Craniomandibular Disorders in Pregnant Women: An Epidemiological Survey.

Grazia Fichera,Giuseppe Palazzo,Francesco Indelicato,Alessandro Polizzi,Simone Scapellato

doi:10.3390/jfmk5020036

Abstract

Temporomandibular joint (TMJ) disorder has been reported to be 1.5 to two times more common in women than men. Such a gender-based difference could be attributed to behavioral, hormonal, anatomical, and psychological characteristics. Physiological hormonal differences between genders could be one of the possible explanations for the higher incidence of temporomandibular disorder (TMD) in women. As the plasma level of certain female hormones increases during gestation, it could be assumed that there is a higher prevalence of dysfunctional signs and symptoms in pregnant women. We performed an epidemiological survey based on screening for TMD in a group of 108 pregnant women and found that 72% of young women reported significant signs of TMJ disorders, 9% of the young women reported mild signs of TMJ disorders, and 19% of the included subjects reported no signs or symptoms of TMD. The presence of estrogen receptors in the temporomandibular joint of female baboons could be the basis of an explanation for the increased prevalence of dysfunction in young women reported in the literature and the high feedback we have seen of joint noises in pregnant women. On the basis of the present findings, it could be assumed that gestation period could represent a risk factor for craniomandibular dysfunctions.

Highlights

Dysfunction of the masticatory system, including the temporomandibular joint (TMJ), muscular and dental system, and the supporting bones, is called temporomandibular disorder (TMD) [1].Adults are more affected by TMD as compared with children in a range of between 40% and 70%, a relevant high incidence of TMD has been found among subjects in mixed dental dentition [1,2,3]
A preliminary evaluation of sample size power was performed on 20 subjects (10 in the study group and 10 in the control group), the analysis suggested that 79 patients for each group were required to reach the 80% power to detect a mean difference of 7.2% [43] of incidence of clinically assessed joint click between study and control groups, with a confidence level of 95% and a beta error level of 20%
One hundred and eight pregnant females were recruited to participate in the survey of the present investigation and 72% of young women reported significant signs of TMJ disorders

Summary

Introduction

Dysfunction of the masticatory system, including the temporomandibular joint (TMJ), muscular and dental system, and the supporting bones, is called temporomandibular disorder (TMD) [1].Adults are more affected by TMD as compared with children in a range of between 40% and 70%, a relevant high incidence of TMD has been found among subjects in mixed dental dentition [1,2,3]. Previous evidence reported that estrogen receptors are localized in the TMJ tissues, such as chondroid tissue of condyle and retrodiscal tissues [6,17,18,23,24,25,26,27] In this respect, the hormone, estrogen, could influence the incidence of TMD, and its levels can affect the development, restitution, and metabolism of the temporomandibular joint, bone, and associated structures [7,23,25,28,29,30,31,32,33,34]. In chronic inflammatory pain, this hormone has been documented to have a pro-nociceptive effect due to the presence of its receptors in tissues of both the peripheral and central nervous systems [36,37,38,39]

Objectives

Methods

Results

Conclusion