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"The increase of pain symptoms in the temporomandibular joint (TMJ) challenges the scientists to find a more effective therapy. The popular treatment of the temporomandibular disorder (TMD) are eg occlusal splints, orthodontic treatment, electromyographic biofeedback, medication, etc. Among these splint therapy is more successful than the others especially in dealing with pain in the TMJ. Orthodontics as a treatment for the TMD quite often creates new complains on TMJ during and/or after treatment. The extrusion of the posterior teeth in reducing anterior deep overbite have been proposed as possible cause of TMD. This paper reported that a relaxation splint was an effective solution to relieve the pain in the TMJ for the orthodontic patients where occlusal factors were related. One mounth after the splint therapy, the pain in the TMJ was slowly dissapeared, and the orthodontic treatment can be continued with the splint as an occlusal height guidance."

"Splint or orthopedic appliance is routinely used in the treatment of temporomandibular disorders (TMD). This appliance is used to alter occlusal relationship and to redistribute occlisal forces, to prevent wear and mobility of the teeth, to reduce bruxim and parafunction, to treat masticatory muscle pain and dysfunction, and to alter structural relationship of the TMJ. There are 2 kinds of splint, the permissive and non permissive. Stabilization splint and bite plane are permissive splints, and anterior repositioning appliance is a non permissive splints. Each kind of splint has its own indication. There is strong evidence that splint therapy is succesful in the treatment of TMD but there is no consensus of opinion on how splints work."

"Gangguan sendi temporomandibula (GSTM) adalah gangguan otot dan kelainan artikular dalam fungsi komponen otot dan / atau sistem artikular yang disertai dengan tanda dan gejala klinis yang sangat bervariasi. Adanya riwayat GSTM dapat menjadi pertimbangan dalam rencana perawatan ortodonti. Tidak semua menyadari bahwa mereka memiliki GSTM yang salah satunya disebabkan oleh maloklusi, sehingga mereka datang hanya ke klinik Ortodonti hanya untuk perbaikan maloklusi. Tujuan penelitian ini adalah (1) Mengetahui proporsi dan distribusi demografi pasien dengan GSTM termasuk maloklusi (hubungan rahang, overjet, overbite, hubungan molar dan kaninus) dan sudut parameter vertikal pada sefalometri lateral di klinik spesialis ortodonti RSKGM FKG UI. (2) Mengetahui hubungan GSTM dengan maloklusi serta hubungan GSTM dengan sudut parameter skeletal. Studi deskriptif dengan desain penelitian potong lintang pada pasien tahun kunjungan 2013-2018 yang memiliki GSTM pada anamnesis dan/atau pemeriksaan fungsional. Digunakan analisis univariat menggunakan SPSS 23 untuk menggambarkan distribusi dan analisis korelasi untuk menggambarkan hubungan. Didapatkan 98 status pasien yang mengalami GSTM. Ditemukan lebih banyak pasien perempuan daripada laki-laki dengan usia rata-rata 24,8 tahun dan kebanyakan berprofesi sebagai karyawan swasta. Gejala GSTM yang paling sering ditemukan adalah deviasi pergerakan mandibula dan clicking. Terdapat hubungan antara GSTM dengan maloklusi skeletal kelas II dan hubungan kaninus kelas III.

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Temporomandibular joint disorders (GSTM) are muscle disorders and articular abnormalities in the function of the components of the muscle and/or articular system accompanied by highly variable clinical signs and symptoms. The presence of a history of GSTM can be considered in the orthodontic treatment plan. Not all are aware that they have GSTM, one of which is caused by malocclusion, so they come only to the Orthodontic clinic only to repair the malocclusion. The aims of this study were (1) to determine the proportion and demographic distribution of patients with GSTM including malocclusion (jaw relationship, overjet, overbite, molar and canine relationship) and vertical angle parameters on lateral cephalometry at the orthodontic specialist clinic of RSKGM FKG UI. (2) Knowing the relationship between GSTM and malocclusion and the relationship between GSTM and the parameter angle skeletal. Descriptive study with a cross-sectional design on patients in the 2013-2018 visit year who had GSTM on history and/or functional examination. Univariate analysis was used using SPSS 23 to describe the distribution and correlation analysis to describe the relationship. There were 98 patients who had GSTM status. There were more female than male patients with a mean age of 24.8 years and Most of them work as private employees. The most common symptoms of GSTM are deviation of mandibular movement and clicking. There is a relationship between GSTM with skeletal malocclusion class II and class III canine relationship."

"Pre-prosthetic treatment is very important step to get a successful prosthodontic treatment. This study reported a case of a patient with missing teeth on left and right lower first and second molar with TMJ symptoms. Other symptoms felt by the patients were car pain and shoulder pain. After detailed examination, pre-prosthetic treatment needed by the patient was the TMH treatment. The usage of occlusal splint as one of the methods to treat the TMD where i.e. eliminate the occlusal disorder to reduce the neuromuscular activity and to regain a stable centric relation. After the splint treatment, an open bite on the posterior teeth appeared. To solve this problem, a removable frame prosthesis enhanced with overlay rest was fabricated. With this prosthesis, the TMJ symptoms stopped recurring. It was concluded that to achieve a successful prosthesis a detailed and comprehensive treatment was needed including the pre-prosthetic treatment along with the patient's motivation and cooperation."

"Temporomandibular disorder (TMD) usually has non-specific signs and symptoms. The patient generally can only feel the pain, and thus complains about the stomatognatic problems without knowing the cause and the source. When the patient's chied compaint is pain, it is important to identify the source of the problem in order to provide appropriate treatment. Applied treatments for TMD can vary enormously. A female patient, age 35, came to the prosthodontic clinic with the chief complaints of pain in the right joint and limitation in mouth opening for past 7 years. In the last 2 weeks, the complaints worsened. With light pressure she could still open her mouth wider but showing deviations. She also complained about headache, tension in the forehead region, and muscle pain in the upper back body. The patient also reported that she has been chewing only on the right side for more than 20 years. Lateral transcranial x-ray showed that there were no visible structural or positional disorders. Thus, jaw exercise was decided as the initial therapy for the patient. WIthin one week, all complaints dissapeared. It was concluded that jaw exercise was a very useful form of treatment for TMD provided that the correct diagnosis is established."

"Gangguan sendi temporomandibula (GSTM) adalah istilah untuk Temporomandibular Disorders (TMD), yaitu kumpulan gangguan yang melibatkan sendi temporomandibula, otot, dan struktur di sekitarnya. Dokter gigi dan dokter gigi spesialis merasakan hambatan dalam menangani pasien GSTM. Saat ini belum diketahui bagaimana pengetahuan, sikap, dan perilaku dokter gigi dan dokter gigi spesialis di Indonesia dalam menangani pasien GSTM. Etiologi GSTM multifaktorial dan salah satu penanganannya adalah perawatan ortodonti. Namun di sisi lain perawatan ortodonti diduga menjadi salah satu penyebab GSTM akibar perubahan posisi gigi, mandibula, dan letak kondil. Hal ini dapat dilihat melalui kondisi klinis dan radiograf sefalometri. Gangguan sendi temporomandibula dapat menjadi suatu inflamasi sehingga biomarker inflamasi banyak diteliti. Tujuan: Penelitian ini terdiri dari dua tahap. Penelitian tahap I (Kualitatif) bertujuan mendapatkan alat ukur/kuesioner kemampuan operator (dokter gigi dan dokter gigi spesialis) tentang pengetahuan, sikap, dan perilaku terhadap pasien dengan GSTM, yang valid dan reliabel. Penelitian tahap II (Kuantitatif) bertujuan memperoleh indeks prediksi risiko GSTM berdasarkan kemampuan operator (skor kuesioner), kondisi klinis terkait faktor klinis (usia, jenis maloklusi, overjet, overbite, dan indeks etiologi GSTM), kondisi klinis terkait faktor mekanis (jenis bracket, kasus ekstraksi, dan alat tambahan), radiograf sefalometri (sudut ANB, SN-MP, Go Angle, I-I dan Y-Axis), dan biomarker inflasi (IL-1β dan CRP) Metode: Penelitian disetujui Komite Etik Kedokteran Gigi, FKG-UI, No: 11/Ethical Approval/FKGUI/III/2022 dan dilakukan di Klinik Ortodonti dan Laboratorium Biologi Oral, RSKGM, FKG UI, Jakarta, Indonesia, pada November 2021-Januari 2024. Penelitian tahap I, pembuatan kuesioner melalui telaah pustaka, observasi, dan diskusi kelompok terarah (FGD) oleh 10 orang dokter gigi dan dokter gigi spesialis. Hasil FGD dianalisis menggunakan metode Framework dilanjutkan uji face dan content validity menggunakan analisis Aiken’s V, I-CVI, dan I-CVR. Kuesioner juga dilakukan uji validitas (korelasi Spearman) dan uji reliabilitas (Cronbach’s Alpha dan CITC). Setiap tahap pengujian dilakukan diskusi dan revisi terkait substansi oleh pakar. Kuesioner akhir (Kuesioner PSP-GSTM) diujikan pada 370 responden dan PPDGS Ortodonti (operator) yang merawat subjek pada penelitian tahap II. Penelitian tahap II, dilakukan pada 105 subjek pasien pascaperawatan ortodonti yang dipanggil kembali untuk menandatangani informed consent, mengisi indeks etiologi GSTM, dilakukan pemeriksaan DC/ TMD, dan swab mukosa bukal. Data lainnya dilengkapi dari skor kuesioner, rekam medis, dan radiograf sefalometri. Dilakukan analisis bivariat untuk melihat hubungan setiap variabel dengan GSTM dan multivariat regresi logistik berganda. Hasil: Alat ukur/kuesioner PSPGSTM berisi 73 pernyataan, terdiri dari 50 pernyataan domain pengetahuan, 14 pernyataan domain sikap, dan sembilan pernyataan domain perilaku. Domain pengetahuan terdiri dari 12 pernyataan subdomain tanda dan gejala, 14 pernyataan subdomain etiologi, 11 pernyataan subdomain diagnosis, dan 13 pernyataan subdomain perawatan. Kuesioner PSP-GSTM memiliki validitas dan reliabilitas yang baik. Dihasilkan indeks prediksi risiko GSTM dengan empat faktor prediktor yaitu indeks etiologi GSTM, alat tambahan, SN-MP, dan Go Angle. Kesimpulan: Kemampuan dokter gigi dan dokter gigi spesialis terkait pengetahuan, sikap, dan perilaku terhadap pasien dengan GSTM dapat diukur menggunakan kuesioner PSP-GSTM. Indeks prediksi risiko GSTM yang terdiri dari indeks etiologi GSTM, alat tambahan, SN-MP, dan Go Angle dapat digunakan untuk memprediksi faktor risiko terjadinya GSTM.

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The temporomandibular disorders (TMD) are a group of disorders involving the temporomandibular joint, muscles, and surrounding structures. Dentists or dental specialists often encounter challenges when dealing with TMD patients. It is unknown how the knowledge, attitudes, and behavior of dentists and dental specialists in Indonesia are in dealing with TMD patients. The etiology of TMD is multifactorial and one of the treatments is orthodontic treatment. On the other hand, orthodontic treatment is thought to be one of the causes of TMD due to changes in the position of the teeth, mandibles, and the location of the condyle. This can be seen through clinical conditions and cephalometric radiographs. Temporomandibular joint disorders can become inflammatory so inflammatory biomarkers are widely studied. Objective: The research consists of two stages. Phase I (Qualitative) aims to obtain a measurement/questionnaire of operator’s ability (dentists and dental specialists) about knowledge, attitudes, and behavior towards patients with TMD (PSP-TMD Questionnaire), which is valid and reliable. Phase II (Quantitative) aims to obtain TMD risk prediction index based on operator capability (PSP-TMD questionnaire score), clinical conditions related to clinical factors (age, malocclusion type, overjet, overbite, and TMD etiology index), clinical conditions related to mechanical factors (bracket type, extraction case, and auxiliary tools), cephalometric radiographs (ANB, SN-MP, Go Angle, I-I and Y-Axis angles), and biomarkers of inflammation (IL-1β and CRP) Method: The research was approved by the Dental Ethics Committee, FKG-UI, No: 11/Ethical Approval/FKGUI/III/2022 and conducted at the Orthodontics Clinic and Oral Biology Laboratory, RSKGM, FKG UI, Jakarta, Indonesia, in November 2021-January 2024. Phase I involves creating questionnaires through literature review, observation, and focus group discussion (FGD) by 10 dentists and dental specialists. The FGD results were analyzed using the Framework method followed by face and content validity tests using Aiken's V, I-CVI, and I-CVR analysis. Questionnaires were tested using validity tests (Spearman correlation) and reliability tests (Cronbach's Alpha and CITC). Every stage and testing related to the substance is discussed and revised by experts. The final questionnaire (PSPGSTM Questionnaire) was tested on 370 respondents and Orthodontics residents (operators) who treated subjects in phase II research. The phase II study was conducted on 105 subjects of orthodontic post-treatment patients who were called back to sign an informed consent and fill in the TMD etiology index, DC/TMD examination, and buccal mucosal swabs. Other data were supplemented from questionnaire scores, medical records, and cephalometric radiographs. Bivariate analysis was performed to see the relationship of each variable with TMD and multivariate multiple logistic regression. Results: The PSP-TMD measurement tool/questionnaire contained 73 statements, consisting of 50 knowledge domain statements, 14 attitude domain statements, and nine behavior domain statements. The knowledge domain consists of 12 sign and symptom subdomain statements, 14 etiology subdomain statements, 11 diagnosis subdomain statements, and 13 treatment subdomain statements. The PSP-TMD questionnaire has good validity and reliability. The TMD risk prediction index was generated with four predictor factors, namely the TMD etiology index, auxiliary tools, SN-MP, and Go Angle. Conclusion: The capability of dentists and dental specialists regarding knowledge, attitudes, and behavior towards patients with TMD can be measured using the PSP-TMD questionnaire. The TMD risk prediction index consisting of the TMD etiology index, auxiliary tools, SN-MP, and Go Angle can be used to predict risk factors for TMD"

"Occlusal splint is commonly used for treatment of the temporomandibular joint disorder (TMD). It can be made of hard and soft material. Hard occlusal splint (HOS) which was known earlier had been recognized more effective then soft occlusal splint (SOS) which recently gained some popularity. This clinical study based on case series was to detemined which type of occlusal splint was more effective for TMD. This study involved 20 subjects and they were divided into HOS and SOS group with 10 subjects in each group. HOS was processed with heat curing acrylic and SOS with vacuum former. Before and after 4 weeks of treatment, 5 TMD symptoms (impaired range of movement, impaired TMJ function, muscle pain, TMJ pain and pain on movement of mandible) were measured using Helkimo diagnostic index. The results were analyzed with Kolmogorov-Smimov Z's test. The findings showed statistically significant improvement in impaired range of movement and muscle pain in favor of HOS group(p<0.05). Although they were not statistically significant, HOS group showed better improvement than SOS group in TMJ pain and pain on movement of the mandible. In TMJ's function, no changes werefound in both groups. In general, HOS was more effective than SOS for treating TMD in relatively short period of time. Despite of the phenomena, the popularity of SOS was not followed with its effectiveness."

"In human, the temporomandibular joint (TMJ) has been proven as a stress-bearing joint, especially during mastication. Overload of shear stress on the joint can cause degenerative diseases of the joint, such as osteoarthrosis or TMJ osteoarthritis (TMJ-OA). Free radicals have been assumed to be associated in the pathogenesis of various degenerative diseases of the joint and oxidative stress is important in the mechanism of TMJ dysfunction. Free radicals are superoxide (O2-), hydrogen peroxide (H2O2) and hydroxyl (OH-), and are called reactive oxygen species (ROS). Hydroxyl is most destructive in patients with TMJ dysfunction. ROS exert their effects on TMJ by reducing the viscosity of synovial fluid, decreasing joint surface lubrication, breakdown of collagen and proteoglycan, and increasing the activity of cartilage degradation enzymes such as metalloproteinases."

"Latar belakang: Prevalensi burnout syndrome ditemukan tinggi pada mahasiswa. Hal ini dapat dipengaruhi oleh prestasi akademik, status sosioekonomi, faktor budaya, dan rumpun ilmu. Tingkat burnout syndrome yang tinggi pada mahasiswa terutama mahasiswa tingkat akhir, dapat meningkatkan risiko terjadinya gangguan sendi rahang. Tujuan: Mengetahui hubungan burnout syndrome terhadap gangguan sendi rahang pada mahasiswa sarjana Universitas Indonesia Angkatan 2019, serta mengetahui hubungan antara prestasi akademik, status sosioekonomi, faktor budaya, dan rumpun ilmu terhadap burnout syndrome dan gangguan sendi rahang pada mahasiswa sarjana Universitas Indonesia Angkatan 2019. Metode: Studi dengan desain cross-sectional berupa kuesioner online, disebarkan pada bulan November 2022 kepada mahasiswa Universitas Indonesia dengan jumlah 134 responden. Burnout syndrome diukur menggunakan kuesioner MBI-SS dan gangguan sendi rahang menggunakan kuesioner TMD-DI. Hasil Penelitian: Uji Fisher exact menunjukkan adanya perbedaan bermakna (p<0,05) burnout syndrome terhadap gangguan sendi rahang, uji kendall menunjukkan korelasi positif lemah antara burnout syndrome terhadap gangguan sendi rahang. Uji chi square menunjukkan adanya perbedaan bermakna antara prestasi akademik dengan burnout syndrome (p<0,05), uji kendall menunjukkan korelasi negatif lemah antara prestasi akademik dengan burnout syndrome. Namun tidak terdapat perbedaan bermakna antara prestasi akademik dengan gangguan sendi rahang, serta status sosioekonomi, faktor budaya, dan rumpun ilmu dengan burnout syndrome dan gangguan sendi rahang . Kesimpulan: Terdapat hubungan antara burnout syndrome terhadap gangguan sendi rahang. Terdapat hubungan antara prestasi akademik terhadap burnout syndrome. Namun tidak terdapat hubungan antara prestasi akademik terhadap gangguan sendi rahang, serta status sosioekonomi keluarga, faktor budaya, dan rumpun ilmu terhadap burnout syndrome dan gangguan sendi rahang

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Background: The prevalence of burnout syndrome is found to be high in university students. This can be influenced by academic achievement, socioeconomic status, cultural factors, and knowledge groups. The high rate of burnout syndrome in university students, especially final year students, can increase the risk of developing temporomandibular disorder. Objective: This study aims to find out the relationship between burnout syndrome and temporomandibular disorder in fourth year undergraduate students at the University of Indonesia, and to determine the relationship between academic achievement, socioeconomic status, cultural factors, and knowledge groups with burnout syndrome and temporomandibular disorders in fourth year undergraduate students at the University of Indonesia. Methods: A cross-sectional study using an online questionnaire of 134 students from the University of Indonesia was distributed in November 2022. Burnout syndrome was measured using the MBI-SS questionnaire and temporomandibular disorders using the TMD-DI questionnaire. Results: The Fisher exact test showed a significant difference between burnout syndrome and temporomandibular disorder (p<0.05). The Kendall test showed a weak positive correlation between burnout syndrome and temporomandibular disorders. The chi-square test showed that there was a statistically significant difference between burnout syndrome based on academic achievement (p<0.05). The Kendall test showed a weak negative correlation between academic achievement and burnout syndrome. However, there is no statistically significant difference between temporomandibular disorders based on academic achievement, as well as burnout syndrome and temporomandibular disorder based on socioeconomic status, cultural factors, and knowledge groups. Conclusion: There is a relationship between burnout syndrome and temporomandibular disorders, as well as burnout syndrome and academic achievement. However, there is no relationship between temporomandibular disorder based on academic achievement, as well as burnout syndrome and temporomandibular disorders based on family socioeconomic status, cultural factors, and knowledge groups."