Symptoms Of Craniomandibular Disorders Research Articles

Correlation between dento-skeletal characteristics and craniomandibular disorders in growing children and adolescent orthodontic patients: retrospective case-control study.

The aim of this retrospective case-control study was to identify, in a group of growing children and adolescents affected by malocclusion, specific dento-skeletal characteristics which could be correlated to the onset, in the above-mentioned subjects, of craniomandibular disorders (CMD). Among the patients treated at the Paedodontics and Orthodontics department of Bari Dental School, we recruited a group of patients with malocclusion and symptoms of temporomandibular disorders, as an experimental group. We considered as controls those patients who, match-paired to their skeletal class depending on the ANB angle, did not show any CMD sign or symptom. Of the 128 examined patients, 15 showed signs and/or symptoms of CMD (11.7%). When compared to 15 patients non-affected by CMD, we could not detect statistically significant differences in both skeletal and occlusal characteristics. It is still interesting to notice how in CMD patients, characteristics of skeletal hyperdivergence are often to be found. The present study seems to confirm that in growing children and adolescents, the presence of signs and/or symptoms of CMD is not associable to a specific vertical skeletal growth pattern or to other specific occlusal characteristics.

Quality of Life in Fibromyalgia Patients with Craniomandibular Disorders

Fibromyalgia (FM) is a rheumatic disease which affects fibrous tissues and muscles; it is characterized by chronic pain and it is often associated with craniomandibular disorders (CMD). 31 patients were assessed from March 2012 to October 2012 through the administration of specific questionnaires and following neurologic and gnatologic assessment. A relevant corre-lation between FM and CMD emerges from the present study, as 80.6% of our patients report CMD symptoms with high prevalence of myofascial pain (84%). Multivariate regression analysis revealed that the patients in the present study did not differ in score of quality of life questionnaires from patients with fibromyalgia. The neuropathic pain diagnostic question-naire (DN4) scores were positively affected by belonging to group II of Research Diagnostic Criteria of Temporomandibular Disorders (RDC/ TDM) classification, suggesting the possibility of a neuropathic component in chronic pain in this CMD group, as already speculated in our study on the correlation between burning mouth syndrome and CMD and by other au-thors in studies on chronic low back pain. However, further clinic and instrumental studies are needed in order to test this as-sumption.

Craniomandibular Disorders and Burning Mouth Syndrome in Removable Denture Wearers

Objectives: The frequent finding of craniomandibular disorders (CMD) in burning mouth syndrome (BMS) patients has led the scientific community to hypothesize that the two diseases have common aspects that require further examination. Some authors have evaluated the presence of CMD in patients with BMS. No studies have limited the investigation to denture patients affected by BMS. The aim of the study is to estimate signs and symptoms of Craniomandibular Disorders (CMD) in patients with BMS and to investigate for the existence of a possible association between CMD and BMS in removable denture wearers. Materials and Methods: From April 2010 to March 2012 we enrolled forty-eight patients affected by BMS, of which 24 wearing removable denture and 24 without denture, in accordance with the inclusion/exclusion criteria. A clinical-gnathological evaluation and a prosthodontic examination were performed and the results were compared. Original Research Article Corsalini et al.; BJMMR, 7(6): 529-540, 2015; Article no.BJMMR.2015.359 530 Results and Discussion: Nineteen patients of the sample showed disorders classified as primary signs and symptoms of CMD on the basis of Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TDM), compared with ten patients of the control group. Most common disorders were disc displacement and muscle pain. The chi-square test was statistically significant (p <.05) for 6 of the 10 relationships studied. Conclusion: A higher number of CMD cases was observed in the original sample compared with the control group. In BMS patients therefore being a denture-wearer may contribute to the onset of CMD.

Influence of psychopathologies on craniomandibular disorders

Psychopathologies play a role in the etiology and maintenance of craniomandibular disorders (CMD). In this study, the craniomandibular index was applied to valuate signs and symptoms of CMD in 60 dentate patients, who were assigned to 2 groups: symptomatic (n=35) and asymptomatic (n=25). An interview on psychopathologies was carried out with the aim to detect the presence of some mood disorders, such as depression, dysthymic and bipolar I disorders. Among these disturbances, depression was the most significant aspect to be reported (p<0.05) since it was present in most symptomatic patients. This important interaction was also significantly correlated (p<0.05) with the Palpation Index. These results suggest that psychopathological aspects could increase muscle tenderness and pain in addition to sleep dysfuntions and other physical complaints. Therefore, psychopathologies should be regarded as an important aspect in patients with orofacial pains.

Occlusion Splint Therapy in Patients with Craniomandibular Disorders (CMD)

The etiology of craniomandibular disorders (CMD) is multi-factorial and the treatment should be selected with recognition of the different factors. The aim of the study was to investigate the influence of occlusion splint therapy (Michigan splint), physical exercises and transcutaneous nerve stimulation (TENS) on CMD symptomatology. At the Clinic of Maxillofacial Surgery in Belgrade, in the period from May, 2001-December, 2003, 168 patients were examined by the CMD working group. This group, comprised of different specialties (maxillofacial surgeon, prosthodontist, orthodontist, neurologist, psychiatrist and physiatrician), enabled multidisciplinary treatment of CMD patients according to the guidelines given by American Academy for Craniomandibular Dysfunctions. In all, a total of 30 patients with prevalent muscular tensions among other CMD symptoms were included in this study. The examination form according to Fricton and Shiffman for Craniomandibular Index (CMI) was used in order to evaluate the function of Craniomandibular system before and after therapy.A statistically significant difference (t = 8,735; P < 0,001) between the average values for CMI of patients before (0,2297 +/- 0,0827) and after therapy (0,1002 +/- 0,0479) was observed. Performed treatment resulted in complete response (pain relief and absence of CMD symptoms and signs) in over than 80% of patients and could be considered as a method of choice in reversible occlusal therapy.

THE PREVALENCE OF CRANIOMANDIBULAR DISORDERS (CMD) IN MALE COMPETITIVE ROWERS

Objective: Based on observations that competitive rowers show a high facial activity during exercise, the aim of this study was to assess the prevalence of the signs and symptoms of Craniomandibular Disorders (CMD) in male rowers by evaluating functional and muscular parameters. Methods: In a cross-sectional study, 16 male rowers were compared with 16 controls. All subjects filled out a general questionnaire and underwent dental functional analysis. Results: The rowing volunteers reported pain/complaints in the head/neck/facial area more often than the controls and showed more parafunctional activities. Oral inspection showed a significantly higher prevalence of tongue and buccal impressions, abrasion and enamel cracks. Muscular palpation pain was significant in the rower group for the M. masseter profundus et superficialis, the temporomandibular joint (TMJ) area, and the M. pterygoideus lateralis. Conclusion: The study indicates a high prevalence for the signs and symptoms of CMD in male competitive rowers, which may be attributed to the rowing activity and/or the associated training program.

The relationship between craniomandibular disorders and occlusal disharmonies in the adolescent population of the Republic of Serbia

Using a special questionnaire adapted for computer evaluation, the prevalence of signs and symptoms of craniomandibular disorders (CMD) and occlusal disharmonies was investigated in a group of 500 adolescents of the Republic of Serbia ranging between 18 and 25 years of age. The presence of signs (symptoms) of CMD and occlusal discrepancies was established using clinical exsamination and evaluated according to the clinical disfunction index (D i) and index of the occlusal state (Oi) proposed by Helkimo et al. 1974. The results of this study revealed that 327 (65.4%) adolescents in the examined group had at least one sign (symptom) of CMD, (Di > 1), and that 271 (54.2%) adolescent had also mild, or severe occlusal discrepancies (Oi > 1). The percentage of persons with signs(symptoms) of CMD was significantly greater in the group having occlusal discrepancies (X = 7.76, P<0.01). The multiple regression analysis of the obtained data and the ODDS ratio confirmed the risk of CMD in the group with occlusal discrepancies to be 2.5 times greater than in the group of adolescents without occlusal discrepancies.

The relationship between craniomandibular disorders and occlusal disharmonies in the adolescent population of the Republic of Serbia

Using a special questionnaire adapted for computer evaluation, the prevalence of signs and symptoms of craniomandibular disorders (CMD) and occlusal disharmonies was investigated in a group of 500 adolescents of the Republic of Serbia ranging between 18 and 25 years of age. The presence of signs (symptoms) of CMD and occlusal discrepancies was established using clinical exsamination and evaluated according to the clinical disfunction index (D i) and index of the occlusal state (Oi) proposed by Helkimo et al. 1974. The results of this study revealed that 327 (65.4%) adolescents in the examined group had at least one sign (symptom) of CMD, (Di &gt; 1), and that 271 (54.2%) adolescent had also mild, or severe occlusal discrepancies (Oi &gt; 1). The percentage of persons with signs(symptoms) of CMD was significantly greater in the group having occlusal discrepancies (X = 7.76, P&lt;0.01). The multiple regression analysis of the obtained data and the ODDS ratio confirmed the risk of CMD in the group with occlusal discrepancies to be 2.5 times greater than in the group of adolescents without occlusal discrepancies.

A kinematic analysis of mandibular border movements in patients with craniomandibular disorderds

Disturbances in mandibular kinematics are supposed to be one of the main signs of craniomandibular disorders (CMD). In that regard, recordings of mandibular border movements may offer valuable data in assessing functional efficiency of the OF complex, as well as in diagnosing CM disorders. The electronic pantograph Arcus Digma (Kavo EWL GmBH, Leutkirch, Germany) was used in this study to record and evaluate the trajectories of the interincisal point in three planes during mandibular protrusion laterotrusion and mouth opening. Two groups of volunteers between 18 and 26 years of age were established for this investigation: one consisting of persons with signs (symptoms) of CMD and the other of persons without such signs and symptoms. The results of this study point out the significant differences in the length and shape of interincisal point tracings in the horisontal plane, as well as in angulation of laterotrusive tracings between the examined groups. The reduced mandibular opening was established in 17% of females and 13% of males in the group presenting the signs (symptoms) of CMD.

A kinematic analysis of mandibular border movements in patients with craniomandibular disorderds

Disturbances in mandibular kinematics are supposed to be one of the main signs of craniomandibular disorders (CMD). In that regard, recordings of mandibular border movements may offer valuable data in assessing functional efficiency of the OF complex, as well as in diagnosing CM disorders. The electronic pantograph Arcus Digma (Kavo EWL GmBH, Leutkirch, Germany) was used in this study to record and evaluate the trajectories of the interincisal point in three planes during mandibular protrusion laterotrusion and mouth opening. Two groups of volunteers between 18 and 26 years of age were established for this investigation: one consisting of persons with signs (symptoms) of CMD and the other of persons without such signs and symptoms. The results of this study point out the significant differences in the length and shape of interincisal point tracings in the horisontal plane, as well as in angulation of laterotrusive tracings between the examined groups. The reduced mandibular opening was established in 17% of females and 13% of males in the group presenting the signs (symptoms) of CMD.

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.

Mandibular helical axis pathways during mastication.

Condylar and incisor trajectories are often used for the study of mandibular movements. Condylar trajectories, however, depend on the location of the reference point and can be interpreted erroneously. In contrast, the helical axis analysis yields an unequivocal description of rigid body kinematics. The aim of this study was to analyze the mandibular helical axis during mastication. Seven subjects without signs and symptoms of craniomandibular disorders and with class I occlusion were recorded by means of the opto-electronic system Jaws-3D during unilateral mastication of bread cubes (2-cm side). The helical axis was computed every 14 ms with a rotation threshold of 1 . Parameters describing its spatial orientation and position relative to the condyles were calculated. The helical axis changed orientation and position more pronouncedly during the closing than during the opening phases of mastication. The orientation varied significantly from beginning to end of closing but not of opening, indicating less fluctuation of the helical axis on opening than on closing. Also, the distance dCP between helical axis and reference condylar point varied more significantly (p < 0.05) on the working than on the balancing side: On the working side, dCP decreased during both opening and closing, whereas on the balancing side, dCP increased only for closing. Furthermore, the helical axis pathway often showed a bowing ventrally to the balancing condyle, indicating that, during closing, the balancing condyle still translated backward while essentially only rotation occurred around the working condyle. Thus, the helical axis changed its position and orientation continuously during mastication.

Distúrbios craniomandibulares em pacientes edentados unilaterais inferiores com e sem próteses parciais removíveis (PPR): um estudo transversal utilizando o índice craniomandibular

No presente trabalho, foi feito um estudo clínico em 102 pacientes, 78 mulheres e 24 homens, com idade variando entre 18 e 61 anos, com a finalidade de analisar comparativamente a severidade de sinais e sintomas das desordens craniomandibulares (DCM). Procedeu-se a anamnese, o exame clínico e as moldagens e estabeleceu-se um método de escores, através do qual se avaliou o grau de severidade das DCM. Os pacientes foram divididos em três grupos de 34 pessoas, assim constituídos: a) portadores de prótese parcial removível corretiva para arcos com ausência unilateral de dentes inferiores (classe II de Kennedy); b) edentados unilaterais inferiores, sem tratamento protético (ausência unilateral de dentes naturais ou artificiais); e c) pacientes com todos os elementos dentais. Todos os indivíduos estudados apresentavam alguma queixa de dor facial ou desconforto muscular. Foram analisados e comparados estatisticamente todos os dados, e concluiu-se que o grau de severidade dos sinais e sintomas das DCM, refletido pelos diversos escores obtidos, mostrou comportamento diferente nos grupos de pacientes estudados. Os edentados unilaterais não portadores de PPR, com ausência de dentes por período superior a cinco anos, foram os que apresentaram maior grau de severidade dos sinais e sintomas das DCM. Os resultados ainda nos permitiram sugerir que o emprego de uma PPR corretamente planejada poderá diminuir significativamente o grau de severidade dos sinais e sintomas das DCM, em pacientes edentados unilaterais mandibulares, correspondentes à classe II de Kennedy. A utilização do índice craniomandibular (ICM) permitiu avaliar com segurança sinais e sintomas dos distúrbios craniomandibulares.

A survey of craniomandibular disorders in 500 19-year-olds.

This study examines the development of signs and symptoms of craniomandibular disorders (CMD), and some effects of orthodontic treatment from the age of 12-19 years of age. The data is drawn from a special sample of adolescents recruited at 11 years of age by random stratified sampling to contain a high prevalence of malocclusions of particular orthodontic interest. The sample does not reflect malocclusion in a normal population. The prevalence of frequent headache and TMJ disorders shows a major increase from 12 to 15 years of age. From 15 to 19 years of age, there is some increase in the prevalence of TMJ disorders in girls, but altogether the prevalence of signs and symptoms of CMD is much more stable. When the data from subjects who received orthodontic treatment were compared with data from subjects who had not received orthodontic treatment, only small differences were found.

Influence of complete denture renewal on craniomandibular disorders: a 1-year follow-up study

Great individual variation in the signs and symptoms of craniomandibular disorders (CMD) and in the adaptability of the masticatory system is evident among complete denture wearers. The masticatory system of 64 edentulous patients (41 women, 23 men; mean age 59 years, range 41-80 years), who came to the Institute of Dentistry for renewal of their complete dentures, was examined before prosthetic treatment and after a 1-year follow-up period. The degree of CMD was assessed using the anamnestic and clinical dysfunction indices of Helkimo. The results show that few complete denture wearers had severe signs and symptoms of CMD. No statistically significant correlation was noted between CMD and either the duration of edentulousness or the number of sets of dentures.

Influence of complete denture renewal on craniomandibular disorders: a 1‐year follow‐up study

summary Great individual variation in the signs and symptoms of craniomandibular disorders (CMD) and in the adaptability of the masticatory system is evident among complete denture wearers. The masticatory system of 64 edentulous patients (41 women, 23 men; mean age 59 years, range 41‐80 years), who came to the Institute of Dentistry for renewal of their complete dentures, was examined before prosthetic treatment and after a 1‐year follow‐up period. The degree of CMD was assessed using the anamnestic and clinical dysfunction indices of Helkimo. The results show that few complete denture wearers had severe signs and symptoms of CMD. No statistically significant correlation was noted between CMD and either the duration of edentulousness or the number of sets of dentures.

Craniomandibular disorders and orthodontic treatment need in children

summary Two hundred and forty subjects (113 boys and 127 girls), divided in three age groups, 7, 11, and 16 years were interviewed and clinically examined to estimate the prevalence of CMDs and the need for functional treatment, and to compare the functional status of the stomatognatic system in two subgroups: those judged to need orthodontic treatment and those judged not to need orthodontic treatment. Signs and symptoms of craniomandibular disorders were quite common and, in most cases, mild. There were significant differences in prevalence of CMDs between sexes. Only 3.7% of the patients were judged to need some functional treatment for CMDs. Trauma to the facial area and headaches were significantly associated with signs and symptoms of CMDs. No indication was found that oral parafunctions produce CMDs. No greater prevalence of CMDs signs and symptoms was found in subjects who needed orthodontic treatment than in subjects who did not need orthodontic treatment. In conclusion, preliminary results of this ongoing study support the contention that the high prevalence of signs and symptoms of CMDs is not really a measure of masticatory dysfunction, and that malocclusion does not appear to cause CMDs and/or to increase craniomandibular treatment need in a young population.

Longitudinal course of symptoms of craniomandibular disorders in men and women. A 10-year follow-up study of an epidemiologic sample.

An epidemiologic sample (n = 285) drawn from the population of Skellefteå, Sweden, was examined to evaluate the prevalence of signs and symptoms of craniomandibular disorders (CMD) at the age of 17 years. The sample was then followed up prospectively at the ages of 18 and 19 years. The year they reached 28 years of age a questionnaire concerning prevalence, incidence, frequency, duration, location, and intensity of symptoms of CMD was sent to the same subjects. Two hundred and thirty-four subjects responded (82%). The number of subjects who participated in all examinations (at the ages of 17, 18, 19, and 28 years) was 215 (107 women and 108 men). During the 10-year period from the late teens onwards a significant increase in reported symptoms of CMD occurred in both men and women. For the whole sample the prevalence increased from approximately 20% to 37%. The incidence of CMD symptoms at the age of 28 years was 6% in both sexes. Although fluctuations of symptoms during the period from the age of 17 to 28 occurred in both sexes, the course of CMD in men and women differed significantly. All women who consistently reported symptoms at the age of 17-19 years also reported symptoms at the age of 28 years; the corresponding figure for men was 60%. At the age of 17 years 25 women reported CMD; 23 of these reported CMD at the age of 28 years (92%). At the age of 17 years 17 men reported CMD; 5 of these reported CMD at the age of 28 (29%). The result indicates different courses for CMD in men and women.

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)

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.