Abstract
To examine the effects of stress, bruxism, malocclusion, and oral habits on the incidence of temporomandibular disorders (TMDs) using a classification tree method (CTM). We obtained data from a total of 1.338 patients: 669 who had TMDs and 669 who but haven’t TMDs. We recorded interview data on stress and oral habits, and during oral examination, noted malocclusions, bruxism, and any sign of poor oral habits. All data were subjected to CTM analyses. The TMD rate was highest in stressed patients (96.8%), and significantly lower in stress-free patients (25.3%) (P < 0.001). TMD was evident in all patients exhibiting both stress and bruxism (100.0%). In stressed patients lacking bruxism, the effects of malocclusion on TMD were significant (P < 0.001). CTM analyses showed that the most significant factor affecting TMD was stress, followed by bruxism and malocclusion. This is the first report to use CTM to define factors affecting TMD.
Highlights
Temporomandibular disorders (TMDs) include conditions of the masticatory muscles, the temporomandibular joint (TMJ), or both, and constitute a subgroup of musculoskeletal disorders (Scrivani et al, 2008)
The optimum tree is shown in Figure 1; it predicts TMD by reference to stress, bruxism, malocclusion, and poor oral habits
TMD was most prominent in stressed patients (Node 1; 96.8%), and significantly less common in those without stress (Node 2; 25.3%) (P < 0.001)
Summary
Temporomandibular disorders (TMDs) include conditions of the masticatory muscles, the temporomandibular joint (TMJ), or both, and constitute a subgroup of musculoskeletal disorders (Scrivani et al, 2008). The most important signs and symptoms of TMD are joint pain during mandibular function, restricted mandibular movement, limited mouth-opening, jawlocking when the mouth is open or closed, and a noisy TMJ during jaw movement (Mujakperuo et al, 2010; Leite et al, 2013). These disorders have been the concerns of dentists. Several epidemiological studies on the prevalence of TMD in children and adolescents have been published, and rates of 9.8–80% have been reported. 75% of the general population exhibits at least one sign of TMD and approximately 33% has at least one symptom (List et al, 1999; Luther et al, 2016), but only 25% are aware of the symptoms and signs and report them to specialists (List et al, 1999)
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