Temporomandibular Bozukluklar ve Bruksizmde Eşlik Eden Psikiyatrik Bozukluklar ve Tedavi Seçenekleri

Year 2020, Volume: 12 Issue: 2, 205 - 231, 30.06.2020

Bahadır Geniş Çiçek Hocaoğlu

https://doi.org/10.18863/pgy.570861

Abstract

Temporomandibular bozukluk (TMB) çiğneme kaslarını,
temporomandibular eklemi (TME) ve bu eklemi çevreleyen yapıların etkilendiği
klinik bir durumdur. Bruksizm, diş sıkma ve taşlamayla stomatognatik yapıların aşırı
yüklenmesinin bir sonucu olarak ortaya çıkan, TMB etiyolojisinde yer alan
parafoksiyonel bir alışkanlıktır. TMB popülasyonun yaklaşık %10'unda, bruksizm %8-20'sinde
görülür. TMB ve bruxism etiyolojisinde birçok faktör etkilidir ve bu faktörler
arasında etkileşimler vardır. Biyomekanik, nöromüsküler, biyopsikososyal ve
nörobiyolojik faktörler hastalığa katkıda bulunur. Psikiyatrik bozuklukların
prevalansı TMB ve bruxism olan bireylerde yüksektir. Birçok psikiyatrik
bozukluk, özellikle de depresyon ve anksiyete bozuklukları, TMB ve bruksizme eşlik
eder. Bu hastalıkların tedavisinde kullanılan antidepresanlar bruksizme neden
olur. Bu, TMB ve bruksizmin tedavisinde önemli zorluklardan biridir. TMB ve bruksizmin
tedavisinde ilk adım temel önleme yöntemlerine değinmektir. Amitriptilin
kullanımı TMB farmakoterapisinde belirgin olmakla birlikte, bruksizmde buspiron
ve klonazepam kullanılan iki önemli ilaçtır. Bu ilaçların küçük örneklerde incelenmesi ve mevcut
bilgilerin çoğunlukla vaka raporlarına dayanması gerçeği, ileri ki çalışmaların
gerekliliğini açıkça göstermektedir. Her iki hastalıkta da bilişsel davranışçı
terapinin yaygın kullanımı bir çözüm olacak ve ilacın yan etkilerini ortadan
kaldıracaktır. Tedavi seçeneği ne olursa olsun hem diş hekimleri hem de
psikiyatristler multidisipliner bir çalışma ortamında olmalı ve bu hastalıkları
biyopsikososyal model çerçevesinde değerlendirmelidir.

Keywords

Temporomandibular Bozukluklar, bruksizm, depresyon, mental bozukluklar, tedavi

Comorbid Psychiatric Disorders and Treatment Options in Temporomandibular Disorders and Bruxism

Abstract

Temporomandibular disorder (TMD) is a
clinical condition affecting the masticatory muscles, the temporomandibular
joint (TMJ) and the structures surrounding this joint.Bruxism is a
parafunctional habit that occurs as a result of overloading of stomatognathic
structures with tooth squeezing and grinding, which is included in the etiology
of TMB.TMB is seen in approximately 10% of the population and bruxism is seen
in 8-20%. Many factors are effective in the etiology of TMD and bruxism, and
there are interactions between these factors. Biomechanical, neuromuscular,
biopsychosocial and neurobiological factors contribute to the disease. The
prevalence of psychiatric disorders is high in individuals with TMB and
bruxism. Many psychiatric disorders, especially depression and anxiety disorders,
accompany TMB and Bruxism. The antidepressants used in the treatment of these
disorders cause bruxism. This is one of the important challenges in the
treatment of TMB and bruxism.The first step in the treatment of TMB and bruxism
is to address the basic prevention methods. While amitriptyline use is prominent in
TMB pharmacotherapy, in bruxism, buspirone and clonazepam are two important
drugs used.The study of these drugs in small samples and the fact that the
available information is mostly based on case reports clearly shows the
necessity of further studies. The widespread use of cognitive behavioral
therapy in both disorders will be a solution and eliminate the side effects of
medication.Regardless of the treatment option, both dentists and psychiatrists
should be in a multidisciplinary working environment and should evaluate these
diseases within the framework of the biopsychosocial model.

Keywords

Temporomandibular Disorders, Bruxism, depression, mental disorders, treatment

References

• Aguilera SB, Brown L, Perico VA (2017) Aesthetic Treatment of Bruxism. J Clin Aesthet Dermatol, 10:49-55.
• Amerikan Psikiyatri Birliği (2000) Psikiyatride Hastalıkların Tanımlanması ve Sınıflandırılması El Kitabı, Yeniden Gözden Geçirilmiş Dördüncü Baskı (DSM-IV TR) (Çeviri Ed. E Köroğlu). Ankara, Hekimler Yayın Birliği.
• Amerikan Psikiyatri Birliği (2013) Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı, Beşinci Baskı (DSM-V) (Çeviri Ed. E Köroğlu) Ankara, Hekimler Yayın Birliği.
• Bayar GR, Tutuncu R, Acikel C (2012) Psychopathological profile of patients with different forms of bruxism. Clin Oral Investig, 16:305-311.
• Benoliel R, Zini A, Zakuto A, Slutzky H, Haviv Y, Sharav Y et al. (2017) Subjective Sleep Quality in Temporomandibular Disorder Patients and Association with Disease Characteristics and Oral Health-Related Quality of Life. J ORAL FACIAL PAIN H, 31:313-322.
• Brand HS, Dun SN, Nieuw Amerongen AV (2008) Ecstasy (MDMA) and oral health. Br Dent J, 204:77-81.
• Calderon Pdos S, Tabaquim Mde L, Oliveira LC, Camargo AP, Ramos Netto Tde C, Conti PC (2011) Effectiveness of cognitive-behavioral therapy and amitriptyline in patients with chronic temporomandibular disorders: a pilot study. Braz Dent J, 22:415-421.
• Camparis CM, Siqueira JT (2006) Sleep bruxism: clinical aspects and characteristics in patients with and without chronic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:188-193.
• Canales GDLT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR and Manfredini D (2019) Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sci, 27:e20180210-e20180210.
• Chang JP, Wu CC, Su KP (2011) A case of venlafaxine-induced bruxism alleviated by duloxetine substitution. Prog Neuropsychopharmacol Biol Psychiatry, 35:307.
• Chikhani L, Dichamp J (2003) [Bruxism, temporo-mandibular dysfunction and botulinum toxin]. Ann Readapt Med Phys, 46:333-337.
• Clark J, Nijs J, Yeowell G, Goodwin PC (2017) What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review. Pain Physician, 20:487-500.
• Cruz-Fierro N, Vanegas-Farfano MTJ, González-Ramírez MT, Landero-Hernández R (2016) Anxiety symptoms, the mismanagement of negative emotions and the association with self-reported bruxism. Ansiedad y Estrés, 22:62-67.
• Dalkız M, Baydemir B (2003) Temporomandibular eklem hastalıklarının teşhis ve tedavi yöntemleri. Ankara, Gata Basımevi.
• Darcan A, Onur E, Köse T, Alkın T, Erdem A (2008) Temporomandibuler Bozukluğu Olan Hastalarda Mizaç ve Karakter Boyutları. Turk Psikiyatri Derg, 19:274-282.
• Dimitroulis G (2011) Temporomandibular joint surgery: what does it mean to the dental practitioner?. Aust Dent J, 56:257-264.
• Doepel M, Nilner M, Vahlberg T, Le Bell Y (2018) Similar treatment outcome in myofascial TMD patients with localized and widespread pain. Acta Odontol Scand, 76:175-182.
• Dworkin SF, Huggins KH, Wilson L, Mancl L, Turner J, Massoth D et al. (2002) A randomized clinical trial using research diagnostic criteria for temporomandibular disorders-axis II to target clinic cases for a tailored self-care TMD treatment program. J Orofac Pain, 16:48-63.
• Emshoff R, Bertram F, Schnabl D, Emshoff I (2017) Association Between Chronic Tension-Type Headache Coexistent with Chronic Temporomandibular Disorder Pain and Limitations in Physical and Emotional Functioning: A Case-Control Study. J ORAL FACIAL PAIN H, 31:55-60.
• Özen NE (2007) Psychiatric Aspects In Temporomandibular Disorders and Bruxism. J Clin Psy, 10:148-156.
• Eren S, Arıkan H, Tamam C, Kasapoğlu Ç (2015) Bruksizm ve Güncel Tedavi Yaklaşımları. Arşiv Kaynak Tarama Dergisi, 24:241-258.
• Ethunandan M, Wilson AW (2006) Temporomandibular joint arthrocentesis -more questions than answers?. J Oral Maxillofac Surg, 64:952-955.
• Fernandes AC, Duarte Moura DM, Da Silva LGD, De Almeida EO, Barbosa GAS (2017) Acupuncture in Temporomandibular Disorder Myofascial Pain Treatment: A Systematic Review. J ORAL FACIAL PAIN H, 31:225-232.
• Ferrando M, Andreu Y, Galdon MJ, Dura E, Poveda R, Bagan JV (2004) Psychological variables and temporomandibular disorders: distress, coping, and personality. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 98:153-160.
• Finnerup NB, Sindrup SH, Jensen TS (2010) The evidence for pharmacological treatment of neuropathic pain. Pain, 150:573-581.
• Fishbain DA, Cutler RB, Lewis J, Cole B, Rosomoff RS, Rosomoff HL (2004) Do the second-generation "atypical neuroleptics" have analgesic properties? A structured evidence-based review. Pain Med, 5:359-365.
• Garrett AR, Hawley JS (2018) SSRI-associated bruxism: A systematic review of published case reports. Neurol Clin Pract, 8:135-141.
• Gerber PE, Lynd LD (1998) Selective serotonin-reuptake inhibitor-induced movement disorders. Ann Pharmacother, 32:692-698.
• Gezer İ, Levendoğlu F (2016) Temporomandibular eklem rahatsızlıklarının sınıflandırılması, tanı ve tedavisi. Genel Tıp Dergisi, 26:34-40.
• Gultekin H, Ahmedov V (2006) Role of the opioidergic system and nitric oxide in the analgesic effect of venlafaxine. Yakugaku Zasshi, 126:117-121.
• Gurbuz O, Alatas G, Kurt E (2009) Prevalence of temporomandibular disorder signs in patients with schizophrenia. J Oral Rehabil, 36:864-871.
• Hersh EV, Balasubramaniam R, Pinto A (2008) Pharmacologic management of temporomandibular disorders. Oral Maxillofac Surg Clin North Am, 20:197-210.
• Hoffmann RG, Kotchen JM, Kotchen TA, Cowley T, Dasgupta M, Cowley AW (2011) Temporomandibular disorders and associated clinical comorbidities. Clin J Pain, 27:268-274.
• Huynh NT, Rompre PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ (2006) Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. Int J Prosthodont, 19:435-441.
• Jariyasakulroj S, Mitrirattanakul S (2018) Excessive daytime sleepiness in temporomandibular disorder patients. Cranio, 1-5.
• Kara MI, Yanik S, Keskinruzgar A, Taysi S, Copoglu S, Orkmez M et al. (2012) Oxidative imbalance and anxiety in patients with sleep bruxism. Oral Surg Oral Med Oral Pathol Oral Radiol, 114:604-609.
• Karan A, Aksoy C (2004) Temporomandibular eklem rehabilitasyonu. İstanbul, Nobel Kitabevi.
• Kazan D (2018) Temporomandibular Eklem Bozukluğu Olan Hastalarda Tükrük ve Serum Oksidatif Stres ve İnflamasyon Markerlarının Değerlendirilmesi (Uzmanlık Tezi). Samsun, Ondokuz Mayıs Üniversitesi.
• Kimos P, Biggs C, Mah J, Heo G, Rashiq S, Thie NM et al. (2007) Analgesic action of gabapentin on chronic pain in the masticatory muscles: a randomized controlled trial. Pain, 127:151-160.
• Kimura M, Saito S, Obata H (2012) Dexmedetomidine decreases hyperalgesia in neuropathic pain by increasing acetylcholine in the spinal cord. Neurosci Lett, 529:70-74.
• Kindler S, Samietz S, Houshmand M, Grabe HJ, Bernhardt O, Biffar R et al. (2012) Depressive and anxiety symptoms as risk factors for temporomandibular joint pain: a prospective cohort study in the general population. J Pain, 13:1188-1197.
• Kuloglu M, Ekinci O, Caykoylu A (2010) Venlafaxine-associated nocturnal bruxism in a depressive patient successfully treated with buspirone. J Psychopharmacol, 24:627-628.
• Kuloğlu M, Ekinci O (2009) Psikiyatride Bruksizm. New/Yeni Symposium Journal, 47:218-224.
• Kurita H, Ikeda K, Kurashina K (2000) Evaluation of the effect of a stabilization splint on occlusal force in patients with masticatory muscle disorders. J Oral Rehabil, 27:79-82.
• Lee HJ, Kim ST (2018) A questionnaire-based study of sleep-wake patterns and sleep quality in a TMJ and orofacial pain clinic. Cranio, 1-8.
• Leeuw Rd, Klasser GD (2013) Orofacial pain : guidelines for assessment, diagnosis, and management. Chicago, Quintessence Publishing.
• Lei J, Fu J, Yap AU, Fu KY (2016) Temporomandibular disorders symptoms in Asian adolescents and their association with sleep quality and psychological distress. Cranio, 34:242-249.
• LeResche L, Mancl L, Sherman JJ, Gandara B, Dworkin SF (2003) Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain, 106:253-261.
• List T, Axelsson S (2010) Management of TMD: evidence from systematic reviews and meta-analyses. J Oral Rehabil, 37:430-451.
• Lobbezoo F, Soucy JP, Hartman NG, Montplaisir JY, Lavigne GJ (1997) Effects of the D2 receptor agonist bromocriptine on sleep bruxism: report of two single-patient clinical trials. J Dent Res, 76:1610-1614.
• Long H, Liao Z, Wang Y, Liao L, Lai W (2012) Efficacy of botulinum toxins on bruxism: an evidence-based review. Int Dent J, 62:1-5.
• Magnusson JE, Fisher K (2000) The involvement of dopamine in nociception: the role of D(1) and D(2) receptors in the dorsolateral striatum. Brain Res, 855:260-266.
• Manfredini D, Bandettini di Poggio A, Cantini E, Dell'Osso L, Bosco M (2004) Mood and anxiety psychopathology and temporomandibular disorder: a spectrum approach. J Oral Rehabil, 31:933-940.
• Manfredini D, Ciapparelli A, Dell'Osso L, Bosco M (2005) Mood disorders in subjects with bruxing behavior. J Dent, 33:485-490.
• Manfredini D, Landi N, Romagnoli M, Bosco M (2004) Psychic and occlusal factors in bruxers. Aust Dent J, 49:84-89.
• Manfredini D, Marini M, Pavan C, Pavan L, Guarda-Nardini L (2009) Psychosocial profiles of painful TMD patients. J Oral Rehabil, 36:193-198.
• Marbach JJ, Lund P (1981) Depression, anhedonia and anxiety in temporomandibular joint and other facial pain syndromes. Pain, 11:73-84.
• Matsuoka H, Chiba I, Sakano Y, Toyofuku A, Abiko Y (2017) Cognitive behavioral therapy for psychosomatic problems in dental settings. Biopsychosoc Med, 11:18-18.McNeill C (1997) Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent, 77:510-522.
• Michelotti A, Martina R, Russo M, Romeo R (1998) Personality characteristics of temporomandibular disorder patients using M.M.P.I.. Cranio, 16:119-125.
• Mısırlıoglu M, Adışen M, Yılmaz S (2012) New Apsects On Diagnosis, Management And Imaging Of Bruxism. The Journal of the Dental Faculty of Ankara University, 39:93-102.
• Mohamed SE, Christensen LV, Penchas J (1997) A randomized double-blind clinical trial of the effect of amitriptyline on nocturnal masseteric motor activity (sleep bruxism). Cranio, 15:326-332.
• Montero J, Gomez-Polo C (2017) Personality traits and dental anxiety in self-reported bruxism. A cross-sectional study. J Dent, 65:45-50.
• Morales-Chávez MC, Rueda-Delgado YM, Peña-Orozco DA (2014) Prevalence of bucco-dental pathologies in patients with psychiatric disorders. J Clin Exp Dent, 6:e7-e11.
• Mostafavi SN, Jafari A, Hoseini SG, Khademian M, Kelishadi R (2019) The efficacy of low and moderate dosage of diazepam on sleep bruxism in children: A randomized placebo-controlled clinical trial. J Res Med Sci, 24:8.
• Muzalev K, van Selms MK, Lobbezoo F (2018) No Dose-Response Association Between Self-Reported Bruxism and Pain-Related Temporomandibular Disorders: A Retrospective Study. J ORAL FACIAL PAIN H, 32:375-380.
• Natu VP, Yap AU, Su MH, Irfan Ali NM, Ansari A (2018) Temporomandibular disorder symptoms and their association with quality of life, emotional states and sleep quality in South-East Asian youths. J Oral Rehabil, 45:756-763.
• Naylor B, Boag S, Gustin SM (2017) New evidence for a pain personality? A critical review of the last 120 years of pain and personality. Scand J Pain, 17:58-67.
• Nazeri M, Ghahrechahi HR, Pourzare A, Abareghi F, Samiee-Rad S, Shabani M et al. (2018) Role of anxiety and depression in association with migraine and myofascial pain temporomandibular disorder. Indian J Dent Res, 29:583-587.
• Obata H (2017) Analgesic Mechanisms of Antidepressants for Neuropathic Pain. Int J Mol Sci, 18:2483.
• Okeson JP (2013) Management of Temporomandibular Disorders and Occlusion. St Louis, Elsevier Health Sciences.
• Oral K, Bal Kucuk B, Ebeoglu B, Dincer S (2009) Etiology of temporomandibular disorder pain. Agri, 213:89-94.
• Özkan S, Özkan M (2016) Liyezon Psikiyatrisi Açısından Temporomandibular Eklem Rahatsızlıkları. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 56:49-52.
• Pallegama RW, Ranasinghe AW, Weerasinghe VS, Sitheeque MA (2005) Anxiety and personality traits in patients with muscle related temporomandibular disorders. J Oral Rehabil, 32:701-707.
• Patetsos E, Horjales-Araujo E (2016) Treating Chronic Pain with SSRIs: What Do We Know?. Pain Res Manag, 2016:2020915-2020915.
• Polmann H, Domingos FL, Melo G, Stuginski-Barbosa J, Guerra E, Porporatti AL et al. (2019) Association between sleep bruxism and anxiety symptoms in adults: A systematic review. J Oral Rehabil, 46:482-491.
• Raigrodski AJ, Christensen LV, Mohamed SE, Gardiner DM (2001) The effect of four-week administration of amitriptyline on sleep bruxism. A double-blind crossover clinical study. Cranio, 19:21-25.
• Raigrodski AJ, Mohamed SE, Gardiner DM (2001) The effect of amitriptyline on pain intensity and perception of stress in bruxers. J Prosthodont, 10:73-77.
• Rajan R, Sun YM (2017) Reevaluating Antidepressant Selection in Patients With Bruxism and Temporomandibular Joint Disorder. J Psychiatr Pract, 23:173-179.
• Reissmann DR, John MT, Seedorf H, Doering S, Schierz O (2014) Temporomandibular disorder pain is related to the general disposition to be anxious. J ORAL FACIAL PAIN H, 28:322-330.
• Onat SS, Malas FU (2015) Duloxetine-induced Sleep Bruxism in Fibromyalgia Successfully Treated With Amitriptyline. Acta Reumatol Port, 40:391-392.
• Sakai T, Kato T, Yoshizawa S, Suganuma T, Takaba M, Ono Y et al. (2017) Effect of clonazepam and clonidine on primary sleep bruxism: a double-blind, crossover, placebo-controlled trial. J Sleep Res, 26:73-83.
• Saletu A, Parapatics S, Saletu B, Anderer P, Prause W, Putz H et al. (2005) On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology, 51:214-225.
• Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP et al. (2014) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J ORAL FACIAL PAIN H, 28:6-27.
• Schmitter M, Kares-Vrincianu A, Kares H, Malsch C, Schindler HJ (2019) Chronic stress and temporalis muscle activity in TMD patients and controls during sleep: a pilot study in females. Clin Oral Investig, 23:667-672.
• Scrivani SJ, Keith DA, Kaban LB (2008) Temporomandibular disorders. N Engl J Med, 359:2693-2705.
• Seidel S, Aigner M, Ossege M, Pernicka E, Wildner B, Sycha T (2013) Antipsychotics for acute and chronic pain in adults. Cochrane Database Syst Rev, 8:Cd004844.
• Shedden Mora M, Weber D, Borkowski S, Rief W (2012) Nocturnal masseter muscle activity is related to symptoms and somatization in temporomandibular disorders. J Psychosom Res, 73:307-312.
• Shedden Mora MC, Weber D, Neff A, Rief W (2013) Biofeedback-based cognitive-behavioral treatment compared with occlusal splint for temporomandibular disorder: a randomized controlled trial. Clin J Pain, 29:1057-1065.
• Singh RK, Pal US, Goyal P, Nischal A, Gurung TR, Daga D (2018) TMJ Arthrocentesis Alone and in Combination with Duloxetine in Temporomandibular Joint Pain. J Maxillofac Oral Surg, 17:270-275.
• Somtürk E, Koray M, Yaltirik M, Öğünç N, İşsever H, Balkaya M et al (2010) State or Trait Anxiety Levels in Patients with Nocturnal Bruxism. Turkiye Klinikleri Journal of Dental Sciences, 16:44-50.
• Stahl S (2012) Stahl'ın Temel Psikofarmakoloji (Çeviri Ed. İT Uzbay). İstanbul, İstanbul Tıp Kitabevi.
• Stechman-Neto J, Porporatti AL, Porto de Toledo I, Costa YM, Conti PC, De Luca Canto G et al. (2016) Effect of temporomandibular disorder therapy on otologic signs and symptoms: a systematic review. J Oral Rehabil, 43:468-479.
• American Society of Temporomandibular Joint Surgeons (2003). "Guidelines for Diagnosis and Management of Disorders Involving the Temporomandibular Joint and Related Musculoskeletal Structures. Cranio, 21:68-76.
• Suvinen TI, Reade PC, Kemppainen P, Kononen M, Dworkin SF (2005) Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain, 9:613-633.
• Turkoglu S, Akca OF, Turkoglu G, Akca M (2014) Psychiatric disorders and symptoms in children and adolescents with sleep bruxism. Sleep Breath, 18:649-654.
• Ursavaş A (2014) Yeni Uyku Bozuklukları Sınıflaması (ICSD-3) Uykuda Solunum Bozukluklarında Neler Değişti?. Güncel Göğüs Hastalıkları Serisi, 2:139-151.
• Van der Zaag J, Lobbezoo F, Van der Avoort PG, Wicks DJ, Hamburger HL, Naeije M (2007) Effects of pergolide on severe sleep bruxism in a patient experiencing oral implant failure. J Oral Rehabil, 34:317-322.
• Yaltırık M, Palancıoglu A, Turgut CT, Koray M (2017) Temporomandibular bozuklukların tedavileri. 7tepe Klinik, 13:43-50.
• Yap AU, Chua EK, Tan KB, Chan YH (2004) Relationships between depression/somatization and self-reports of pain and disability. J Orofac Pain, 18:220-225.
• Yap AU, Dworkin SF, Chua EK, List T, Tan KB, Tan HH (2003) Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients. J Orofac Pain, 17:21-28.
• Yap AU, Tan KB, Chua EK, Tan HH (2002) Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent, 88:479-484.
• Yener M, Aynali G (2012) The treatment choices in temporomandibular disorders. SDU Journal of Health Science Institute, 3:150-154.
• McNeill C (1997) Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent, 77:510-522.