporomandibular joint (TMJ) and occlusion. these disorders can explain these dynamic changes (structural, functional and psychological alterations). The objective of this review is to define the association between TMD and malocclusion, in addition to structuring an evidence-based orthodontic management protocol. Materials and methods: the search was performed in the databases (PubMed, Scopus and google scholar) from 2010 to 2019 with MeSH terms such as "TMD" (temporomandibular disorders), "maloclussion", "orthodontics", "TMJD",” Craniomandibular disorders” and “osteoarthritis” in addition to boolean operators. 166 articles were selected, 36 duplicates and 130 articles were located. 23 articles were selected for the present review. Results: TMD affect the patient from early stages to adulthood, being an ethological factor of malocclusion in the three planes of space. Conclusion: acute and chronic malocclusions are the result of muscular alteration, condylar degenerative disease and trauma. The orthodontist must know the protocol to treat these occlusal disorders. An adequate anamnesis at the initial consultation, a physical examination and compilation of clinical signs can be the gold standard for making a correct diagnosis and successful treatmenthttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0001374637https://orcid.org/0000-0001-7329-2663jorge.bernalf@campusucc.edu.coRodrigo.Restrepo@campusucc.edu.coUniversidad Cooperativa de Colombia, Facultad de Ciencias de la Salud, Especialización en Ortodoncia, Medellín y EnvigadoEspecialización en OrtodonciaMedellínTMD (temporomandibular disorders)MaloclussionOrthodonticsTMJDCraniomandibular disordersosteoarthritisTG 2021 EOFMaloclussionOsteoarthritisTMDTemporomandibular disordersOrthodonticsTMJDcraniomandibular disordersDesórdenes temporomandibulares como factor etiológico de maloclusiones: revisión sistemática.Artículos Científicoshttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionNINGUNAinfo:eu-repo/semantics/closedAccesshttp://purl.org/coar/access_right/c_14cbSchiffman E, Look J, Anderson G, Goldberg LJ, Haythornthwaite JA, Hollender L, et al. diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical research applications: recomendations of the international RDC/TMD consortium network and orofacial pain special interest group. 2014;28(1):6–27.Racich MJ. Occlusion , temporomandibular disorders , and orofacial pain : An evidence-based overview and update with recommendations. J Prosthet Dent [Internet]. 2015;(October):1–8. Available from: https://doi.org/10.1016/j.prosdent.2018.01.033Manfredini D. O ral Rehabilitation Temporomandibular disorders and dental occlusion . A systematic review of association studies : end of an era ? 2017;(5):908–23.National Institute of Dental and Craniofacial Research. [7/28/2013]. Facial Pain. http:// www.nidcr.nih.gov/DataStatistics/FindDataByTopic/FacialPain/.Sena MF De, Santos FRR, Silva FWGP, Serrano KVD. Prevalence of temporomandibular dysfunction in children and adolescents. 2013;31(4):538–45.Mcnamara JA, Arbor A. Orthodontic treatment and temporomandibular disorders. 1997;107–17.Nassif NJ. The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males. 2003;(i):944–50.Hiltunen K, Schmidt-kaunisaho K, Nevalainen J, Närhi T, Hiltunen K, Schmidt-kaunisaho K, et al. Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki , Finland Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki , Finland. 2009;6357(March 2016).Okeson JP. O ral Rehabilitation Does altering the occlusal vertical dimension produce temporomandibular disorders ? A literature review. 2015;Okeson JP. disorder in orthodontics : Past , present , and future. Am J Orthod Dentofac Orthop [Internet]. 2015;147(5):S216–23. Available from: http://dx.doi.org/10.1016/j.ajodo.2015.02.007Mtaya M, Brudvik P AA. Prevalence of malocclusion and its relationship with socio‑demographic factors, dental caries, and oral hygiene in 12‑ to 14‑year‑old Tanzanian school children.le. Eur J Orthod. 2009;31:467–76.Karaiskos N, Wiltshire WA, Odlum O, Brothwell D HT. Preventive and interceptive orthodontic treatment needs of an inner‑city group of 6‑ and 9‑year‑old Canadian children. J Can Dent Assoc. 2005;71:649.Marques LS, Pordeus IA, Ramos‑Jorge ML, Filogônio CA F, CB, Pereira LJ et al. Factors associated with the desire for orthodontic treatment among Brazilian adolescents and their parents. BMC Oral Health. 2009;9:34.Silva RG, Kang DS. Prevalence of malocclusion among Latino adolescents. 2004;313–5.Caldas W, Cláudia A, Ferreira DC, Janson G, César P, Conti R. Occlusal changes secondary to temporomandibular joint conditions : a critical review and implications for clinical practice. :411–9.Melvin L Moss RMR. the role of the functional matrix in mandibular growth. Columbia; 1968. p. 95–102.Chouinard A, Peacock ZS. A c q u i red Ab n o r m a l i t i e s o f t h e Te m p o rom a n d i b u l a r Joint. Oral Maxillofac Surg Clin NA [Internet]. 2018;30(1):83–96. Available from: https://doi.org/10.1016/j.coms.2017.08.005Prevalence of Temporomandibular Dysfunction and its Association with Malocclusion in Children: An Epidemiologic Study. 2017;41(2):161–6.Bindayel NA. Occurrence of Malocclusion in Patients with Orofacial Pain and Temporomandibular Disorders. 2018;19(May):477–82.Aboalnaga AA, Amer NM, Elnahas MO, Fayed MMS, Lumpur K, Soliman SA, et al. Malocclusion and Temporomandibular Disorders: Verification of the Controversy. 2019;33(4).Petty RE, Southwood TR, Manners P, Baum J, Glass DN, He X, et al. rs on m e Co r ig ht rig s International League of Associations for Rheumatology Classification of Juvenile Idiopathic Arthritis : Second Revision , Edmonton , 2001 se. 2004;31(2).Gäre BA. Juvenile arthritis - Who gets it , where and when ? A review of current data on incidence and prevalence. 1999;Stoll ML, Sharpe T, Beukelman T, Good J, Young D, Cron RQ, et al. Idiopathic Arthritis Risk Factors for Temporomandibular Joint Arthritis in Children with Juvenile Idiopathic Arthritis. 2012;39(9).Palmer AJR, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ. Seminar Osteoarthritis. 2015;386.Chen Y, Dent M, Shih TT, Wang J. ORAL AND MAXILLOFACIAL RADIOLOGY Editor : Allan G . Farman Magnetic resonance images of the temporomandibular joints of patients with acquired open bite. 2005;99(6):734–42.Chatzigianni A, Kyprianou C, Papadopoulos MA, Sidiropoulou S. Dentoalveolar characteristics in children with juvenile idiopathic arthritis. 2018;Sarver DM, Janyavula S, Cron RQ. Condylar Degeneration and Diseases — Local and Systemic Etiologies. YSODO [Internet]. 2013;19(2):89–96. Available from: http://dx.doi.org/10.1053/j.sodo.2012.11.008Wang M, He J, Chen C, Widmalm SE, He J, Chen C, et al. A Preliminary Anatomical Study On the Association of Condylar and Occlusal Asymmetry. 2016;9634(July).Kasimoglu Y, Tuna EB, Rahimi B, Marsan G, Gencay K. Condylar asymmetry in different occlusion types. 2014;1–5.Duy T, Duong T, Jinnavanich S, Chen M, Ko EW, Chen Y, et al. “Are signs of degenerative joint associated with chin deviation?” [Internet]. Journal of Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons; 2020. Available from: https://doi.org/10.1016/j.joms.2020.03.019Veldhuis EC, Veldhuis AH, Koudstaal MJ. Treatment management of children with juvenile idiopathic arthritis with temporomandibular joint involvement : a systematic review. OOOO [Internet]. 2014;117(5):581–589.e2. Available from: http://dx.doi.org/10.1016/j.oooo.2014.01.226Krisjane Z, Urtane I, Krumina G, Neimane L, The IR. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities : a cone-beam CT study. Int J Oral Maxillofac Surg [Internet]. 2012;41(6):690–5. Available from: http://dx.doi.org/10.1016/j.ijom.2012.03.006Elgazzar RF, Abdelhady AI, Saad KA, Elshaal MA, Hussain MM. Treatment modalities of TMJ ankylosis : experience in Delta. Int J Oral Maxillofac Surg [Internet]. 2010;39(4):333–42. Available from: http://dx.doi.org/10.1016/j.ijom.2010.01.005Gayle EA, Young SM, Mckenna SJ, Mcnaughton CD. Septic arthritis of the temporomandibular joint: case reports and riview of the literature. J Emerg Med [Internet]. 2013;(November 2012):1–5. Available from: http://dx.doi.org/10.1016/j.jemermed.2013.01.034Chin R, Cheong T, Kassam K, Eccles S, Hensher R. Case Report Congenital Temporomandibular Joint Ankylosis : Case Report and Literature Review. 2016;2016(May 2011):2010–4.Ali Ghasemzadeh, B.S., Gerhard S. Mundinger, M.D., Edward W. Swanson, M.D. AFU. treatment of pediatric condylar fractures: a 20-year experience. 2016;136(6):1279–88.Becking G. Management of Posttraumatic Malocclusion Caused by Condylar Fractures. 1998;1370–4.Kommers C, Bergh B Van Den, Boffano P, Verweij KP, Forouzanfar T. Dysocclusion after maxillofacial trauma : A 42 year analysis. 2013;2011–4.Harvey NC. Epidemiology of fractures in the United Kingdom 1988–2012: Variation with age, sex, geography, ethnicity and socioeconomic status. Bone [Internet]. 2016; Available from: http://dx.doi.org/10.1016/j.bone.2016.03.006Brasileiro BF, Passeri LA. Epidemiological analysis of maxillofacial fractures in Brazil : A 5-year prospective study. 2004;28–34.Rudisch A, Ulmer H. Cranio-maxillofacial trauma : a 10 year review of 9543 cases with 21 067 injuries. 2003;5182:51–61.Handelman CS, Greene CS. Progressive / Idiopathic Condylar Resorption : An Orthodontic Perspective. YSODO [Internet]. 2013;19(2):55–70. Available from: http://dx.doi.org/10.1053/j.sodo.2012.11.004FERRI. J NR. Condylar resorptions and orthodontic- surgical treatment: State of the art. 2016;223:1–25.Kajii TS, Fujita T, Sakaguchi Y, Shimada K. Osseous changes of the mandibular condyle affect backward-rotation of the mandibular ramus in Angle Class II orthodontic patients with idiopathic condylar resorption of the temporomandibular joint. CRANIO® [Internet]. 2018;9634:1–8. Available from: http://doi.org/10.1080/08869634.2017.1421446Michelotti A, Iodice G. The role of orthodontics in temporomandibular disorders. J Oral Rehabil. 2010;37(8):411–29.Kamble V, Rawat J, Kulkarni A, Pajnigara N, Dhok A. Osteochondroma of Bilateral Mandibular Condyle with Review of Literature. 2016;10(8):2–3.Luo E, Du W, Li J, Zhu S, Li J, Hu J. Guideline for the Treatment of Condylar Osteochondroma Combined With Secondary Dentofacial Deformities. 2016;27(5):1156–61.Wolford LM, Movahed R, Perez DE. Classification System for Conditions Causing Condylar Hyperplasia. J Oral Maxillofac Surg [Internet]. 2014;72(3):567–95. Available from: http://dx.doi.org/10.1016/j.joms.2013.09.002Dari M. Condylar Hyperlasia : Diagnosis and Treatment , a review Condylar Hyperlasia : Diagnosis and Treatment , a review. webmed Cent Orthod. 2017;44–6.Almeida LE. Condylar hyperplasia : An updated review of the literature. 2015;333–40.Olate S, Netto HD, Rodriguez-chessa J, Alister JP, De J. Mandible condylar hyperplasia : a review of diagnosis and treatment protocol. 2013;6(9):727–37.Mauro G. Temporomandibular disorders , a review of current diagnosis and treatment. 2018;86(5):364–75.Okeson JP. Tratamiento de oclusión y afecciones temporomandibulares. 7th ed. elsevier, editor. españa; 2013. 198-199 p.Ngan P, Fields HW. Open bite: a review of etiology and management. Pediatr Dent [Internet]. 1997;19(2):91–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9106869Kurodaa ETEYTIS, A. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage. 2012;144–54.Sang-Woon Haa ; Jin-Young Choib ; Seung-Hak Baek. Correction of unilateral condylar hyperplasia and posterior open bite with proportional condylectomy and fixed orthodontic treatment. Angle Orthod. 2020;90(1):144–58.Kuroyanagi F, Tome W, Jogaki C, Kitai N. ScienceDirect Treatment of a patient with mandibular deviation and dentofacial various problems on alignment and multidirectional relationships. Orthod Waves [Internet]. 2017;1–8. Available from: http://dx.doi.org/10.1016/j.odw.2017.08.001Machado M, Oliveira AS De. durante a mastigação Muscle activation time during chewing in temporomandibular disorder patients Tempo de ativação muscular em portadoras de disfunção temporomandibular durante a mastigação. 2014;(February 2016).Martini M, Pecora CN, Ortensi L, Pietravalle G, Paolo C Di. Variation of Occlusal Contacts and Activity of Masticatory Muscles , In Relation to Increasing the Capacity of Movement of the Cervical Spine after Thrust Maneuver. 2017;(November 2016).Aliko A, Ciancaglini R, Alushi A, Tafaj A, Temporomandibular DR. Temporomandibular joint involvement in rheumatoid arthritis , systemic lupus erythematosus and systemic sclerosis. Int J Oral Maxillofac Surg [Internet]. 2011;40(7):704–9. Available from: http://dx.doi.org/10.1016/j.ijom.2011.02.026Mehra P, Wolford LM. Single-Stage Comprehensive Surgical Treatment of the Rheumatoid Arthritis Temporomandibular Joint Patient. YJOMS [Internet]. 2009;67(9):1859–72. Available from: http://dx.doi.org/10.1016/j.joms.2009.04.035Symmons DPM, Barrett EM, Bankhead CR, Silman AJ. THE INCIDENCE OF RHEUMATOID ARTHRITIS IN THE UNITED KINGDOM : RESULTS FROM THE NORFOLK ARTHRITIS REGISTER. 1994;(d):735–9.Cordeiro PCF, Guimaraes JP, Souza VA De. TEMPOROMANDIBULAR JOINT INVOLVEMENT IN RHEUMATOID ARTHRITIS PATIENTS : ASSOCIATION BETWEEN CLINICAL AND TOMOGRAPHIC DATA. 2016;29:219–24.Sonnesen L, Bakke M, Solow B. Temporomandibular disorders in relation to craniofacial dimensions , head posture and bite force in children selected for orthodontic treatment. 2001;23:179–92.Custodio W, Guimarães S, Gomes F, Faot F, Cunha R, Rodrigues M, et al. PDVWLFDWRU \ PXVFOHV DQG PDQGLEXODU ÀH [ XUH RI subjects with different facial types. :343–9.Han UK, Vig KWL, Orth D, Eng F, Welntraub JA, Vig PS, et al. Consistency of orthodontic treatment decisions relative to diagnostic records. (1).Martinez JE, Grassi DC, Marques LG. Analysis of the applicability of diff erent pain questionnaires in three hospital settings : outpatient clinic , ward and emergency unit. 2011;51(4):299–304.Maydana AV, Tesch RDS, Vitor O, Denardin P. Possible etiological factors in temporomandibular disorders of articular origin with implications for diagnosis and treatment. 2010;15(3):78–86.Köhler AA, Helkimo AN, Magnusson T, Hugoson A. Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents . A cross-sectional epidemiological investigation covering two decades. 2009;10.Torii K. Longitudinal course of temporomandibular joint sounds in Japanese children and adolescents. 2011;1–5.Akhter R, Murray A, Hassan N, Wickham J. Temporomandibular Disorder Symptoms and their Association with Anxiety and Depression Among University Students. 2019;10(3):96–100PublicationORIGINALAVANCES PUBLICAR DEFINITIVO PDF.pdfAVANCES PUBLICAR DEFINITIVO PDF.pdfArtículoapplication/pdf1136224https://repository.ucc.edu.co/bitstreams/12b155bf-8a95-4a8d-84bc-edca2a3e0fa8/downloada5c704062ddf96394fb6fc79a836f9b1MD542 PDF Licencia de uso jorge DTM.pdf2 PDF Licencia de uso jorge DTM.pdfLicencia de usoapplication/pdf725913https://repository.ucc.edu.co/bitstreams/4544b560-114f-477e-9abe-21b6840754e3/download338f75186557c565ccb99621906e0cacMD57LICENSElicense.txtlicense.txttext/plain; charset=utf-84334https://repository.ucc.edu.co/bitstreams/408cc8c3-4abb-49ea-8301-b4e5d045cb7e/download3bce4f7ab09dfc588f126e1e36e98a45MD58THUMBNAILAVANCES PUBLICAR DEFINITIVO PDF.pdf.jpgAVANCES PUBLICAR DEFINITIVO PDF.pdf.jpgGenerated 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Universidad Cooperativa de 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