Abstract
Background: Temporomandibular joint disorder (TMD) includes symptoms of pain and dysfunction in the muscles of mastication and the temporomandibular joint. Differences in vertical condylar height, observed in the assessment of mandibular asymmetry, is a structural alteration that represents a risk factor for TMD. The study aimed to evaluate the association between TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia. Methods: The cross-sectional study included 18-25-year-old (mean ± SD, 21.9 ± 2.0 years) old orthodontic patients admitted to the Dental Hospital of Universitas Sumatera Utara, Medan, between June 2016 and March 2017. Vertical mandibular asymmetry was assessed from all 106 subjects using Kjellberg's technique from pre-treatment panoramic radiographs. The TMD symptoms were assessed by structural interviews using modified questionnaires based on Temporomandibular Disorder Diagnostic Index and Fonseca's Anamnestic Index. Results: Of the 106 subjects, 26 (24.5% of the total) with vertical mandibular symmetry and 39 (36.8%) with vertical mandibular asymmetry were positive for TMD symptoms. By contrast, 17 patients (16.0% of the total) with vertical condylar symmetry and 24 patients (22.6%) with vertical mandibular asymmetry were regarded negative for TMD symptoms. There was no significant difference (p=0.520) in TMD symptoms based on vertical mandibular symmetry. Conclusion: The results from this studied Sumatran population indicate that there are common TMD symptoms in young adult orthodontic patients, but there is no significant association between vertical mandibular asymmetry and TMD symptoms. Further study on the development of TMD, mandibular asymmetry and treatment planning for growing patients is suggested, using longitudinal and transitional approaches.
Highlights
The goal of orthodontics for young patients is to provide a functional occlusion to give harmony in the dental arrangement, the anatomy of temporomandibular joints, and the activity of the masticatory muscles in later adulthood[1]
Since Temporomandibular joint disorder (TMD) and mandibular asymmetry are complex issues that cover a large variety of symptoms, this study aims to analyze the association between TMD symptoms and vertical mandibular asymmetry measured using Kjellberg’s technique in young adults that sought orthodontics treatment at the Dental Hospital in Universitas Sumatera Utara, Medan, Indonesia
From 106 young adult orthodontic patients, TMD symptoms were present in 24.53% (n=26) of patients with vertical mandibular symmetry and in 36.79% (n=39) with vertical mandibular asymmetry
Summary
The goal of orthodontics for young patients is to provide a functional occlusion to give harmony in the dental arrangement, the anatomy of temporomandibular joints, and the activity of the masticatory muscles in later adulthood[1]. According to a study on 8–30-year-old subjects in Jakarta, Indonesia, based on questionnaires and posteroanterior radiography, the main risk factor of mandibular asymmetry is temporomandibular joint disorder (TMD)[8]. Asymmetry in the vertical dimension, based on posteroanterior radiography, was significantly correlated with temporomandibular joint internal derangement in a study on 187 Japanese subjects with pre-orthodontic mandibular asymmetry and a mean age of 23.9 years[9]. The study aimed to evaluate the association between TMD symptoms and vertical mandibular symmetry in young adult orthodontic patients in North Sumatra, Indonesia. There was no significant difference (p=0.520) in TMD symptoms based on vertical mandibular symmetry. Conclusion: The results from this studied Sumatran population indicate that there are common TMD symptoms in young adult orthodontic patients, but there is no significant association between vertical mandibular asymmetry and TMD symptoms. Further study on the development of TMD, mandibular asymmetry and treatment version 2
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