Oral surgery, oral medicine, oral pathology and oral radiology · 2025
Does the use of the levonorgestrel intrauterine system increase the prevalence of masticatory muscles tenderness?
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Can Serhat, Can Sinem Büşra Kıraç, Karakuş Sultan Seren, Berkel Gülcan
Аннотация
OBJECTIVES: To investigate the incidence of temporomandibular joint disorders signs (sTMD) in women using a levonorgestrel releasing intrauterine system (LNG-IUS).
STUDY DESIGN: In this case-control study women using LNG-IUS and demographically matched healthy controls were compared. In both groups, comprehensive clinical examination of temporomandibular joint (TMJ) and masticatory muscles was performed and pain was reported using visual analog scores (VAS). In addition, maximum interincisal opening (MIO), pain-free (MIO2), TMJ sound, laterotrusive movements and deviation-deflection were measured.
RESULTS: Thirty-two patients, aged 25-50 years, using LNG-IUS >3 months and 32 healthy volunteers with normal menstrual cycles were included. MIO and MIO2 did not differ between two groups (P = .789 and P = .765, respectively). In LNG-IUS group, incidence of TMJ pain (P < .001), tenderness in the tendon of temporalis muscle (P < .001), and pain in masseter (P < .001), lateral pterygoid (P < .001) and temporalis muscles (P = .021) was significantly greater. In additionally, there was a difference in incidence of left sided laterotrusive movement limitation (P < .001) and TMJ sounds (P = .041) in LNG-IUS group compared to the control group.
CONCLUSIONS: We suggest that chronic low-level progesterone release by LNG-IUS may play a role in the development of this condition. In female patients presenting with masticatory muscle tenderness, the use of LNG-IUS should be questioned in the anamnesis.
CLINICAL TRIALS REGISTRATION NUMBER: NCT06500390.
STUDY DESIGN: In this case-control study women using LNG-IUS and demographically matched healthy controls were compared. In both groups, comprehensive clinical examination of temporomandibular joint (TMJ) and masticatory muscles was performed and pain was reported using visual analog scores (VAS). In addition, maximum interincisal opening (MIO), pain-free (MIO2), TMJ sound, laterotrusive movements and deviation-deflection were measured.
RESULTS: Thirty-two patients, aged 25-50 years, using LNG-IUS >3 months and 32 healthy volunteers with normal menstrual cycles were included. MIO and MIO2 did not differ between two groups (P = .789 and P = .765, respectively). In LNG-IUS group, incidence of TMJ pain (P < .001), tenderness in the tendon of temporalis muscle (P < .001), and pain in masseter (P < .001), lateral pterygoid (P < .001) and temporalis muscles (P = .021) was significantly greater. In additionally, there was a difference in incidence of left sided laterotrusive movement limitation (P < .001) and TMJ sounds (P = .041) in LNG-IUS group compared to the control group.
CONCLUSIONS: We suggest that chronic low-level progesterone release by LNG-IUS may play a role in the development of this condition. In female patients presenting with masticatory muscle tenderness, the use of LNG-IUS should be questioned in the anamnesis.
CLINICAL TRIALS REGISTRATION NUMBER: NCT06500390.