Signs Of Craniomandibular Disorders Research Articles

Relation between stress and symptoms of craniomandibular disorders in adolescents.

The psychophysiologic theory proposes that stress can precipitate craniomandibular disorders (CMD) and that stress correlates more strongly to disorders of the masticatory muscles than to temporomandibular joint disorders. Empirical reports show only low correlations between emotional stress and CMD signs and symptoms, and that some of them might be spurious. In the present study this correlation was assessed in 417 adolescents from 11 to 16 years old. Data from the clinical examination were used to construct two indices: 1) The number of muscles sites tender to palpation, and 2) signs from the joint and restricted movement. Results show that global stress was only significantly correlated with the muscle index (r = .20), but not with the other index. Only the multiple regression analyses regarding muscle disorders had a significant beta weight of global stress that remained significant when controlling for the intervening variables age, gender and psychosomatic symptoms. The pattern of the stress-specific and unspecific CMD signs was consistent with the postulated stress model. Since there are positive results with regard to the stress model in patient samples and in this unselected sample of adolescents, further research is indicated, including the concept of somatization more explicitly.

Association between CMD signs and symptoms, oral parafunctions, race and sex, in 4–6‐year‐old African‐American and Caucasian children

The associations between oral parafunctions, signs and symptoms of craniomandibular disorders (CMD), race, and sex were analysed in recordings from 203 4-6-year-old African-American and Caucasian children. Significant correlations were found between bruxism, nail biting, thumb sucking and most of the CMD signs and symptoms. There were also significant associations between most of the signs and symptoms and race, while significant association with sex was found only regarding headache, TMJ sounds and chewing pain. Significant associations were found between most CMD signs and TMJ sounds supporting the view that joint sound recordings have diagnostic value. There were also significant associations between the pain variables recorded by questionnaire and those recorded by palpation, which indicates that reliable data can be obtained by interviewing children as young as five. The results of this study support the concept that oral parafunctions have a significant role in the aetiology of CMD. The results also show that race and sex need to be considered when analysing the possible aetiological role of oral parafunctions in CMD. Longitudinal studies, beginning with low age groups are needed to better determine the role of childhood oral parafunctions in CMD aetiology.

Prevalence of signs and symptoms of craniomandibular disorders and orofacial parafunction in 4-6-year-old African-American and Caucasian children.

Children, 4-6 years old, 153 Caucasian and 50 African-American, from a pre-school and kindergarten programme in a low income industrial area, who participated in a voluntary oral health examination, were questioned and examined for signs and symptoms of craniomandibular disorders (CMD) and of oral parafunctions. Most of the CMD signs and symptoms were mild. Eight per cent had recurrent (at least 1-2 times per week) TMJ pain, and 5% had recurrent neck pain, African-American children more often than Caucasian children (P < 0.05). Seventeen per cent had recurrent headache. Three per cent had recurrent earache. Pain or tiredness in the jaws during chewing was reported by 25% of the children, more often by African-American than by Caucasian children (P < 0.001) and more often by girls than by boys (P < 0.05). Pain at jaw opening occurred in 10% of the children, more often in the African-American than in the Caucasian group (P < 0.001). Thirteen per cent of the children had problems in opening the mouth. Deviation during opening was observed in 17% and reduced opening in 2%. Reduced lateral movements, locking or luxation were not observed in any child. Palpation pain was found in the lateral TMJ area in 16%, in the posterior TMJ area in 25%, in the temporalis and masseter areas in 10%, and pain for all regions was found more often in the African-American than in the Caucasian children (P < 0.01). Thirty-four per cent of the African-American, and 15% of the Caucasian children admitted to having ear noises (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Maximal bite force and its association with signs and symptoms of craniomandibular disorders in young Finnish non-patients.

Maximal bite force values and subjective symptoms and clinical signs of craniomandibular disorders (CMD) were recorded for a non-patient sample of 129 young adults, 56 men and 73 women. The signs and symptoms of CMD were classified on the basis of Helkimo's clinical dysfunction index. The two genders reported equally frequently subjective symptoms of CMD, but women had significantly more severe clinical signs of CMD than did men. Mean maximal bite force values for men were 909 N (SD, 177) in the molar region and 382 N (SD, 133) in the incisal region and thus significantly higher than corresponding figures for women, 777 N (SD, 168) in the molar, 325 N (SD, 116) in the incisal region, suggesting that separate evaluation of the genders would be advisable in future studies involving bite force assessments. Neither subjective symptoms nor clinical signs of CMD correlated significantly with maximal bite force values. The bite force values measured were in line with theoretical calculations.

Association between craniomandibular disorders and occlusal interferences in children

The association between clinical signs of craniomandibular disorders (CMD) and occlusal interferences was studied longitudinally in two cohorts of children, 5 and 10 years of age at baseline, representing the nonpatient population. They were followed up for 5 years. The range of active participants was 96 to 106 in the younger group, and 64 to 74 in the older group. The subjects were seen annually for registration of signs of CMD and for the presence of interferences, and for a real or placebo occlusal adjustment. The double-blind study design was applied. Baseline data showed no association between the variables studied; parts of data from second and third examinations disclosed significant associations; and fourth, fifth and sixth examinations disclosed a consistent pattern of significant associations.

顎関節症の臨床像に関する研究

It has been commonly accepted that the craniomandibular disorders (CMD) have been characterized to show various clinical signs and symptoms. However the prevalence patterns of CMD signs and symptoms have not been thoroughly studied. The aim of this study was to clarify the clinical aspects of CMD. The samples were 413 CMD patients treated in our clinic. The prevalence of the symptoms were analyzed using the clinical records at first examinations. The following results were obtained.1. Age distribution showed two peaks in twenties and fifties. The ratio of male to female was about 1: 5.2. Pain of TMJ regions and masticatory muscles was the most frequent chief complaint, reported by 58.3% of patients.3. Opening pain and limited opening were frequently observed with percentage of 65.0% and 60.4% of prevalence, respectively. TMJ noise and chewing pain were followed with percentage of about 50%. Spontaneous pain was less prevalent (25.3%).4. Palpation pains of TMJ region, superficial masseter and medial pterygoid were observed in more than 50% of the patients, and those of lateral pterygoid, deep masseter, and posterior digastic were followed. Palpation pains of the other muscles were relatively low in percentage. Those of trapezius and occipital muscle were in less than 10%.5. In associated symptoms, shoulder stiffness and headache were observed in about 30% of patients, however earache, tinnitus and dizziness were less prevalent.

Temporalis and masseter muscle activity in patients with anterior open bite and craniomandibular disorders

Activity in temporalis and masseter muscles, and traits of facial morphology and occlusal stability were studied in 22 patients (19 women, 3 men; 15-45 yr of age) with anterior open bite and symptoms and signs of craniomandibular disorders. Facial morphology was assessed by profile radiographs, occlusal stability by tooth contacts, and craniomandibular function by clinical and radiological examination. Electromyographic activity was recorded by surface electrodes after primary treatment with a reflex-releasing, stabilizing splint. Maximal voluntary contraction was reduced compared to reference values, particularly in subjects with muscular affection, but maximal activity increased significantly when biting on the splint. Maximal voluntary contraction was positively correlated to molar contact and negatively to anterior face height, mandibular inclination, vertical jaw relation and gonial angle. Relative loading of the muscles was markedly increased during resting posture. It was concluded that reduced occlusal stability and long-face morphology were associated with weak elevator muscle activity with disposition overload and tenderness. The results also indicated that increase of occlusal stability might lead to increased muscle strength and possibly reduce risk of physical strain.

A survey of craniomandibular disorders in 1000 12-year-olds. Study design and baseline data in a follow-up study

One-thousand-and-eighteen 12-year-old children were chosen by use of preselected screening criteria, and disproportionate sampling to participate in a longitudinal study into the dental and social effects of malocclusion. The data has now been used to investigate the effects of malocclusion and orthodontic treatment on craniomandibular disorders. The sampling method was designed to create sub-groups large enough to study effectively the whole range of malocclusion, even those which have a low prevalence. This report will give baseline data in a longitudinal study. Intra-observer variability on recordings of signs of craniomandibular disorders was tested and reproducibility was found to be on an acceptable level. Almost half the children had signs of CMD, but few of these were severe and overall, only a very small minority of children in this sample required treatment. A preliminary examination has been made into possible relationships between the signs and symptoms of CMD, and significant associations were found between headache and several clinical signs.

Occlusal contacts in maximum intercuspation and craniomandibular dysfunction in 16- to 17-year-old adolescents

The relationship between number, distribution and intensity of occlusal tooth contacts and the craniomandibular functional status was investigated in 56 subjects aged 16-17 years. The photocclusion technique was used for the qualitative and quantitative evaluation of occlusal contacts, and a clinical examination was performed to assess the function of the stomatognathic system. According to a matched-pairs design two groups were formed, one consisting of individuals with signs of craniomandibular disorders, and the other consisting of functionally healthy adolescents. The pairs were matched according to morphological occlusal characteristics. The results of the present study emphasize the importance of occlusal contacts in relation to craniomandibular function. In particular the posterior occlusion appeared to be related to function, since statistically significant differences between the two groups were detected with regard to the number and load of contacts. Symmetry of intensity rather than symmetry of contact distribution per se seemed to be important in relation to craniomandibular function.

Association between craniomandibular disorders and occlusal interferences

No theoretical model explaining craniomandibular disorders has been generally accepted, despite the large number of studies on its etiology. This article suggests that one reason for the lack of a well-structured causal explanation could be associated with the study design most often used: cross-sectional studies of samples representative of a base population. Variation in the number of interferences was increased among the subjects by eliminating occlusal interferences annually in the treatment group (n = 53). The control group (n = 46) underwent placebo treatment. A double-blind design was used throughout the 3-year study. A cross-sectional analysis in the third year disclosed a significant association between the number of interferences and the signs of craniomandibular disorders. The results suggest that the absence of interference-free subjects in nonselected samples can be one explanation for the lack of association reported in most studies.

Clinical signs of craniomandibular disorders patients with psoriatic arthritis.

110 patients with psoriatic arthritis (PA) and 110 individually matched control subjects were examined for clinical signs of craniomandibular (CM) disorders. Patients with PA differed significantly from control patients as regards the range of mandibular movements, tenderness to palpation of the masticatory muscles and TMJs, and the frequency of TMJ sounds and painful mandibular movements. In the PA-group clinical signs of CM disorders correlated with the duration, extent and severity of PA.

Craniomandibular disorders in psoriatic arthritis. Correlations between subjective symptoms, clinical signs, and radiographic changes.

One hundred and ten patients with psoriatic arthritis (PA group) and 110 individually matched control subjects (C group) without general joint or skin disease were studied to determine correlations between radiographic changes, detected on orthopantomography, in the condyle of the temporomandibular joint and subjective symptoms and clinical signs of craniomandibular (CM) disorders. In the PA group there was a correlation, not found in the C group, between the radiographic changes, especially erosions, and subjective symptoms and clinical signs of CM disorders. The correlations found indicate that in PA subjective symptoms, clinical signs, and radiographic changes in the stomatognathic system are mainly caused by the systemic joint disease.