Is the Temporomandibular Joints' Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?-A Case-Control Study.

Marcin Derwich,Maria Mitus-Kenig,Elzbieta Pawlowska

doi:10.3390/ijerph18094994

Abstract

The number of patients diagnosed with temporomandibular joint (TMJ) internal derangements, who are seeking orthodontic treatment, is increasing. The aim of the study was to assess the relationship between the presence of TMJ reciprocal clicking and the morphology and position of the mandible, and position of lower incisors, examined on the lateral cephalograms. Fifty patients diagnosed with reciprocal clicking in at least one of the TMJs and 55 patients with no symptoms of TMJ dysfunction were included in the study. Cephalometric analysis was used for the assessment of: skeletal class, sagittal and vertical position of the mandible, angle of the mandible, inclination of the mandibular ramus and the mandibular corpus, as well as for the assessment of the position of the mandibular incisors. The statistical significance level was set at p = 0.05. There were no statistically significant differences between the examined groups regarding the sagittal and vertical position of the mandible, as well as regarding the sagittal position of the mandibular incisors. Presence of TMJ reciprocal clicking is not associated with the position and the morphology of the mandible, as well as with the sagittal position of the mandibular incisors. Patients with early stages of TMJ internal derangements do not present any significant changes in Cephalometrics. Patients diagnosed with TMJ internal derangements before orthodontic treatment require an interdisciplinary approach to the treatment, including physiotherapy.

Highlights

Temporomandibular joint (TMJ) reciprocal clicking is a pathological double-clicking sound localized in the area of the temporomandibular joints (TMJs), which occurs during both mouth opening and closing and is related to the changes in the position of the articular disc
There were 50 generally healthy patients included in the study who had been diagnosed with reciprocal clicking with at least one of the temporomandibular joints and 55 generally healthy patients who had never presented any symptoms related to temporomandibular joint disorders (TMD), including reciprocal clicking
The mean value of the SNPg angle was slightly decreased and the mean value of the SaGo angle was slightly increased in patients diagnosed with TMJ reciprocal clicking compared to the asymptomatic patients

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Temporomandibular joint (TMJ) reciprocal clicking is a pathological double-clicking sound localized in the area of the temporomandibular joints (TMJs), which occurs during both mouth opening and closing and is related to the changes in the position of the articular disc. Reciprocal clicking is one of the clinical symptoms typical for the disc displacement with reduction (DDwR) [1,2,3,4,5,6]. DDwR is characterized by the malposition of the articular disc in relation to the mandibular condyle in closed mouth position and by its repositioning during mouth opening [1]

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