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					Reference list “Whiplash” and “TMJ” AUTOPP 2002 Heidi C. Crow Bergman, H, Andersson, F, Isberg, A. Incidence of temporomandibular joint changes after whiplash trauma: a prospective study using MR imaging. Am J Roentgenology 1998;171:1237-43. Prospective study of MRI results of subjects involved in rear-end collisions resulting in whiplash. MRI completed within 2 weeks of the trauma, and compared to asymptomatic control subjects. No difference in incidence of disk displacement or effusion seen in the two groups. Brooke, RI, Stenn, PG. Postinjury myofascial pain dysfunction syndrome: its etiology and prognosis. Oral Surg Oral Med Oral Path 1978; 45(6):846-850. Demonstrates a less favorable response to therapy in patients that have myofascial pain subsequent to a motor vehicle accident. Thirty-seven posttrauma TMD patients were followed after treatment. Thirty six percent of the patients were successfully treated, 62% showed no permanent improvement following treatment. DeBoever, JA, Keersmaekers, K. Trauma in patients with temporomandibular disorders: frequency and treatment outcome. J Oral Rehabilitation 1996;23:91-6 Four hundred consecutive patients were divided into groups dependent on the association of their complaints with trauma. All received similar, conservative treatment. Follow-up at one year indicated similar successful outcomes between groups. Ferrari, R., Leonard, M.S. Whiplash and temporomandibular disorders: A critical review. J Am Dent Assoc 129:1739, 1998. Review of the literature that concludes whiplash injuries unaccompanied by blunt trauma do not cause TMD. Ferrari, R, Schrader, H, Obelieniene, D. Prevalence of temporomandibular disorders associated with whiplash injury in Lithuania. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:653-7. Reports no difference in TMD symptoms two years after rear-end MVA when MVA subjects were compared with non-MVA population. Garcia, R Jr., Arrington, JA. The relationship between cervical whiplash and temporomandibular joint injuries: an MRI study. J Craniomandibular Practice 1996;14:233-9. MRI study of patients diagnosed with cervical whiplash injuries. MRI was completed from 1 day to over 12 months after the MVA. No control subjects were used. The authors found a high incidence of disc displacements in the population studied. Goldstein, B.H. Medical legal considerations in temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88: 395, 1999.

Presents information regarding impairment and disability in TMD as well as current review of articles demonstrating association or lack thereof between MVA’s and TMD. Greco, CA, Rudy, TE, Turk, DC, Herlich, A. Zaki, HH. Traumatic onset of temporomandibular disorders: Positive effects of a standardized conservative treatment program. Clinical Journal of Pain 1997;13: 337-347. Prospective study evaluating trauma and non-trauma linked TMD response to the same conservative therapy regimen. None of the trauma associated TMD patients were involved in litigation. Both groups responded equally with significant improvement. Heise, AP, Laskin, DM, Gervin, AS. Incidence of temporomandibular joint symptoms following whiplash injury. J Oral Maxillofac Surg 1992 50(8):825-8. One hundred and fifty five patients were evaluated after whiplash injury and divided into two groups, those with and those without radiographic evidence of cervical skeletal injury. 13% in the first group and 15% of the second group complained of masticatory muscle and TMJ pain. The patients were followed up by phone at one month and at one year. All of the patients reporting TMD pain had diminished pain at 1 month, and there were no reports of persistent pain at one year. Howard, RP, Benedict, JV, Raddin, JH, Smith, HL. Assessing neck extension-flexion as a basis for temporomandibular joint dysfunction. J Oral Maxillofac Surg 1991; 49(11):1210-1213. Claims the stretching/crushing TMJ theory in whiplash injuries is inaccurate. Forces delivered to the joint would be compressive in nature and be within physiologic levels. Howard, RP, Hatsell, CP, Guzman, HM. Temporomandibular Joint Injury Potential Imposed by the Low-Velocity Extension-Flexion Maneuver. J Oral Maxillofac Surg 1995; 53:256-262. Utilized four live human subjects involved in low-velocity rear end collisions to demonstrate the movement of the jaw in the resultant extension-flexion of the neck. Estimates force based on velocity change to be within normal physiologic levels. Kolbinson, DA, Epstein, JB, Senthilselvan, A, Burgess, JA. A comparison of TMD patients with or without prior motor vehicle accident involvement: treatment and outcomes. J Orofacial Pain 1997;11:337-45. Retrospective review of records comparing patients with trauma associated vs. nontrauma associated TMD diagnoses. All trauma associated TMD patients were involved in litigation. Found posttraumatic TMD patients utilized more treatments, more medications, and had a poorer outcome than nontrauma associated TMD patients. Kronn, E. The incidence of TMJ dysfunction in patients who have suffered a cervical whiplash injury following a traffic accident. J Orofacial Pain 1993; 7:209-213. Forty patients s/p whiplash injuries were compared to matched controls. There were more reports of TMJ pain, limitation of jaw movement, and masticatory muscle pain in the post-whiplash patients. When joint noise or overall presence or absence of any joint symptoms was evaluated, there was no significant difference between groups.

McKay, DC, Christensen LV. Whiplash injuries of the temporomandibular joint in motor vehicle accidents: speculations and facts. J Oral Rehabilitation 1998;25:731-46. Extensive review of the literature (95 references) with discussion of the physical likelihood of whiplash causing TMJ disorders. Concludes that “for the asserted TMJ whiplash manoeuvre and ensuing injury to occur as postulated, the laws of physics and biology would have to be suspended.” O’Shaughnessy, T. Craniomandibular/temporomandibular/cervical implications of a forced hyper-extension/hyperflexion episode (i.e., whiplash). Functional Orthodontist 1994;11:5-10. Review of anecdotal literature supporting a relationship between TMD and whiplash injuries. Plesh, O, Gansky, SA, Curtis, DA, Pogrel, MA. The relationship between chronic facial pain and a history of trauma and surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:16-21. Suggests that trauma (including previous surgical trauma) sensitizes patients to subsequent pain. Pressman, BD, Shellock, FG, Schames, J, Schames, M. MR imaging of temporomandibular joint abnormalities associated with cervical hyperextension/hyperflexion (whiplash) injuries. J Magnetic Resonance Imaging 1992; 2(5): 569-574. Thirty-three patients with symptomatic TMJ complaints following whiplash injury were evaluated by MRI. No control subjects were used. The authors found a high percentage of disk displacements in subjects having TMJ complaints. Romanelli, GG; Mock, D. Tenenbaum, HC. Characteristics and response to treatment of posttraumatic temporomandibular disorder: A retrospective study. Clinical J Pain 1992; 8:6-17. Compared results of treatment between 52 posttraumatic TMD patients and 52 matched nontrauma associated TMD patients. Significantly less of the posttraumatic TMD patients reported recovery with treatment, and a larger percentage of posttraumatic TMD patients had symptoms suggestive of affective disorder. Schneider, K, Zernicke, RF, Clark, G. Modeling of jaw-head-neck dynamics during whiplash. J Dent Res 1989;68:1360-5. Describes development of a model system to assess whiplash effects on the TMJ at 15 mph and 30 mph. Steed, PA, Wexler, GB. Temporomandibular disorders-traumatic etiology vs. nontraumatic etiology: A clinical and methodological inquiry into symptomatology and treatment outcomes. J Craniomand Prac 2001; 19(3):188-194. A case series of 1842 patients from 60 practices were evaluated pre- and post-treatment utilizing the TMJ scale. Five hundred twenty three patients reported trauma as an

immediate factor compared to 1319 nontrauma patients. Treatment outcomes of the groups were unrelated to their trauma status. Weinberg, S, LaPointe, H. Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint. J Oral Maxillofac Surg 1987; 45(8):653656. Classic illustration of hypothetical TMJ trauma induced by whiplash. Proposed that the trauma caused stretching and tearing, followed by crushing, of the posterior attachment.


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