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Notes: summary  The literature has documented a controversial discussion on the possible relationship of otogenous symptoms and craniomandibular dysfunction since the 1920s. Therefore, an investigation was conducted which consisted of two parts: a case study with population-based controls and a cross-sectional study. The aim of the first study was to screen a group of patients suffering from acute or chronic tinnitus for temporomandibular disorders (TMD) in comparison with a population-based group of volunteers without tinnitus. To this end, 30 patients (13 females and 17 males, age 18–71 years) suffering from acute hearing loss associated with tinnitus, isolated acute tinnitus, and chronically transient tinnitus were examined for symptoms of craniomandibular dysfunction. The results were compared with those of clinical functional analysis from 1907 subjects selected representatively and according to age distribution from the epidemiological ‘Study of Health in Pomerania’ (SHIP); the occurrence of tinnitus was ruled out in these control subjects. Statistical analysis was performed with Chi-square and Mann–Whitney U-tests. Sixty per cent of the tinnitus patients and 36·5% of the control subjects exhibited more than two symptoms of TMD (P = 0·004). Tinnitus patients had significantly more muscle palpation pain (P 〈 0·001), temporomandibular joint (TMJ) palpation pain (P 〈 0·001), and pain upon mouth opening (P 〈 0·001) than the general population group. No statistical differences were found in TMJ sounds, limitation of mandibular movement, or hypermobility of the TMJ. Furthermore, 4228 subjects of the population group examined in the epidemiological study were screened for co-factors of tinnitus with the help of a multivariate logistic regression model which was adjusted for gender, age, and a variety of anamnestic and examined data. Increased odds ratios (OR) were found for tenderness of the masticatory muscles (OR = 1·6 for one to three painful muscles and OR = 2·53 for four or more painful muscles), TMJ tenderness to dorsal cranial compression (OR = 2·99), listlessness (OR = 2·0) and frequent headache (OR = 1·84) A relationship between tinnitus and TMD was established in both examinations. Tinnitus patients seem to suffer especially from myofascial and TMJ pain. A screening for TMD should be included in the diagnostic survey for tinnitus patients.

Notes: abstract  A multi-centre randomized clinical trial is under way at 14 university dental schools in Germany to compare prosthodontic treatments for the shortened dental arch (SDA). One of the aims of this pilot-study was to measure the effect of two treatment options of the SDA on oral health-related quality of life and on the Research Diagnostic Criteria (RDC) for temporomandibular disorders (TMD). Thirty-four patients participated in the pilot-study. Inclusion criteria were: all molars were missing and the presence of at least both canines and one premolar in each quadrant. Participants were randomly assigned to receive either removable partial dentures including molar replacement (RPD_group) or retain a premolar occlusion (PROC_group). The Oral Health Impact Profile (OHIP-49) and the RDC for TMD were completed by participants before treatment (pre-treatment), 6 weeks (6wks), 6 months (6m) and 12 months (12m) after treatment. At the 12-month follow up, data of 10 women and 11 men (mean age: 62 ± 10 years) were available. Medians of the OHIP total-scores were as follows: RPD (n = 10), 43·5 (pre-treatment), 18·2 (6wks), 13·3 (6m), 14·7 (12m). PROC (n = 11): 31·8 (pre-treatment), 27·1 (6wks), 8·8 (6m), 8·3 (12m). Significant differences were shown for RPD_group between pre-treatment and 6m/12m and for PROC_group between pre-treatment and 6m. There were no significant differences between treatment groups at any time. Within each group, an improvement of life-quality was observed. No significant difference could be reported between the two therapy concepts. This may be due to the low sample size within the pilot study.