Presence Of Temporomandibular Disorders Research Articles

Temporomandibular disorders in a skeletal class II patietns

Background: The Temporomandibular Disorders (TMD) is the chronical orofacial pain most common, found by dentists and by other health professionals. The etiological factors for TMD are complex and they have a multifactorial character which includes, from parafunctional habits, malocclusions, abnormalities of the intra-articular disc, postural changes and even anxiety and stress. Many studies try to show the relation between malocclusions and the presence of TMD. nonetheless, there is not yet a consensus regarding the real influence of these malocclusions in relation to TMDs. This way, the patients having dentoskeletal deformities may have a stronger prevalence of these troubles.

Masticatory behaviour and chewing difficulties in young adults with temporomandibular disorders.

Difficulties and limitations on masticatory function are among the main reasons why patients with temporomandibular disorder (TMD) seek care. To evaluate the masticatory behaviour and perception of chewing difficulties in adults with mild TMD of recent onset, considering the presence of malocclusion. Eighty-one young adults were divided into groups according to the presence of TMD and malocclusion: Non-TMD Normal Occlusion (n=18), Non-TMD Malocclusion (n=22), TMD Normal Occlusion (n=18) and TMD Malocclusion (n=23). TMD was assessed using the TMD Research Diagnostic Criteria and volunteers also answered questionnaires regarding their perception about jaw functional limitation and difficulty to chew foods of different textures. Masticatory and swallowing behaviours were assessed using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Chewing time and chewing frequency taken to ingest the test-food were also obtained. Two-way-ANOVA was used to analyse the TMD, occlusion and TMD×occlusion interaction effects. Temporomandibular disorder effect was observed on vertical jaw mobility and jaw function limitation total scores, meaning that groups differed in the perception of opening limitation and mandibular limitation according to TMD status with a medium effect size. Also, more changes in chewing function (OMES-chewing score) and higher chewing frequency was observed in the presence of TMD (P<0.05). Occlusion effect was only observed on OMES-swallowing score and no TMD×occlusion interaction effect was observed. Changes in chewing behaviour, frequency and perception of mandibular limitation was observed in the presence of TMD, pointing out the importance of functional evaluation when planning and establishing a treatment plan.

Assessment of the impact of temporomandibular disorders on maximum bite force.

Temporomandibular disorders (TMD) refer to functional disorders of the masticatory system, temporomandibular joint (TMJ) and masticatory muscles. The main objective of this study was to determine whether and to what extent temporomandibular disorders (TMD) affect the maximum bite force (MBF). The present study included subjects with and without temporomandibular disorder. The presence of TMD was assessed by means of the Helkimo clinical dysfunction index analysis. We measured the maximum bite pressure (MBP) and occlusal contact area (OCA) by means of a Fuji Prescale Pressure measurement film. Based on the MBP and OCA values obtained, MBF values were determined. The MBF values were significantly lower in patients with TMD compared to subjects without TMD (P Conclusion: TMDs have a significant impact on MBF and masticatory muscle action potential. More research is needed to determine the impact of reduced maximum bite force on the functional efficiency of the masticatory system.

Prevalence of temporomandibular joint disorder in people with Parkinson’s disease in a public university hospital

ABSTRACT Objective: to evaluate the prevalence of temporomandibular joint disorder in people with Parkinson’s disease in a public university hospital, and relate it to sociodemographic factors, general health and oral health self-report, and phase and time of illness. Methods: the Research Diagnostic Criteria for Temporomandibular Disorders were used. The sample was classified according to the diagnosis of temporomandibular disorder and associated with the variables. The odds ratio of Chi-square was applied with a 95% confidence interval and a level of significance set at p&lt;0.05. Results: 110 people presented with Parkinson's disease were assessed. The prevalence of temporomandibular disorder was 35%, being more frequent among males (58%), in elderly people (53%), in phase 2 of the disease (61%), click (37%) being the predominant clinical indication. Of the variables analyzed, only gender and self-perception of oral health showed to be associated with temporomandibular disorders. Conclusion: the presence of temporomandibular disorder has been observed in people with Parkinson's disease, and the fact of being male and reporting moderate oral health seen as associated factors.

Relationship between Cervical Spine and Skeletal Class II in Subjects with and without Temporomandibular Disorders

Aim To assess changes in the craniocervical structure and in hyoid bone position in skeletal Class II subjects with and without temporomandibular disorders (TMD). Materials and Methods The cephalometric analysis of 59 subjects with skeletal Class II was evaluated and compared. The measurements considered were ANB as a parameter of Class II and C0-C1 distance, C1-C2 distance, craniocervical angle, and hyoid bone position for the cervical spine analysis. Patients were divided into patients with TMD (group A) and patients without TMD (group B). TMD were evaluated with Diagnostic Criteria for TMD (DC/TMD). Descriptive statistics and Pearson's and Spearman's correlation analysis, with p value <0,005, were performed. Results C0-C1 and C1-C2 distance values and hyoid bone position resulted within the normal range in the majority of patients examined. Craniocervical angle was altered in 33 patients. The reduction of this angle with the increase of the ANB value resulted to be statistically significant in group A, according to Pearson's correlation index. No other data were statistically significant. Conclusions The significant relationship between skeletal Class II and cervical spine cannot be highlighted. The alteration of craniocervical angle seems to be mildly present, with backward counterclockwise rotation of the head upon the neck in the sample (groups A and B). The presence of TMD as a key factor of changes in neck posture could explain the different result between the two groups about the relationship between ANB and craniocervical angle. This result should be further analyzed in order to better understand if cervical spine changes could be related to mandibular postural ones in the craniocervical space or to temporomandibular joint retropositioning, more recognizable in Class II with TMD, which could determine functional changes in other structures of this unit; neck posture could be the result of a compensatory/antalgic mechanism in response to TMD.

Prevalence of the Signs and Symptoms of Temporomandibular Disorders Among Spanish Adults and Seniors According to Five National Surveys Performed Between 1993 and 2015.

To determine the prevalence of the signs and symptoms of temporomandibular disorders (TMD) and associated variables over the past two decades in samples of Spanish adults and seniors. Data from Spanish national oral health surveys from the last two decades (1993, 2000, 2005, 2010, and 2015) were analyzed from a total of 2,602 adults (35-44 years of age) and 2,529 seniors (65-74 years of age). All surveys were carried out using similar methods (according to World Health Organization standards) for determining prosthetic, dental, and periodontal statuses. For TMD (assessed only among the adults and seniors), inspection/palpation of the temporomandibular joint and masticatory muscles was used to evaluate three different domains: joint sounds; pain-related conditions (joints/muscles); and range of jaw motion. Risk factors were identified using bivariate analysis and were confirmed after a multivariate logistic regression analysis for predicting the presence of TMD pain/dysfunction. Despite the clear improvement in oral health status observed over the entire study period (1993-2015), the prevalence of temporomandibular pain and dysfunction increased over time in both adults and seniors (the odds ratio [OR] 95% confidence interval [CI] for the entire study period increased, to 2.39 to 4.29). The odds of women and those living in rural areas developing TMD were higher than for men (OR = 1.85; 95% CI 1.52 to 2.25; P < .001) and for those living in urban areas (OR = 1.55; 95% CI 1.24 to 1.94; P < .001), respectively; however, the prevalence of joint sounds (with no pain or functional restrictions) appeared to be stable throughout the study period at around 14%. The prevalence of painful or dysfunctional TMD has significantly increased in the last 22 years in Spain. Besides the time factor, other major predictors of TMD were gender and place of residence.

Temporomandibular joint disorder determined by Fonseca anamnestic index and associated factors in 18- to 27-year-old university students

ABSTRACT Objective The aim of this study was to investigate temporomandibular disorder (TMD) and associated risk factors. Methods This study was conducted using 212 university students. Based on the Fonseca anamnestic index, the population was divided into two groups: those with TMD and those without TMD. The two groups were compared in terms of global body posture, craniohorizontal and craniovertebral angles, neck and temporomandibular joint range of motion, stress level, and sleep quality. Results Stress level, sleep quality, and left cervical rotation were found to have statistical differences between the groups (p = 0.00, 0.00, and 0.046, respectively). Sleep quality and stress level were found to be important risk factors for the presence of TMD (p = 0.017 and 0.00, respectively). Discussion In the prevention and treatment of TMD, a holistic approach that evaluates mechanical factors and psychosocial factors should be adopted.

Temporomandibular disorder symptoms and their association with quality of life, emotional states and sleep quality in South-East Asian youths.

Population studies on the prevalence of temporomandibular disorders (TMD) and their associations with quality of life (QoL), emotional states and sleep quality in South-East Asian youths are not available. This cross-sectional study assessed the presence of TMD and their relationships to QoL, depression, anxiety, stress and sleep quality in a cohort of South-East Asian adolescents/young adults. Three hundred and sixty-two students from a polytechnic were enrolled in the study and completed an online questionnaire consisting of the Fonesca's Anamnestic Index (FAI), Oral Health Impact Profile for TMD (OHIP-TMD), Depression, Anxiety and Stress Scales-21 (DASS-21) and Pittsburgh Sleep Quality Index. The FAI appraises TMD severity while OHIP-TMD determines the effect of TMD on oral health-related QoL. Statistical analysis was performed using chi-square test for categorical data whilst one-way ANOVA/post hoc Bonferroni's tests were employed for numerical scores (P<0.05). Of the 244 participants who completed the questionnaires in their entirety (37 males; 207 females, mean age 20.1±3.2years), 32.4% had mild TMD, 9.4% had moderate TMD and 58.2% were TMD free. The total prevalence of TMD was 41.8% (n=102) and most OHIP-TMD domains including functional limitation (P=0.000), physical pain (P=0.000), handicapped (P=0.000) and psychological discomfort (P=0.001) showed significant differences in mean scores depending on TMD severity. A similar trend was observed for DASS-21. The majority of participants with TMD (69.6%; n=71) had poor sleep quality (P=0.004). TMD appear to be prevalent in South-East Asian youths with varying severity. Severity of TMD had some bearing on QoL, emotional states as well as sleep quality.

Association of Oral Conditions with Quality of Working Life of Brazilian Police Officers

Objective: To evaluate the impact on the quality of working life of Brazilian police officers with Temporomandibular Disorders (TMD). Materials and Methods: The sample consisted of 52 subjects and information was collected through the WHOQOL-BREF questionnaire and the Fonseca Anamnesis Index to evaluate the level of temporomandibular disorder (TMD), followed by clinical examination to determine the experience of dental caries, by means of the DMFT index. Descriptive and inferential statistical analysis (chi-square test) was performed through the Statistical Package for the Social Sciences software. The significance level was 5%. Results: The sample was predominantly composed of males (94.2%) with a mean age of 39.4 years (±9.4) and mean service length of 17.3 years (±11.0). The mean DMFT index value was 15.6 (±6.1), especially the "filled" component, whose mean was 12.1 (±5.4). The presence of TMD was found in 67.3% of the sample, of predominating mild degree (91.4%). Quality of working life (QWL) was classified as unsatisfactory/neutral by 57.7% of participants. There was a statistically significant association between QWL and presence of TMD (p&lt;0.05); however, there was no association between DMFT index and the presence of TMD (p&gt;0.05). Conclusion: Although military police officers presented a high mean DMFT index value, there was highest prevalence of the "filled" component, evidencing a past experience of caries and evidencing that this population has access to oral health services. The occurrence of TMD was high, predominating the mild degree, and there was an association with QWL.

Association of temporomandibular disorder and high frequency of suicide ideation in Korean adolescents: a cross-sectional survey

Background: This study investigated the association between psychological factors and temporomandibular disorder (TMD) in a representative sample using data from the Korean nationwide survey.Methods: The study included 1337 adolescents. Participants provided demographic, socio-economic and behavioural information, and responses to questionnaires assessing their mental health status including perceived stress, depressed mood and suicidal ideation in the presence of TMD. In univariate analysis, t-test was used to test the association between TMD and risk factors by gender in a complex sampling design. Multivariate logistic regression analyses were used to examine the association between TMD and psychological factors.Results: Male adolescents with TMD were highly engaged with depressed mood and suicidal ideation (p = .0006, p = .0223), however, no psychological factors were significant in female adolescents (p < .05). Male adolescents with both depressed mood and suicidal ideation had significantly high rates of TMD (p = .0024). The risks for experiencing depressed mood (OR: 3.07) and suicidal ideation (OR: 2.564) were significantly associated with TMD in male adolescents after adjusting confounders.Conclusions: The results provide evidence that the depressed mood and suicidal ideation were associated with TMD in male adolescents. This study has important implications for enhanced screening and evaluation of mental health among patients with TMD according to gender.

The Relationship of Tempromandibular joint disorders with Bony Exostosis in the Oral Cavity

The temporomandibular joint (TMJ) may be affected by inflammatory, traumatic, infectious, congenital, and developmental, as seen in other joints. However, the most common affliction of the TMJ and masticatory apparatus is a group of functional disorders with associated pain that occurs predominantly in women and was previously known as the TMJ pain dysfunction syndrome. Since 1978, there have been substantial changes in the study of etiologic factors, pathophysiology, diagnosis, and management of what are now called temporomandibular disorders (TMD).(1)The general perception that all symptoms in the head, face, and jaw region without an identifiable cause constitute a "TMJ" problem is clearly unfounded.Although some oral lesions, such as torus palatinus and torus mandibularis are normal variants, but require prompt diagnosis and sometime treatment to reduce the potential for serious complication and enhance prosthodontic treatment. The purpose of this study is to inspect the relation of TMJ dysfunction syndrome to the presence of oral exostosis, and find the prevalence of torus palatinus (TP) and torus mandibularis (TM)The sample consisted of 932 teachers, 301 males and 631 females were examined for the presence of TMD, TP and / or TM. Analysis was carried out according to age, gender, TMJ dysfunction and the presence of TP and TM.Results indicated that 123(16.1%) had at least one symptoms of TMD, where as 49 (5.3%) had TP; and 67 (7.2) had TM. The male: female prevalence ratios of TP and TM were 1: 3.42 and 1: 1.81 respectively. The results revealed that significant relationship between TMD and tori, and increase in percentage of mandibular tori with the presence of TMJ dysfunctional syndrome more than maxillary tori were found.TP and TM were more frequent in females and there is significant relation between the TP and TM with presence of TMJ dysfunction syndrome ( P&lt; 0.05 ) especially TM , the presence of TM might be useful to look for sign of dysfunction.

Relationship between Expanded Disability Status Scale scores and the presence of temporomandibular disorders in patients with multiple sclerosis.

Objectives:The objectives of this study were to assess the prevalence of temporomandibular disorders (TMDs) in patients with relapsing-remitting multiple sclerosis (MS) and to investigate whether an association exists between the presence of TMD symptoms and the degree of MS-related disability.Materials and Methods:In all, 120 individuals were evaluated: 60 patients with a diagnosis of relapsing-remitting MS and 60 age- and sex-matched controls without neurological impairments. A questionnaire recommended by the European Academy of Craniomandibular Disorders for the assessment of TMD symptoms was administered. For those who answered affirmatively to at least one of the questions, the RDC/TMD Axis I instrument was used for a possible classification of TMD subtypes. The Expanded Disability Status Scale (EDSS) was the measure of the degree of MS-related disability.Statistical Analysis Used:Fisher's exact test was used to analyze the data. ANOVA was used to detect significant differences between means and to assess whether the factors influenced any of the dependent variables by comparing means from the different groups.Results:The prevalence of TMD symptoms in patients with MS was 61.7% versus 18.3% in the control group (CG). A diagnosis of TMD was established for 36.7% in the MS group and 3.3% in the CG (P = 0.0001). There were statistically significant differences between degrees of MS-related disability and the prevalence of TMD (P = 0.0288).Conclusions:The prevalence of both TMD and TMD symptoms was significantly greater in the MS group. EDSS scores and TMD prevalence rates were inversely related.

Association Between Polymorphisms in the Genes of Estrogen Receptors and the Presence of Temporomandibular Disorders and Chronic Arthralgia

The high prevalence of painful temporomandibular disorders (TMDs) in women suggests that estrogen and its receptors play a fundamental etiologic role in the development of this joint pathology through complex action mechanisms. The aim of this study was to evaluate the possible association between polymorphisms in the ESR1 (estrogen receptor-1) and ESRRB (estrogen-related receptor-β) genes and the risk of simultaneous development of TMDs and pain in other joints in the body. All participants were clinically evaluated for the presence of TMD (Research Diagnostic Criteria for TMD) and asked about the presence of chronic joint pain. The control group consisted of 72 patients without TMD and without pain. Participants with arthralgia were divided into 3 groups: with muscular TMD (n=42), with articular TMD (n=16), and without TMD and with systemic arthralgia (n=82). Eight single-nucleotide polymorphisms in the ESR1 (rs12154178, rs1884051, rs2273206, rs7774230) and ESRRB (rs1676303, rs4903399, rs10132091, rs7151924) genes were investigated. The χ2 test and Student t and Mann-Whitney tests were used to assess the relevance of nominal and continuous variables, respectively. A P value less than .05 was considered significant. The TT (timin/timin) genotype for the ESR1 (rs2273206) gene was strongly associated with the risk of developing muscle TMDs and temporomandibular joint pain (P=.04). For the ESRRB (rs1676303) gene, an association was observed between the CC (cytosine/cytosine) genotype and the presence of articular TMDs associated with other chronic arthralgia (P=.02). These results were confirmed by the increased risk of developing articular TMDs associated with the C allele (P=.04). This study supports the hypothesis that changes in the ESR1 and ESRRB genes influence the presence of TMDs associated with chronic joint pain.

Are Pain-Related Temporomandibular Disorders the Product of an Interaction Between Psychological Factors and Self-Reported Bruxism?

To investigate whether pain-related temporomandibular disorders (TMD) are the product of an interaction between psychological factors and self-reported bruxism activities. Patients referred to a specialized clinic for complaints of orofacial pain and dysfunction completed a digital questionnaire prior to the first clinical visit. The patient sample was then split into a case group consisting of 268 patients diagnosed with TMD pain according to the Diagnostic Criteria for Temporomandibular Disorders (85.8% women; mean ± standard deviation [SD] age = 40.1 ± 14.5 years) and a control group consisting of 254 patients without any pain in the orofacial area (50.8% women; 46.9 ± 13.6 years). The possible moderating roles of six psychological factors (depression, somatic symptoms, anxiety, stress, optimism, and prior psychological treatment) on the relationship between self-reported bruxism and the clinical presence of TMD pain were examined. Patients with TMD pain reported significantly more bruxism than patients without any report of orofacial pain. Furthermore, bruxism intensity was associated with a variety of psychological factors; however, there were no significant interactions between any of the psychological factors and bruxism with respect to the clinical presence of TMD pain. These findings do not support the view that the effect of bruxism on TMD pain is stronger in patients who experience higher levels of psychological distress compared to those with lower levels of distress.

Influence of anthropometry, TMD, and sex on molar bite force in adolescents with and without orthodontic needs.

Bite forcehas been studied as representative of functional indices of mastication and its value may have diagnostic significance in disorders of the musculoskeletal system of facial bones. This study aimed to evaluate bite force in adolescents with and without orthodontic needs considering presence of temporomandibular disorders (TMD) as well as anthropometry: craniofacial dimensions and body mass index (BMI). A total of 80 subjects were screened (61 females, 19 males; 18±3years old). Unilateral molar bite force was measured using a digital dynamometer with a fork thickness of 12mm. Direct anthropometry was used to quantify craniofacial measurements. Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were used to classify samples according to malocclusion and to TMD, respectively. Data were analyzed using normality tests, Mann-Whitney U test, and multiple linear regression analyses with stepwise backward elimination, controlling for the presence of malocclusion and TMD (p≤0.05). The cephalic index was greater in females with malocclusion and the longitudinal cranial diameter was reduced in females with malocclusion. BMI was not different between normal and malocclusion groups for either gender. Bite force was negatively related with vertical dimension of the face, and positively related with facial width and facial index. The model explained 32% of bite force variability, considering the sample size (coefficient of determination R 2=0.324). Even when orthodontic needs and TMD signs and symptoms are present, stronger bite force is still observed in males and in subjects with smaller anterior facial heights and wider facial widths.

The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms.

The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study the influence of possible confounding factors on this association, the regression models were extended with age, sex, bruxism, stress, depression, and somatic symptoms. Of the included patients (n=203), 67.5% experienced headaches. In the subsample of patients with a painful TMD (n=58), the prevalence of self-reported headaches increased to 82.8%. The associations found between self-reported headache and (1) painful TMD and (2) function-related TMD were confounded by the presence of somatic symptoms. For probable migraine, both somatic symptoms and bruxism confounded the initial association found with painful TMD. The findings of this study imply that there is a central working mechanism overlapping TMD and headache. Health care providers should not regard these disorders separately, but rather look at the bigger picture to appreciate the complex nature of the diagnostic and therapeutic process.

Haplotypes of the RANK and OPG genes are associated with chronic arthralgia in individuals with and without temporomandibular disorders

The aim of this study was to evaluate the association between genetic polymorphisms and the comorbid presence of chronic systemic arthralgia in patients with articular temporomandibular disorders (TMD). Subjects were evaluated for the presence of TMD and asked about the presence of chronic joint pain. Four groups were included in the study: articular TMD and systemic arthralgia (n=85), no articular TMD and systemic arthralgia (n=82), articular TMD and no systemic arthralgia (n=21), no articular TMD and no systemic arthralgia (control, n=72). A total of 14 single nucleotide polymorphisms in the OPG, RANK, and RANKL genes were investigated. In the statistical analysis, a P-value of <0.05 was considered significant. For the OPG gene, an association was observed between the group with chronic arthralgia and joint TMD and the control group (P=0.04). There was also a tendency towards an association of the haplotype CGCCAA with an increased risk of developing chronic joint pain, even in the absence of TMD (P=0.06). For the RANK gene, the AGTGC haplotype was associated with the lowest risk of presenting chronic joint pain in individuals without TMD (P=0.03). This study supports the hypothesis that changes in the OPG and RANK genes influence the presence of chronic joint pain in individuals with and without TMD.

Evaluation of depressive symptoms and quality of life in individuals with tinnitus and temporomandibular disorders

Various etiologies are attributed to the development of subjective tinnitus, but their inter-relationship with the presence of temporomandibular disorders and depression is still poorly understood. To assess the presence of depressive symptoms in individuals with TMD and subjective tinnitus, assessing the impact on their quality of life. This is a cross-sectional observational descriptive study. We evaluated 44 patients in a public University. For TMD diagnosis as well as assessment of depressive symptoms, the RDC/TMD questionnaire was used. Otolaryngological assessment was conducted by means of pure tone, speech, and immitance audiometry. The “Tinnitus Handicap Inventory” questionnaire was also administered. 84% of the individuals with tinnitus had myofascial pain, with the masseter muscle being the most prevalent area of pain, and 16% exclusively had painful and/or degenerative TMJ changes. Among the patients with myofascial pain, 86,5% had depressive symptoms, while among those without myofascial pain, only 42,8% presented these symptoms. Eleven (11) patients (25%) reported slight impact of tinnitus on quality of life, 15 (34%) mild impact, 7 (16%) moderate, 7 (16%) severe, and 4 (9%) catastrophic impact. There was a positive association between the presence of myofascial pain and depressive symptoms (p=0,02), as the intensity of tinnitus increases and the severity of depressive symptoms (p

Influence of the presence of Temporomandibular Disorders on postural balance in the elderly

To investigate the influence of the presence of Temporomandibular Disorders (TMD) on postural balance in elderly individuals. The study sample consisted of 150 elderly: 103 women (67.7±5.0 years) and 47 men (69.3±5.5 years). Evaluation of the presence and severity of TMD included an anamnesis questionnaire, an evaluation of the temporomandibular joint (TMJ), and a muscular examination, which allowed the division of the elderly into 2 groups: G1 (experimental, n=95), with TMD; G2 (control, n=55), without TMD. Postural balance was assessed by means of the one-leg stance test (OLST) on a force platform (BIOMEC400), thus permitting the following measurements: center of foot pressure (COP); mean sway velocity (MV) and frequency (MF) of COP in both the anteroposterior (VAP and FAP) and medial/lateral (VML and FML) directions. The statistical analysis of data was performed using independent t-test, Variance Analysis, and Chi Square test (α=5%). Presence of TMD was observed in 63.3% of the individuals (Group 2), with different degrees of severity (mild: 42.7%, moderate: 14.7%, severe: 6%). Significantly higher TMD was observed for women (73.8%) compared with men (40.4%) (p=0.0002). No significant difference was found in between the groups for all balance parameters, e.g., presence and severity of TMD, presence of pain to palpation of TMJ and of masticatory and cervical muscles. The presence and severity of TMD, in addition to the presence of pain to palpation of TMJ and masticatory and cervical muscles did not alter the variables related to postural balance in this population.

Psychosocial aspects and temporomandibular disorders in dental students.

Dental students have high levels of anxiety that can affect not only academic performance but also increase the risk for other diseases. It is believed that the increase in the incidence of chronic orofacial pain in temporomandibular disorders (TMDs) may have an impact on the quality of life and general health of subjects. The aim of this study was to evaluate the prevalence of TMD in dental students and its association with general health, quality of life, and anxiety. Ninety students were evaluated by four questionnaires to determine the prevalence and sever-ity of TMD (Fonseca's questionnaire) and to quantify general health (General Health Questionnaire - GHQ), quality of life (World Health Organization Quality of Life - Brief version - WHOQOL-brief) and anxiety levels (State-Trait Anxiety Index - STAI). Approximately 58.9% of dental students presented TMD. Among the indicators of general health, psychologic stress (P = .010), distrust in their own performance (P = .012), and psychosomatic disorders (P = .020) showed a statistically significant difference with the presence of TMD. The four areas proposed in the questionnaire regarding quality of life, such as physical (P = .016), psychologic (P < .001), social (P = .045), and environmental (P = .017) factors also showed significant differences with the presence of TMD. A high prevalence of TMD was observed in dental students. In addition, some psychologic domains are important psychosocial indicators associated with the presence of TMDs.