Stehen CMD-Symptome und -Diagnosen in Zusammenhang mit der pubertären Entwicklung bei Jugendlichen? Eine epidemiologische Studie

Abstract

In addition to low back pain, temporomandibular disorders (TMDs) are the most prevalent pain- and disability-related musculoskeletal conditions. However, the influence of pubertal development on TMD diagnoses remains unknown. To assess whether the prevalence of TMD diagnoses, in addition to self-reported symptoms (pain, restricted mandibular mobility, clicking), change according to pubertal stage. A random sample of 1,011 children and adolescents was chosen from the general population of 24,129 children and adolescents aged 10-17 years living in the urban area of Halle, Germany. Study participants were examined for TMD symptoms and diagnoses according to the Research Diagnostic Criteria for TMDs (RDC/TMD). Status of pubertal development was assessed using the Pubertal Development Scale (PDS). The χ(2) tests and multivariate logistic regression models were used, and odds ratios (ORs) and 95% confidence intervals calculated. The observed increase in TMD symptoms during adolescence was mainly due to the higher frequency of self-reports of these symptoms by girls than boys (ORs for girls vs. boys: 1.42-1.53; p ≤ 0.05), whereas clinical TMD diagnoses (any RDC/TMD diagnosis, or RDC/TMD group IIa diagnosis) in adolescence increased mainly due to pubertal development itself (ORs for subjects beyond vs. before puberty: 1.58-2.00; p < 0.05; no significant sex-related effect was found). Pubertal development increases the probability of self-reported TMD symptoms among girls, while the probability thereof decreases among boys. Independent of sex, pubertal growth increases the prevalence of RDC/TMD-related diagnoses-mainly disk displacement-in both sexes.