Abstract
Dysfunction of the stomatognathic apparatus is a disturbance of the biomechanics of the masticatory system and craniofacial structure, usually generated by tissue damage of its main components (temporomandibular, neuromuscular, and dental-occlusal system, besides in the craniocervical spine) when the morphofunctional adaptability is exceeded. Musical activity is well-known as one of the most complex activities executed by the human musculoskeletal system, as practitioners require to adopt a non-physiological posture. Therefore, by performing an integrative review of the available literature, this study aimed to investigate the potential relationship between temporomandibular disorders and the practice of wind musical instruments. We included peer-reviewed primary studies published in the last ten years, either in English, Portuguese, or Spanish, and with a full-text available. We searched four databases (PubMed, LILACS, Scielo, and Portal Capes), using a specific search strategy using the terms “wind instrument players”, “oral parafunction”, and “temporomandibular disorders”. We excluded articles published before 2011, studies that did not correlate temporomandibular disorders with wind music practice, as well as studies without a full text. Overall, the search retrieved ten primary studies, including 3,206 amateur and professional wind instrument players. Included studies were essentially cross-sectional studies (n= 8) and case-control studies (n= 2). The most common signs and symptoms of temporomandibular disorder and deleterious oral habits among wind players were crackling and popping sounds of the temporomandibular joint, headache, should and neck pain, mouth opening limitation, and temporomandibular joint pain. Three studies identified factors that were statistically associated with the development of temporomandibular disorders (presence of temporomandibular pain, mouthpiece pressure, and higher distance of mandible protrusion). Although we have observed a high prevalence of temporomandibular diseases among musicians who play wind musical instruments, further research is required to clarify better variables and risk factors associated with developing several systemic and oral-related diseases among these individuals.
Highlights
The stomatognathic system is a multi-functional and complex system involved in several functional tasks and is associated with various disturbances or diseases [1], [2]
Even though a previous non-systematic review of the literature showed a probable relationship between the practice of musical instruments and temporomandibular disorder, the study did not precisely evaluate the possible association of temporomandibular dysfunction and playing a wind musical instrument [9]
We considered only studies published between January 2009 and January 2020, using the keywords and medical subject headings “wind instrument players”, “oral parafunction”, and “temporomandibular disorders”
Summary
The stomatognathic system is a multi-functional and complex system involved in several functional tasks (sucking, chewing, swallowing, breathing, and speech functions) and is associated with various disturbances or diseases [1], [2]. Temporomandibular dysfunction is classified as a stomatognathic system disorder, which encompasses signs and symptoms including crackling and popping sound in the ear, limited mouth opening, pain in masticatory muscles and around the jaw area, tinnitus, pain around the ear area, and headache [3]. These before-mentioned set of clinical signs and symptoms frequently occur during activation of muscles of mastication, muscles of the head, neck, and temporomandibular joints [4]. We assessed the craniofacial impact of playing wind instruments, including the effect on the temporomandibular joint
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