Signs Of Mandibular Dysfunction Research Articles

Chronic or atrophie masticatory myositis in the dog. A report of two spontaneous cases

Two young adult dogs (case 1: German wirehaired pointer male, case 2: mongrel female) were admitted to our Clinic because of a progressive, bilateral and symmetrical atrophy of the masticatory muscles, that was most obvious in the temporal muscles. No signs of mandibular dysfunction were detected in both animals. The clinical diagnosis of chronic or atrophic myositis was confirmed by the histopathology of temporal muscle biopsies, which revealed the typical of the disease lesions, such as myofiber degeneration, regeneration and atrophy, interstitial or perivascular cellular infiltrates, chiefly of lymphocytes and plasma cells plus perimysial fibrosis. Temporal muscle electromyography, done only in case 1, showed abnormal spontaneous activity indicating myositis. The use of prednisolone at immunosuppressive doses, with or without azathioprine, not only stopped the progression of the disease but resulted in a partial restoration of the masticatory muscle mass.

Occlusal abnormalities, pericranial muscle and joint tenderness and tooth wear in a group of migraine patients

Seventy-two migraine sufferers, whose attacks normally begin during or soon after waking from sleep, were compared with 37 age- and sex-matched controls to establish whether signs of mandibular dysfunction, occlusal discrepancies and known clenching or grinding habits were any more frequent among the former group. Temporomandibular joint tenderness or pain history, masticatory muscle tenderness and known clenching or grinding habits were found to occur at significantly increased levels in the migraine sufferers, with two-thirds of these patients reporting a parafunctional habit. Occlusal abnormalities, including non-working side or protrusive interferences and slides of greater than 1 mm to the intercuspal position, were found to occur at similar frequencies in the two groups. Assessment of wear of the occlusal surfaces also showed no difference, suggesting that any nocturnal habit with a role in migraine is more likely to be clenching in nature. In conclusion, evidence was found to support an aetiological role for nocturnal tooth clenching or grinding in migraine characterized by attacks that start predominantly during sleep or soon after waking, but no evidence of a link with occlusal factors was found in these patients.

バイトプレーンの装着がそしゃく筋筋電図に及ぼす影響 Ｉ タッピング運動時の筋活動について

The purpose of this study is to examine the influence of the insertion of bite plane on masticatory muscle activity during tapping movement, and find out useful parameters for examination and diagnosis of stomatognathic dysfunction. The subjects in this study were twenty normal subjects with intact dentition and no signs of mandibular dysfunction as the control group, and twelve subjects with unilateral temporomandibular joint pain during jaw opening or closing movement as the patient group. Electromyographic activity in the bilateral anterior temporal and masseter muscles and mandibular movement using the Mandibular Kinesiograph were recorded simultaneously during tapping movement. The usefulness of the 61 items used in this study was evaluated. The results were summarized as follows: 1. In the patient group, a significant correlation between the jaw opening degree during tapping movement and the maximal jaw opening one without pain was recognized. 2. The total muscle activity in the patient group decreased significantly by the insertion of the bite plane. 3. Many subjects of the patient group showed a significant difference between the right and left activity of each muscle. 4. A significant difference between the two groups was found in the duration of muscle activity before and after Silent period, those coefficients of variation and the difference between those durations of the right and left muscle activity. This study suggests that the above factors are very useful parameters for examination and diagnosis of temporomandibular joint dysfunction.

Mandibular dysfunction in adulthood in relation to morphologic malocclusion at adolescence.

The purpose of this 20-year follow-up study was to assess whether pronounced morphologic traits of malocclusion, persisting from adolescence to about 35 years of age, imply an increased risk of persistent and severe mandibular dysfunction. In 1965-66 malocclusion was recorded in 176 adolescents; in 1981 these persons responded to a questionnaire concerning symptoms of functional disorders, and in 1986-87 malocclusion and signs of dysfunction were registered. Highly significant associations were observed between some of the self-reported symptoms and the signs registered 5-6 years later. Spearman correlation coefficients between the persistent traits of malocclusion, occurring at both examinations, and the signs of mandibular dysfunction were low in general. No association was found between the most severe and persistent functional disorders and any particular malocclusion. It is concluded that orthodontic screening of morphologic malocclusion in childhood would seem of limited value in attempts to predict mandibular dysfunction in adulthood.

Relationship between signs and symptoms of mandibular dysfunction in adolescents.

The relationship between signs and symptoms of mandibular dysfunction was studied in 285 17-yr-old adolescents living in the municipality of Skellefteå, Sweden. Of the sample 62% had either some sign or symptom of dysfunction, and there was a positive correlation (P less than 0.05) between the two indices used. Neither morphologic nor functional malocclusions were related to the anamnestic dysfunction index. Signs of mandibular dysfunction were significantly more frequently found in those with a feeling of fatigue in the jaw (P less than 0.001). TMJ sounds were related to palpation tenderness in the lateral pterygoid muscle and to impaired horizontal mobility of the mandible. The most frequent symptom related to various signs of mandibular dysfunction was feeling of fatigue in the jaws which suggests that this is an early symptom of muscular origin that should be observed more closely. The study supports the view that even a moderate reduction of mouth opening capacity may indicate mandibular dysfunction and we recommend that this variable be routinely recorded.

Two-year longitudinal study of signs of mandibular dysfunction in adolescents.

Signs of mandibular dysfunction in adolescents were studied longitudinally from the age of 17 to 19 years. Totally, 27 subjects dropped out, leaving 258 for the longitudinal intraindividual comparisons. TMJ sounds were found in about one-fifth of the adolescents and were recorded significantly more often in girls than boys from the age of 18 years. The frequency of muscles tender to palpation fluctuated somewhat between the annual examinations. At the first and second examination muscle tenderness was statistically significantly commoner in girls than in boys. Except for TMJ sounds and muscle tenderness signs of mandibular dysfunction were rare. About half of the subjects had signs of mandibular dysfunction, mostly of mild character. Girls regularly had significantly higher dysfunction index (Di) values than boys. No change between the annual recordings was noted in 60% of the individuals, and impairment and improvement had occurred about equally often. In 29%, signs were recorded all years.

Stability of results and function of the masticatory system in patients treated with the Herren type of activator.

Forty-nine individuals, aged 15–24 years, who had been out of retention for 3–8 years after treatment of distal occlusion with the Herren type of activator were examined for stability of the treatment results and the function of the masticatory system. The examination comprised measurements on dental casts of the overjet, overbite, molar relation and length, widths and relative space of the dental arches. Facial morphology was analysed from profile cephalograms and the function of the masticatory system by means of a questionnaire and a clinical examination. The treatment had brought about a substantial reduction of the overjet that was essentially stable after retention. The long-term effect on the overbite was slight. After retention, a partial relapse in the molar relation improvement achieved during active treatment occurred in the majority of subjects. The changes in upper arch widths were within the limits for normal growth. There were no marked changes in lower arch widths but the width between the lower canines tended to decrease. The dental arch lengths decreased and the crowding increased in both arches after retention. The morphology of the face at the follow-up examination was within normal limits except for a total facial retrognathism. The treatment had generally not brought about a lasting proclination of the lower incisors. The lip profile was also normal. The prevalence of symptoms and signs of mandibular dysfunction was in agreement with that found in random samples of untreated individuals. The prevalence of a large distance between the retruded contact and intercuspal positions of the mandible was high, however, indicating a functionally less statisfactory occlusion in part of the sample.

Relationship between occlusal factors and signs and symptoms of mandibular dysfunction. A clinical study of 48 dental students.

Forty-eight young adults answered a questionnaire and were examined clinically for determination of symptoms and signs of mandibular dysfunction in accordance with the Helkimo indices. Occlusal conditions recorded included contacts in centric and excentric mandibular positions in accordance with specified criteria for registration of "ideal occlusion', various occlusal patterns, occlusal interferences, and dental attrition. Relatively frequent but mainly mild signs and symptoms of mandibular dysfunction were found. The occlusal conditions were extremely varied and did not show any significant correlations with signs and symptoms of mandibular dysfunction.

Stability of results and function of the masticatory system in patients treated with the Herren type of activator

Forty-nine individuals, aged 15–24 years, who had been out of retention for 3–8 years after treatment of distal occlusion with the Herren type of activator were examined for stability of the treatment results and the function of the masticatory system. The examination comprised measurements on dental casts of the overjet, overbite, molar relation and length, widths and relative space of the dental arches. Facial morphology was analysed from profile cephalograms and the function of the masticatory system by means of a questionnaire and a clinical examination. The treatment had brought about a substantial reduction of the overjet that was essentially stable after retention. The long-term effect on the overbite was slight. After retention, a partial relapse in the molar relation improvement achieved during active treatment occured in the majority of subjects. The changes in upper arch widths were within the limits for normal growth. There were no marked changes in lower arch widths but the width between the lower canines tended to decrease. The dental arch lengths decreased and the crowding increased in both arches after retention. The morphology of the face at the follow-up examination was within normal limits except for a total facial retrognathism. The treatment had generally not brought about a lasting proclination of the lower incisors. The lip profile was also normal. The prevalence of symptoms and signs of mandibular dysfunction was in agreement with that found in random samples of untreated individuals. The prevalence of a large distance between the retruded contact and intercuspal positions of the mandible was high, however, indicating a functionally less statisfactory occlusion in part of the sample.

Prevalence of recurrent headache and mandibular dysfunction in patients with unsatisfactory complete dentures.

The prevalence of headache and mandibular dysfunction was studied in 43 patients with unsatisfactory complete dentures waiting for prosthodontic treatment at the Dental Clinic of the National Dental Service in Jokkmokk, Sweden. In addition to answering a questionnaire, all patients underwent a clinical-functional examination of the masticatory system. Seventeen patients (40%), 15 women and two men, reported recurrent headache. 63% of the men and 83% of the women showed marked clinical signs of mandibular dysfunction. A significant correlation between headache and mandibular dysfunction was found. The low representation of complete denture wearers in clinical series of patients referred for treatment of mandibular dysfunction may be due to a reduced propensity to seek help and a greater willingness to accept a certain degree of dysfunction compared with other people.

Short term evaluation of counselling and occlusal adjustment in patients with mandibular dysfunction involving the temporomandibular joint

Summary The effect of counselling and occlusal adjustment was investigated in thirty patients with mandibular dysfunction involving the temporomandibular joint (TMJ). The patients were examined at three visits 6 weeks apart. At the first visit all patients received counselling. At the second visit they were divided into two groups, one receiving occlusal adjustment and the other not receiving treatment. The degree of mandibular dysfunction was assessed by the patients according to a five grade scale and by the clinical dysfunction index according to Helkimo (1974a). The score of subjective dysfunction was reduced significantly during the period following counselling and 60% of the patients improved. No effect was found on the clinical dysfunction score. The score of clinical dysfunction was reduced significantly during the period following occlusal adjustment and 67% of the patients improved. No further effect could be detected on the subjective dysfunction score. The correlation between changes in subjective and clinical dysfunction was poor, but changes in the subjective score were generally associated with changes in the clinical score. It was concluded that counselling may reduce the subjective symptoms; and occlusal adjustment the clinical signs of mandibular dysfunction involving the TMJ, but that the individual variation in response is substantial.

Symptoms and signs of mandibular dysfunction in 70‐year‐old men and women in Gothenburg, Sweden*

A representative systematic selection of 30% of all 70-year-olds in Gothenburg were invited to a population study. Forty percent of the sample (384 persons) were subjected to a comprehensive dental examination. The participation rate was 84%. The aim of the present study was to describe the function and dysfunction of the masticatory system of the 70-year-olds. 41% reported no symptoms of dysfunction while 46% had severe dysfunction according to HELKIMO'S Anamnestic Dysfunction Index. The clinical examination revealed that only 14% had no signs of dysfunction. 32% had moderate or severe dysfunction according to Helkimo's Index. In more than half of the subjects the masticatory muscles were tender to palpation and in 37% TMJ sounds were diagnosed. Several of the clinical findings were more common in the women than in the men but only concerning tenderness of the TMJ and the masseter muscle were the differences significant. The degree of dental invalidity was measured by Eichner's Index. The Index showed no or only weak relation to the Anamnestic and Clinical Dysfunction Indices. Neither did the degree of dysfunction in complete denture wearers vary with the condition of their prostheses.

Short term evaluation of counselling and occlusal adjustment in patients with mandibular dysfunction involving the temporomandibular joint

The effect of counselling and occlusal adjustment was investigated in thirty patients with mandibular dysfunction involving the temporomandibular joint (TMJ). The patients were examined at three visits 6 weeks apart. At the first visit all patients received counselling. At the second visit they were divided into two groups, one receiving occlusal adjustment and the other not receiving treatment. The degree of mandibular dysfunction was assessed by the patients according to a five grade scale and by the clinical dysfunction index according to Helkimo (1974a). The score of subjective dysfunction was reduced significantly during the period following counselling and 60% of the patients improved. No effect was found on the clinical dysfunction score. The score of clinical dysfunction was reduced significantly during the period following occlusal adjustment and 67% of the patients improved. No further effect could be detected on the subjective dysfunction score. The correlation between changes in subjective and clinical dysfunction was poor, but changes in the subjective score were generally associated with changes in the clinical score. It was concluded that counselling may reduce the subjective symptoms; and occlusal adjustment the clinical signs of mandibular dysfunction involving the TMJ, but that the individual variation in response is substantial.