Associations among temporomandibular disorder, headache, shoulder pain, craniofacial morphology, and premature contacts in female children and adolescents with malocclusion

Abstract

ABSTRACT Purpose Orthodontic patients frequently exhibit signs and symptoms of temporomandibular disorder (TMD) in combination with symptoms around the stomatognathic region (i.e. headache). Although maxillofacial morphology and malocclusion have been widely investigated as risk factors for TMD and headache, their relationship remains unclear and functional factors have not been verified. This study investigated associations among TMD, headache, craniofacial morphology, and premature contacts in female children and adolescents with malocclusion. Materials and methods One hundred twenty female children and adolescents (mean age, 11.4 ± 2.5 years) who sought orthodontic treatment were randomly selected from a cohort of orthodontic patients. The patients were divided into three groups (no condition, at least one condition, ≥ 2 conditions: TMD, headache, and/or shoulder pain). Premature contacts were determined using the functional wax bite method; craniofacial morphology was analysed using lateral cephalometric radiographs. The χ2 test, Tukey test, and ordered logistic regression were used for statistical analysis. Results Patients with TMD and headache had a steep mandibular plane angle (odds ratio = 1.11), but there were no significant differences among groups in other craniofacial morphology parameters. Patients with premature contacts had a higher incidence of combined TMD and headache (odds ratio = 7.72). Premature contacts more strongly contributed to pathogenesis than did mandibular plane angle or age. Conclusion TMD and headache are associated with both craniofacial morphology and premature contacts.