{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:52:00Z","timestamp":1793119920475,"version":"4.5.0"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:00:00Z","timestamp":1761264000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Temporomandibular joint disorders (TMDs) are a common source of orofacial pain and dysfunction, often characterized by myalgia, restricted mouth opening, and limitations in mandibular movement. This study aims to evaluate the extent of mandibular functional limitation across different TMD subgroups and its relationship with anxiety and depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional descriptive study was conducted on 120 patients diagnosed with temporomandibular joint disorders according to the Diagnostic Criteria for TMDs (DC\/TMD). Participants completed self-report questionnaires assessing the Jaw Functional Limitation Scale-8 (JFLS-8), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Graded Chronic Pain Scale (GCPS), and Oral Behaviors Checklist (OBC). The Mann-Whitney U and Kruskal-Wallis tests were used to compare means between groups for non-normally distributed data. The relationship between JFLS-8 and other variables was assessed using linear regression. Statistical significance was set at\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                        \u2009\n                      <\/jats:italic>\n                      &lt;\u2009.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Chewing hard foods is the most affected activity in the arthralgia group (7.25\u2009\u00b1\u20091.91), while swallowing is the least affected activity (0.13\u2009\u00b1\u20090.35). Statistically significant differences were found among TMJ disorders for chewing tough food, chewing chicken, opening wide enough to drink from a cup, and yawning (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                        \u2009\n                        <jats:italic>&lt;\u2009<\/jats:italic>\n                      <\/jats:italic>\n                      .05). Disc displacement without reduction, with a limited opening subgroup, exhibited the highest JFLS-8 scores for chewing and mouth-opening-related activities. JFLS-8 is correlated with the PHQ-9, GAD-7, GCPS (\n                      <jats:italic>\n                        <jats:italic>p<\/jats:italic>\n                        \u2009\n                        <jats:italic>&lt;\u2009<\/jats:italic>\n                      <\/jats:italic>\n                      .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant variations in mandibular functional limitation were observed across TMD subgroups. The severity of these limitations demonstrated a positive correlation with levels of depression, anxiety, and chronic pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0334508","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T17:34:36Z","timestamp":1761327276000},"page":"e0334508","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of mandibular functional limitation in patients with temporomandibular joint disorders and the relationship with other psychosocial factors"],"prefix":"10.1371","volume":"20","author":[{"given":"Nguyen Ngoc","family":"Hoa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toan","family":"Do","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tran","family":"Thai 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study","volume":"38","author":"Y Zhong","year":"2024","journal-title":"J Oral Facial Pain Headache"},{"key":"pone.0334508.ref023","article-title":"Association of Oral Behaviors with Anxiety, Depression, and Jaw Function in Patients with Temporomandibular Disorders in China: A Cross-Sectional Study","volume":"27","author":"L Xu","year":"2021","journal-title":"Med Sci Monit"},{"issue":"12","key":"pone.0334508.ref024","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1111\/joor.13579","article-title":"Low income is associated with impaired jaw function via anxiety and depression in patients with temporomandibular disorders","volume":"50","author":"Y Zheng","year":"2023","journal-title":"J Oral Rehabil"},{"key":"pone.0334508.ref025","first-page":"4","article-title":"Diagnostic criteria for temporomandibular disorders: Assessment instruments.","author":"R Ohrbach","year":"2014","journal-title":"Inform International Network for Orofacial Pain and Related Disorders Methodology"},{"issue":"6","key":"pone.0334508.ref026","doi-asserted-by":"crossref","first-page":"72","DOI":"10.4103\/0972-4052.246660","article-title":"49. An in-vivo study to evaluate the onset of relief from ibuprofen, placebo and occlusal splint in patients with acute myalgia in muscles related to temporomandibular joint: a comparative randomized study","volume":"18","author":"D Gupta","year":"2018","journal-title":"J Indian Prosthodont Soc"},{"issue":"1","key":"pone.0334508.ref027","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s12903-022-02048-x","article-title":"Local myalgia compared to myofascial pain with referral according to the DC\/TMD: Axis I and II results","volume":"22","author":"O Winocur-Arias","year":"2022","journal-title":"BMC Oral Health"},{"issue":"2","key":"pone.0334508.ref028","doi-asserted-by":"crossref","DOI":"10.24198\/pjd.vol28no2.13723","article-title":"The analysis of temporomandibular disorder based on RDC\/TMD Axis I revision 2010 in dentistry students","volume":"28","author":"R Rikmasari","year":"2016","journal-title":"Padjadjaran J Dent"},{"issue":"2","key":"pone.0334508.ref029","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/0304-3959(92)90154-4","article-title":"Grading the severity of chronic pain","volume":"50","author":"M Von Korff","year":"1992","journal-title":"Pain"},{"issue":"1","key":"pone.0334508.ref030","doi-asserted-by":"crossref","first-page":"42","DOI":"10.13181\/mji.oa.191790","article-title":"Validation of the Indonesian version of the graded chronic pain scale 2.0 in pain-related temporomandibular disorders","volume":"29","author":"I Tanti","year":"2020","journal-title":"Med J Indones"},{"issue":"4","key":"pone.0334508.ref031","doi-asserted-by":"crossref","first-page":"303","DOI":"10.11607\/ofph.2983","article-title":"Importance of the Graded Chronic Pain Scale as a Biopsychosocial Screening Instrument in TMD Pain Patient Subtyping","volume":"35","author":"M Hietaharju","year":"2021","journal-title":"J Oral Facial Pain Headache"},{"issue":"9","key":"pone.0334508.ref032","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"K Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"pone.0334508.ref033","unstructured":"University of Virginia Library. Using and Interpreting Cronbach\u2019s Alpha. 2015, November 16. Available from: https:\/\/data.library.virginia.edu\/using-and-interpreting-cronbachs-alpha\/"},{"issue":"12","key":"pone.0334508.ref034","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1016\/j.pain.2014.09.014","article-title":"Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain","volume":"155","author":"AM Boonstra","year":"2014","journal-title":"Pain"},{"key":"pone.0334508.ref035","unstructured":"INFORM \u2013 International Network for Orofacial Pain and Related Disorders Methodology. DC\/TMD Portuguese Assessment Instruments. 2018 [cited 11 September 2025]. Available from: https:\/\/www.inform-iadr.com"},{"issue":"2","key":"pone.0334508.ref036","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/odi.13004","article-title":"Prevalence and normative values for jaw functional limitations in the general population in Sweden","volume":"25","author":"I Oghli","year":"2019","journal-title":"Oral Dis"},{"key":"pone.0334508.ref037","unstructured":"Amro A, Atrash A, Hamdan A, Matar F, Janineh F, Jafreh R. Musculoskeletal etiology and manifestations of temporomandibular joint disorders in Bethlehem and Jerusalem\/ Palestine. 2018;05."},{"key":"pone.0334508.ref038","doi-asserted-by":"crossref","DOI":"10.1159\/isbn.978-3-8055-9405-9","author":"O Walusinski","year":"2010","journal-title":"The Mystery of Yawning in Physiology and Disease (Vol. 28). S. Karger AG"},{"key":"pone.0334508.ref039","volume-title":"Management of Temporomandibular disorders and occlusion","author":"JP Okeson","year":"2020","edition":"8"},{"issue":"4","key":"pone.0334508.ref040","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1111\/joor.13637","article-title":"Mental health and jaw function of patients with anterior disc displacement with reduction","volume":"51","author":"Y Yao","year":"2024","journal-title":"J Oral Rehabil"},{"issue":"11","key":"pone.0334508.ref041","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1016\/j.jpain.2019.04.003","article-title":"AAPT Diagnostic Criteria for Chronic Painful Temporomandibular Disorders","volume":"20","author":"R Ohrbach","year":"2019","journal-title":"J Pain"},{"issue":"2","key":"pone.0334508.ref042","doi-asserted-by":"crossref","first-page":"96","DOI":"10.2174\/1573397111666150619095330","article-title":"Psychosocial factors and central sensitivity syndromes","volume":"11","author":"LM Adams","year":"2015","journal-title":"Curr Rheumatol Rev"},{"issue":"3","key":"pone.0334508.ref043","doi-asserted-by":"crossref","first-page":"101888","DOI":"10.1016\/j.jebdp.2023.101888","article-title":"Associations between screening for functional jaw disturbances and patient reported outcomes on jaw limitations and oral behaviors","volume":"23","author":"A L\u00f6vgren","year":"2023","journal-title":"J Evid Based Dent Pract"},{"issue":"2","key":"pone.0334508.ref044","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.prosdent.2022.08.002","article-title":"Prevalence of psychological disorders in patients with temporomandibular disorders: A systematic review and meta-analysis","volume":"132","author":"GC Felin","year":"2024","journal-title":"J Prosthet Dent"},{"issue":"2","key":"pone.0334508.ref045","doi-asserted-by":"crossref","first-page":"103","DOI":"10.11607\/ofph.3010","article-title":"Psychologic Impact of Chronic Orofacial Pain: A Critical Review","volume":"36","author":"A Karamat","year":"2022","journal-title":"J Oral Facial Pain Headache"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334508","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T17:34:42Z","timestamp":1761327282000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0334508"}},"subtitle":[],"editor":[{"given":"John Minh","family":"Le","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,24]]},"references-count":45,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0334508","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,24]]}}}