Symptoms Of Mandibular Dysfunction Research Articles

Assessment of functional improvement with temporalis myofascial flap after condylectomy in elderly patients with anterior disc displacement without reduction and an erosive condylar surface.

BackgroundThe purpose of this study was to investigate the functional effects of temporalis myofascial flap after condylectomy, with or without disc removal, in elderly patients with anterior disc displacement (ADD) without reduction and an erosive condylar surface of the temporomandibular joint (TMJ).MethodsA total of 15 joints from 11 elderly patients (71–78 years old) were included. The patients had pain, mandibular dysfunction symptoms, and unilateral or bilateral ADD as well as an erosive condylar surface of the TMJ. All patients underwent temporalis myofascial flap reconstruction after condylectomy, with or without disc removal. If the maximal mouth opening (MMO) remained <35 mm after condylectomy, coronoidotomy was also performed. Self-assessed pain and mandibular function, including MMO and protrusive and lateral movements, were evaluated.ResultsNo patient experienced serious complications. Most measurements improved significantly after surgery compared to preoperatively. Most patients achieved nearly-normal mouth opening at 4 weeks after surgery. Although most patients felt discomfort during active postoperative physiotherapy, no patient reported serious pain during the follow-up period.ConclusionAlthough nonsurgical therapy is often the first treatment choice for ADD without reduction of the TMJ, surgical intervention involving condylectomy and temporalis myofascial flap reconstruction may be a reasonable first option for elderly patients with an erosive condylar surface of the TMJ.

Stomatognathic dysfunctional symptoms in Saudi Arabian adolescents.

Secondary school Saudi students participated in a questionnaire about stomatognathic dysfunction symptoms. The adolescents were interviewed about general health, peripheral joint disease, chewing function, oral parafunctions, and symptoms of dysfunction. Thirty-two per cent of participants had at least one dysfunction symptom. Pain on opening was the most common (35.7%), followed by headache (33.6%), and joint sounds (32.2%). Symptoms increased with decline in general health, particularly the health of peripheral joints. Chewing functions were not impaired. Tooth loss did not affect dysfunction symptoms in adolescents, whilst a weak relation was evident between oral parafunctions and symptoms of mandibular dysfunction.

Pattern of tooth contacts in eccentric mandibular positions in young adults

Tooth contact patterns in laterotrusion, protrusion of the mandible, and in the retruded position were recorded in young men with varying types of occlusion. The tooth contacts were recorded clinically with alginate (irreversible hydrocolloid) indices. In addition, the functional state of the masticatory system was evaluated by the recording of signs and symptoms of mandibular dysfunction and of the abrasion of the teeth. On protrusion, most subjects had contacts only on anterior teeth. Protrusive contacts only on posterior teeth were rare. On laterotrusion, most subjects had group function on the functional side. Contact on the nonfunctional side was found in half of the subjects in a 1.5 mm laterotrusive position and in one third of them in a 3 mm laterotrusive position. No correlation between the types of tooth contacts and mandibular dysfunction was found.

Five-year longitudinal recordings of functional variables of the masticatory system in adolescents with intact and restored dentitions: A comparative anamnestic and clinical study

Recordings of functional variables of the masticatory system were made in 184 subjects, 18-20 years old, 5 years after the first examination. One hundred and six subjects had restored dentitions at both examinations (group F), 35 subjects with previously intact dentitions had received fillings during the follow-up period (group FI), and 43 subjects had intact dentitions at both examinations (group I). In conformity with the first examination 5 years earlier, the subjects in group F had higher scores for dentin facets on the first lower molar. Together with the finding of more frequent attrition on the distal part of the occlusal surface of the second lower molar, this finding indicates more functional or parafunctional activity in restored dentitions. Unilateral contacts in the retruded contact position (RCP) were equally common in all three groups, but the contacts in RCP were more often located in the molar region in group F. The finding at the first examination that interference causing a lateral slide of the mandible between RCP and the intercuspal position (ICP) was commoner in restored dentitions was not confirmed in the present study. Nor did the correlation analysis show any relationship between occlusal factors and signs and symptoms of mandibular dysfunction. However, the differences found between subjects with intact and restored dentitions indicate that the iatrogenic effect of dental filling therapy merits more consideration and more extensive research.

Temporomandibular joint sounds in adolescents: A longitudinal study

A 2-year longitudinal study on signs and symptoms of mandibular dysfunction was performed with 285 17-year-old adolescents living in a certain geographic area in Skellefteȧ, Sweden. Crepitation was neither reported nor recorded in any subject. Both reports and recordings of TMJ clicking sounds fluctuated with time. The 2-year period prevalence was 24%, and 5.8% consistently reported TMJ clicking sounds. The corresponding figures for clinically recorded clickings were 36% and 9.3%, respectively. Both reported and recorded joint sounds were significantly more frequently found in 19-year-old girls than in boys. No consistent pattern of relationships between reported and recorded clicking sounds and single factors obtained by the questionnaire or clinically recorded variables could be found. Palpation tenderness in three muscle sites was to a varying degree related to both reports and recordings of clicking. Each year, significant relationships were found between reports of TMJ sounds and symptom indices. Recorded sounds were significantly related to a clinical index in the two oldest age groups. The prevalence of TMJ clicking sounds increases with age, and girls are more prone to have them than boys. In view of the natural longitudinal fluctuations, most clickings only need to be supervised, and when there is a demand for treatment, reversible methods are advocated in adolescents.

Prevalence of signs and symptoms of mandibular dysfunction among adults aged 25, 35, 50 and 65 years in Ostrobothnia, Finland

The prevalence of objective signs and subjectively perceived symptoms of mandibular dysfunction were studied in a sample comprising 1600 subjects, 400 each aged 25, 35, 50 and 65 years. Eighty per cent of the subjects were examined clinically. The prevalence figures were higher among the females than among the males, and a slight tendency for higher frequencies of clinical signs was observed with increasing age. In view of the severity of clinical signs preference should be given for a total of 27% of the subjects when considering the need of treatment. The number of remaining teeth in subjects with natural teeth and no additional removable dentures had no marked influence on the prevalence of mandibular dysfunction, but subjects with complete dentures had signs and symptoms of dysfunction more often than those with natural dentition. The sex and age differences can partly be explained by the higher frequency of complete dentures in females than in males and in the older age groups.

The silent period in the masseter and anterior temporalis muscles in young adult subjects unaware of mandibular dysfunction symptoms

In fourteen individuals unaware of mandibular dysfunction symptoms, latency and duration of the silent period in the masseter and anterior temporalis muscles at tooth tapping and jaw jerk were reasonably reproducible after 5 weeks and 5 months. Although the subjects felt no discomfort in the stomatognathic system, in some of them mild to moderate muscle tenderness, TMJ sound and occlusal disharmony were found at clinical examination. The relationship between these symptoms and the silent period was analysed. Muscle tenderness was the only factor to affect the silent period. The subjects with muscle soreness had a shorter duration of the silent period than the subjects without such symptoms.

Signs and symptoms of mandibular dysfunction after introduction of experimental balancing-side interferences: Tomas Magnusson and Lars EnbomActa Odontol. Scand. 1984;42:129–135

Signs and symptoms of mandibular dysfunction after introduction of experimental balancing-side interferences: Tomas Magnusson and Lars EnbomActa Odontol. Scand. 1984;42:129–135

Longitudinal variation of maximal mandibular mobility: An intraindividual study

T Ah dt e e ermination of maximal mandibular mobility is essential for judging the functional status of the masticatory system. Normal values of maximal mandibular mobility in both vertical and horizontal planes have been reported.‘.” The mean values and standard deviations of those values, representing five and four specific age groups, are presented in Figs. 1 and 2. A noticeable range of variation for both vertical and horizontal mobility has also been reported.4S8 Extreme values of 40 to 80 mm have been given for young healthy men and women for vertical mobility and 5 to 16 mm for movements in the horizontal plane (maximal movements to the right and the left and in protrusion). Therefore, it has been contended that measurement of maximal opening can be of interest only as an intraindividual comparison at various times during treatment9 Strong correlations between vertical and horizontal mobility have been demonstrated, however.4-8 Posselt’O reported that the border movements of the mandible differ between individuals as to range and directions, but are reproducible in the individual. Repeated measurements of maximal mandibular mobility have been shown to be reliable, especially when recorded by the same observer. In studies of intraobserver and interobserver variations of mandibular mobility,8,11,12 recordings have mainly been performed on the same day. The assessment of the longitudinal variations has generally been focused on subjects with varying degrees of mandibular dysfunction,13 or on patients in whom fluctations in clinical signs have been found to be considerable.14 The magnitude of longitudinal intraindividual variations between multiple examinations at different times in individuals without signs and symptoms of mandibular dysfunction has not been studied. This article is a longitudinal report of the maximal mandibular mobility recorded in two groups of persons at different intervals. The study includes two parts (A and B) in which the maximal mobility was measured on different occasions to assess short-term and long-term variations.

An epidemiologic study of mandibular dysfunction dependence on different variables.

Age and sex characteristics of different signs and symptoms of mandibular dysfunction were studied in 600 randomly selected urban persons. With regard to mandibular mobility marked differences were observed between the sexes, and a steady decrease parallel with ageing. Against this, the percentages of the objective dysfunction signs of impaired mobility and TMJ-sounds, as well as those of the pooled percentages of all the objective signs (Di-I + II + III), increased parallel with ageing. The percentages of headache occurrence peaked in different age groups for men and women. Statistically significant correlations were found between headache, parafunctions, stress, age, the existence of a preferred chewing side, as well as several dental-occlusal factors, and the prevalence of mandibular dysfunction; between Ai and Di according to Helkimo, and between excessive tooth wear and parafunctions.

Five-year longitudinal study of signs and symptoms of mandibular dysfunction in adolescents: Magnusson T, Egermark-Eriksson I, Carlsson GE. J Craniomand Prac 4:338, 1986

Five-year longitudinal study of signs and symptoms of mandibular dysfunction in adolescents: Magnusson T, Egermark-Eriksson I, Carlsson GE. J Craniomand Prac 4:338, 1986

A long-term epidemiologic study of the relationship between occlusal factors and mandibular dysfunction in children and adolescents.

A longitudinal investigation of changes of signs and symptoms of mandibular dysfunction over four to five years was performed, by means of questionnaires and clinical examination, in 240 children, ages 7, 11, and 15 years at the first examination. The objective of this part of the study was to analyze correlations between some occlusal and other factors, and mandibular dysfunction. Signs and symptoms of mandibular dysfunction increased slightly in both frequency and severity but were judged to be mild in most cases. Several types of occlusal interference were frequently recorded at both examinations. Dental wear increased during the follow-up period, while the results of evaluations of motor activity and psychological traits were relatively constant. There were only a few significant correlations, most of which were weak, between the recorded variables and mandibular dysfunction, and those found were not consistent in all age groups. TMJ sounds were positively correlated with lateral deviation of the mandible between retruded contact and intercuspal position in all age groups. An attempt to analyze the longitudinal relationship of occlusal interference with signs and symptoms of mandibular dysfunction did not reveal any strong correlations. The results are interpreted as supporting the heterogeneous and multifactorial nature of functional disturbances of the masticatory system.

Signs and symptoms of mandibular dysfunction in patients with suspected oral galvanism.

Fifty-four consecutive patients were examined by means of a self-administered questionnaire with questions related to general health and subjective symptoms. In addition, a clinical stomatognathic evaluation was carried out including palpation of the temporomandibular joints (TMJ) and the masticatory muscles and functional analysis of occlusion and mandibular mobility. High frequencies of general diseases were reported. The dominant subjective symptom was headache (62%), which often appeared daily. Symptoms such as pain from the teeth, pain in the face/jaws, and burning sensations in the tongue or oral cavity all appeared in more than half of the sample. The patients were frequently aware of parafunctions such as clenching of the teeth and tongue press. None of the investigated persons were completely free of clinical signs of dysfunction. The most frequent clinical finding was palpation tenderness in the masticatory muscles (96%), generally located in the masseter, temporal, and lateral pterygoid muscles. In more than half of the material TMJ findings were recorded, and more than one-third had TMJ pain. In 35% mandibular mobility was reduced. Occlusal interferences on retrusion and on the mediotrusion side were frequent findings. Impaired general state of health and multiple signs and symptoms of mandibular dysfunction were thus frequent findings in these polysymptomatic patients. Three-fourths of the patients needed treatment for mandibular dysfunction, indicating that great consideration must be made for the functional status of the masticatory system in clinical evaluation of so-called 'oral galvanists'.

Comparison of tests for dysfunction of the stomatognathic system

As part of a validating process, tests and indices for dysfunction of the temporomandibular joints and masticatory muscles were compared and correlated in 211 persons with an almost complete or complete natural dentition. Helkimo's Clinical Dysfunction Index (CDI), the Mandibular Dysfunction Symptoms (MDS) scale from the "Erweiterter Giessener Beschwerdebogen", the Modified Half-Minute (MHM) test and the palpation test for the stomatognathic system (PALP-test) were compared. The PALP-test had the highest internal consistency (coefficient alpha = 0.92) and the highest intercorrelation with the CDI. Furthermore, it was found that the PALP-test and the CDI probably yield the most realistic distribution of persons in the three classes no symptoms, mild to moderate and severe, and also show the highest percentage of absolute correspondence. The MDS-scale and MHM-test scores showed little dispersion and probably indicated too much or too little pathology. The correspondence between the last two measures is mainly due to an overrepresentation of the middle scoring class (mild to moderate indication of dysfunction of the temporomandibular joints and masticatory muscles). In screening procedures this can easily result in an overrepresentation of people with supposed pathology.

Five-year longitudinal study of signs and symptoms of mandibular dysfunction in adolescents.

AbstractA longitudinal study covering five years of clinical signs and subjective symptoms of mandibular dysfunction was performed in 119 adolescents, 15 years old at the first examination and 20 years old at the follow-up. Sixty-two percent had clinical signs of mandibular dysfunction, but the signs were in most cases mild, while moderate and severe signs were found in 17%. No change in clinical signs between the two examinations were noted in nearly half of the individuals, and improvement and impairment had occurred at an almost equal rate.At the follow-up, 31% of the participants reported that they sometimes had TMJ sound, tiredness in the jaws, or difficulties in mouth opening, and another 8% suffered from one or more of these symptoms frequently. The frequency of subjective symptoms as well as reports of bruxism had increased statistically significantly compared with five years previously.A statistically significant correlation was found between the subjective symptoms and the clinical dysfunction i...

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.

Prevalence of mandibular dysfunction in an urban population in Hungary.

600 randomly selected subjects from an urban community in Hungary were examined anamnestically and clinically concerning signs and symptoms of mandibular dysfunction. The anamnestic (Ai) and clinical dysfunction (Di) indices according to Helkimo were used. The percentage distribution of the sample was the following: AiO = 79.3%, AiI = 15.3%, AiII = 5.3%; DiO = 20.1%, DiI = 72.3%, DiII = 7%, DiIII = 0.5%. Headache was reported in 23%, bruxism in 10%, joint sounds in 9%, pain in the face, neck, or around the ears in 6%. Clinical signs found at the examination were joint sounds in 46% (crepitation 29%, clicking 22%), muscle tenderness on palpation in 17%, joint tenderness in 3%, pain on movement in 2.5%, restricted mouth opening in 4%, deviation of the mandible in 20%.

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

Symptoms of mandibular dysfunction were followed up longitudinally from the age of 17 to 19 years in 285 adolescents. Totally, 27 subjects dropped out, leaving 258 for the longitudinal intraindividual comparisons. Reports of TMJ sounds increased significantly with age from 14% to 23% for girls, and at 19 years of age they significantly more often reported such sounds than boys. Girls also more frequently reported recurrent headaches (18%) than boys (1-6%). The prevalence of symptoms of mandibular dysfunction was about 20% each year, but there was no general increase of frequency and severity of symptoms during the observation period in spite of an incidence of 8%; new symptoms thus appeared as frequently as old symptoms disappeared. The prevalence of dysfunction was, according to the anamnestic index (Ai), significantly higher for 18- and 19-year-old girls. Girls also significantly more often reported more symptoms than boys, according to an accumulated index (AAi). Most symptoms were of mild character and fluctuated longitudinally. The need and demand for treatment may therefore be considered small. A routine stomatognathic screening is justified to identify those in need of treatment and those who should be observed more closely.

Mandibular dysfunction in adolescents. I. Prevalence of symptoms.

The prevalence of symptoms of mandibular dysfunction was studied in 285 17-year-old adolescents living in the municipality of Skellefteå. They answered a questionnaire concerning general state of health and occurrence of headache, facial pain, or temporomandibular problems. A fifth of the subjects reported some symptoms involving the masticatory system. There was no statistically significant difference between sexes. Of the sample 13% had mild symptoms and 7% had severe symptoms of dysfunction. The most frequent symptoms were clicking sounds from the temporomandibular joint (13%) and a feeling of fatigue in the jaws (6%). Recurrent headache (once a week or more) was reported by 12% and appeared significantly more often among the girls (p less than 0.001). Three-quarters used both sides for chewing, and oral parafunctional habits were reported by 68%. Since mild and moderate symptoms of mandibular dysfunction and headache obviously make an early appearance, a routine dental examination should include screening of these symptoms to identify patients who should be observed more closely.

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.