Temporomandibular Disorders In Children Research Articles

Association between stress and catecholamines with painful TMD in children.

Studying biomarkers in children with temporomandibular disorders (TMD) such as epinephrine, norepinephrine, and dopamine may reveal factors like screen time or sleep loss that affect these biomarkers and predict TMD-related pain, offering new research opportunities. To determine the association between stress and catecholamines with myofascial pain and headache related to TMD in children. Sixty-six 9- to 11-year-old children assisting at the clinics of Pediatric Dentistry of Universidad CES participated in the study. Myofascial pain and headache attributed to TMD were determined according to the Diagnostic Criteria for TMD (DC/TMD) Axis I. Stress was evaluated with the Perceived Stress Scale-Children (PSS-C), and a 24-h urine sample was analyzed using liquid chromatography to assay catecholamines. Single and multiple regression analyses were performed. Children with a mean age of 10.3 years participated in the study. The mean score of stress was 29 ± 4. Perceived stress, dopamine, epinephrine, and norepinephrine were statistically significant predictors of myofascial pain and headache attributed to TMD in the single- and multiple variable logistic regression analyses. Stressful states and its biological biomarkers increase the probability of developing myofascial pain and headache attributed to TMD in children.

Considerations in the Diagnosis and Treatment of Temporomandibular Disorders in Children and Adolescents: A Review

Considerations in the Diagnosis and Treatment of Temporomandibular Disorders in Children and Adolescents: A Review

Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7-14 Years.

The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7-14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7-10) and adolescents (aged 11-14) of both sexes were invited to participate in this study (n = 1468). Descriptive statistics for all observed variables and Mann-Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants (n = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low.

Does dental rehabilitation under general anaesthetic contribute to the development of temporomandibular disorders in children and adolescents? A scoping review.

Temporomandibular disorders (TMDs) have multiple aetiological factors. Although some evidence suggests invasive and lengthy dental procedures may contribute towards TMD development, there is a relative paucity in the literature regarding an association between elements of paediatric dental general anaesthesia (pDGA) and TMDs. This review aims to consider the impact of dental rehabilitation (and its constituent elements) performed under general anaesthesia on the development of TMDs in childhood and adolescence and identify theories and/or gaps in knowledge which may benefit from future research. Due to the need to preliminarily examine the nature and extent of the current evidence base, a scoping review approach was chosen. The review was conducted based on the framework provided by the methodological working group of the Joanna Briggs Institute (JBI) for conducting systematic scoping reviews. Electronic databases MEDLINE, Embase, Scopus, Web of Science and Cochrane Library were searched as well as the grey literature using OpenGrey, Nexis, Ethos, Google Scholar and ProQuest, with eligible studies uploaded onto Zotero (Mac Version 5.0.96.2). A total of 810 records were identified. After removing duplicates and those not available in English, 260 were identified for title and abstract screening. Seventy-six records underwent full-text review of which only one met the broad inclusion criteria. The most common reasons for exclusion were no specific relation to general anaesthesia, not specifically relating to dental treatment and only being concerned with TMD management. The included study found that while development of TMDs following dental rehabilitation under GA did occur in children, whether the problems caused by treatment were exacerbated by other elements of the pDGA process remains unknown. This review has confirmed a distinct paucity of research in this field. While there is no current tangible scientific evidence that common and routine dental procedures lead to TMD, the literature shows that alterations to any one or a combination of critical factors can contribute to TMD development, which may be collectively exacerbated by iatrogenic macrotrauma during the pDGA process. We have highlighted elements of pre-, peri- and post-operative pDGA, alongside biopsychosocial factors, which may contribute to TMD development in childhood and adolescence and may benefit from future research.

Temporomandibular disorders in children and adolescents: A review

BackgroundTemporomandibular disorders (TMD) are generally observed in individuals between the ages of 20 and 40 years. TMD have also been described in children and adolescents but are still not widely detected and treated in routine practice. Through a literature review, this work aims to improve the diagnosis and management of TMD in children and adolescents by dentists. MethodsThis literature review was performed by a computerized search of the database PubMed for published articles on TMD in children and adolescents. Articles evaluating the prevalence, etiologies and risk factors, diagnosis, signs, and symptoms as well as the comorbidities of TMD, published between 2001 and 2022, were included in this review. ResultsA total of 51 articles were included. Most of studies reported a prevalence of over 20%, with a higher prevalence in females. The two most common diagnoses were myofascial pain and disk displacement with reduction. Headaches were often associated with the condition. The management of TMD in children and adolescents has been poorly studied. ConclusionTMD frequently affect children and adolescents. Therefore, for prevention purposes, an examination of the masticatory system should be included in the dental check-up. Early diagnosis is essential in order to limit effects on their growth, development, and quality of life. TMD management is not currently validated for children and adolescents. Noninvasive and reversible care should be preferred.

Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular disorders (DC/TMD): A systematic review with meta-analysis.

The prevalence of temporomandibular disorders (TMDs) in children and adolescents is not well known. This is partly because TMD is not often diagnosed in children and partly because there is no agreed-upon definition of TMD. There is a growing body of evidence to suggest that there are gender differences in the prevalence and presentation of TMD in adult. The aim was to assess the prevalence of TMDs in subjects aged 8-19 evaluated with Diagnostic Criteria for TMDs (DC/TMD) and to assess gender differences. PubMed, Web of Science, and Lilacs were systematically searched until November 30, 2022, to identify studies presenting children and adolescents patients affected by TMDs. Out of 40 papers, 3 studies were included. The included subjects in this review were 1914 (1093 female and 821 male). Seven hundred and thirty-six on 1914 patients (38,4%) presented TMD. Among 1093 female, 489 (44,7%) presented TMD, while 247/821 male (30%) experienced TMD. Meta-analysis revealed that the female had a higher TMD prevalence than male (RR 2.10; 95% CI: 1.21-3.65). TMD prevalence in children and adolescence varies between 20 and 60%. Female had a higher prevalence of TMDs compared to male.

Relationship Analogy between Sleep Bruxism and Temporomandibular Disorders in Children: A Narrative Review.

Sleep bruxism (SB) is a condition characterized by repetitive clenching or grinding teeth and/or by bracing or thrusting of the mandible during sleep. Although SB is not considered a disorder in children, SB can be a potential physical and psychological hazard or consequence, and this study examines whether SB is a risk factor for TMD as it is in adults. A narrative review on the topic of inferring the relationship between sleep bruxism and TMD in children was performed based on a search in the PubMed and Google Scholar databases for articles published between 1999 and 2022. A total of 76 articles were included in this review. SB is very common in children, may be related to psychological distress or sleep breathing disorder, with a prevalence of up to 49%, and mainly occurs in the non-rapid eye movement stage in the sleep structure. SB may be one cause of TMD. The prevalence of TMD in children is 16–33%. Compared to the female-dominant TMD prevalence in adults, the sex-differences in TMD prevalence in children are less pronounced. However, TMD-related pain is more prevalent in girls than in boys. Given the complex etiology of each of SB and TMD in children, it can be inferred that the explanation of the relationship between the two conditions is very challenging. Ultimately, their relationship should be understood in the individual biopsychosocial model in the process of special physical growth and mental development of children. Moreover, appropriate clinical guidelines for a definitive diagnosis of SB and TMD in children and more research with a high scientific evidence level, which is comprehensive, considering physical, psychological, genetic, and social cultural factors, are required.

Accuracy of Surface Electromyography in the Diagnosis of Pain-Related Temporomandibular Disorders in Children with Awake Bruxism.

The study assessed masticatory muscle electromyographic (EMG) activity in both children diagnosed with pain-related temporomandibular disorders (TMD-P) and awake bruxism (AB) and in children without TMD, as well as the diagnostic value of surface electromyography (sEMG) in diagnosing TMD-P in subjects with AB. After evaluation based on the Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), 30 children diagnosed with myofascial pain were included in the myofascial pain group and 30 children without TMD diagnosis comprised the control group (mean age of 9.49 ± 1.34 years). The activity of the anterior temporal (TA) and masseter (MM) muscle was assessed bilaterally using a DAB-Bluetooth device (zebris Medical GmBH, Germany) at rest and during maximum voluntary clenching (MVC). The receiver operating characteristic (ROC) curve was used to determine the accuracy, sensitivity, and specificity of the normalized sEMG data. Statistically significant intergroup differences were observed in TA and MM muscle EMG activity at rest and during MVC. Moderate degree of sEMG accuracy in discriminating between TMD-P and non-TMD children was observed for TAmean, left MM, and MMmean EMG muscle activity at rest. sEMG can be a useful tool in assessing myofascial TMD pain in patients with AB.

Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II.

Unlike the psychosocial assessment established for adults in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), a standardised psychosocial assessment for children and adolescents with TMD complaints has not yet been established. To develop a new standardised instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2 and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophising, sleep problems and stress in children (ages 6-9years old) and adolescents (ages 10-19years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritise the suggested instruments from most to least recommended. The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophising, stress and resilience. Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.

Relationship of Malocclusions with Disorders of the Temporomandibular Joint in Children of CALI-Colombia.

The aim of this study was to determine the relationship of malocclusion with the presence and severity of temporomandibular disorders (TMDs) in children. A clinical examination was performed in 87 patients (from 4 to 14 years of age) who attended the dentistry clinics of Universidad del Valle. The 77 patients studied had malocclusions; 55 patients had TMD and 67.3% were female. The most frequent symptom of TMD was articular unilateral noise with 33.8%, followed by pain in at least one masticatory muscle with 26%. TMJ pain was observed in 24.7% of the patients. There was a statistically significant relationship between the presence and severity of TMD with type of dentition and transverse malocclusion, respectively. The presence of TMD in children with malocclusion presented in a high frequency. TMD depends on the type of dentition and its severity is dependent on transverse malocclusion.

Effect of oral splints on muscular temporomandibular disorders in children: A systematic review

AbstractBackgroundTemporomandibular disorders (TMD) is a common chronic pain problem within the population. An increased prevalence of TMD in children has been noted within the literature (1%–50%). There is extensive published guidance for the treatment of TMD in adults, however, there has been little discussion with regards to advised treatment of TMD in children.MethodsThe aim of this systematic review was to analyse the effectiveness of an oral splint for the treatment of muscular TMD in children and understand the significance of this treatment intervention in reducing pain. The PRISMA guidelines were followed and searches were undertaken of MEDLINE, Embase and Cochrane Central Register of Controlled Trials. Inclusion and exclusion criteria were applied to identify randomised controlled trials with a primary outcome measure of pain reduction. The Cochrane tool to assess risk of bias on interventional studies was used.ResultsTwenty‐nine potentially relevant articles were identified. Two articles met the inclusion criteria. Of the two articles, the main threats to validity were performance bias and attrition bias. Key findings and future research considerations are discussed in this review.ConclusionsThere is insufficient reliable evidence for the use of an oral splint for the treatment of myofascial pain in children. The authors believe that this is the first systematic review on this topic; it highlights the need for further research in this area. The authors suggest the need for well‐conducted RCTs that focus on sample size, method of allocation and duration of follow up.Systematic review registrationPROSPERO 2017 CRD42017080976.

Temporomandibular Joint and Cervical Spine Mobility Assessment in the Prevention of Temporomandibular Disorders in Children with Osteogenesis Imperfecta: A Pilot Study.

Osteogenesis imperfecta is a heterogeneous group of hereditary disorders of connective tissue diseases characterized by increased bone fragility, low growth, sometimes accompanied by abnormalities within the dentine, blue sclera, and partial or total hearing impairment. The changes may affect all joints, including the cervical spine and temporomandibular joints in the future, resulting in pain. The aim of the present study was to assess whether there is a relationship between the active range of motion of the cervical spine and the mobility of temporomandibular joints due to differential diagnosis in children with osteogenesis imperfecta, and to present a prevention algorithm for temporomandibular disorders. The study involved a group of 34 children with osteogenesis imperfecta, and the control group included 23 children (age 9.1 ± 3.8 years). Data were collected through an interview based on the author’s questionnaire, and the physical examination consisted in measuring the mobility of the cervical spine using an inclinometer (Cervical Range of Motion Instrument), the Helkimo scale, and linear measurements. In children with congenital bone fragility, there were acoustic symptoms from the temporomandibular joints more often than in healthy children. A correlation was found between the mobility of the cervical spine and temporomandibular joints in the study group. In the case of detecting irregularities in the temporomandibular joints, children were ordered to perform jaw-tongue coordination exercises.

Evaluation of signs and symptoms of temporomandibular disorders in children and adolescents, before and after rapid maxillary expansion

Evaluation of signs and symptoms of temporomandibular disorders in children and adolescents, before and after rapid maxillary expansion

Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis \u2013 a Norwegian cross- sectional multicentre study

BackgroundChildren and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD.MethodsThis comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs.ResultsIn our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p < 0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p < 0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation.ConclusionSymptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.

A Review the Relationship of Bruxism with Temporomandibular Disorders in Children

Introduction: Bad habits often found in children such as bruxism may have a profound effect on the health of teeth, periodontium, masticatory muscles and TMJ temporomandibular joints. Excessive masticatory muscle activity can result in disruption of local blood flow and micro circulation, and the pain due to ischemia, bruxism increases excessive strength resulting in an abnormal burden on the mastication system causing changes in some elements of the stomatognathic system resulting in an imbalance that causes stomatognathic system dysfunction. Objective: To review the relationship between bruxism and temporomandibular disorders. Method: Scientific evidence and clinical cases taken from the literature to support this review and information about the relationship of bruxism with temporomandibular disorders (TMD) in children is collected. Results/Discussion: There were several relationships of bruxism with temporomandibular disorders such as joint sounds, myalgia and temporomandibular pain. Conclusion: Brusixm in children is usually influenced by psychological factors such as stress or excessive anxiety. Parafunctional habits such as bruxismn will produce excessive strength so that abnormal loads in the mastication system cause changes in some elements of the stomatognathic system, causing an imbalance that causes stomatognathic system dysfunction such as TMJ pain, joints and myalgia.

Association between bruxism and temporomandibular disorders in children: A systematic review and meta-analysis.

Bruxism in children and its relation to the development of temporomandibular disorders (TMD) has not been clearly determined yet. The objective of this systematic review was to evaluate the possible association between bruxism and TMD in children. Seven databases were searched, and 497 articles were assessed. Methodological quality was assessed through Newcastle-Ottawa Scale. The meta-analysis was performed with the articles in which extraction of data was possible and the summary effect measure through odds ratio (OR) and respective 95% confidence intervals (CIs). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. Ten cross-sectional studies were included in the systematic review. Of these, 8 showed a statistically significant association between bruxism and TMD. Seven studies however presented a high risk of bias. The meta-analysis was performed with 3 articles and obtained an OR of 2.97 (95% CI ranging from 1.72-5.15), indicating that children with bruxism are 2.97 times more likely to present TMD, with very low level of certainty defined by GRADE. Although the studies showed high risk of bias, the qualitative analysis of individual studies showed that the children with bruxism have greater chance of developing TMD.

General health & psychological distress in children with temporomandibular disorder.

Temporomandibular disorders (TMD) are an heterogeneous group of disorders affecting temporomandibular joints (TMJ), masticatory muscles, or both. The aim of this study is to evaluate the relationship between general health and psychological distress variables and the clinical diagnosis of TMD in children between 8 - 13 years old. Moreover, it will be underlined the different perception of psychological distress existing between patients and their parents. Patients were divided in two groups: the "case group", which includes patients with TMD, and the "control group", which included patients asymptomatic for TMD. The "case group" is composed by 29 patients, while the "control group" is composed by 22 patients. The patients were asked to fill in a questionnaire called Child Health Questionnaire (CHQ), to evaluate general health and psychological condition and, eventually, the presence of symptoms of stress, anxiety and/or depression. The CHQ is 87 - item questionnaire developed in USA specifically for children. As widely reported during the present work, the link between TMD and psychological distress is existing and quite strong, because of lack of number of patients many aspects worth of attentions have not been analyzed as they deserved. That's way the conclusion must lead to the proposal of going on with the present study following, possibly, some aspects of research as an increase of the number of patients involved in the study; Individuate possible elements, internal and external, that could strongly influence differences between patient's results and parent's results, etc.

Prevalence and treatment strategies regarding temporomandibular disorders in children and adolescents-A systematic review.

Temporomandibular disorders (TMD) in children/adolescents are very common. Yet, there is a lack of consensus regarding which clinical interventions are appropriate. The aim of this systematic review was to gather and assess the quality of the available literature on the prevalence and evidence-based treatment strategies in children and adolescents suffering from TMD. A systematic literature review was conducted including articles from 1992 to 2016. A total of 2293 articles were found. Eight were included, six regarding prevalence and two regarding treatment. Simple or multiple conjunctions of different search words: "temporomandibular disorder", "temporomandibular joint disorder", "prevalence", "children" "adolescents", "occlusal appliance", "jaw exercise" and "relaxation" were used on the databases PubMed and Web of Science. Inclusion criteria were (a) scientific articles or randomised controlled clinical trials evaluating prevalence, choice of therapy and treatment outcome for children and/or adolescents with TMD published in Swedish or English and (b) a TMD diagnosis according to the Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. Prevalence (ages 10-19years) varied between 7.3 and 30.4%, and the most common diagnoses were myofascial pain and anterior disc displacement with reduction. Only two articles were found regarding treatment in adolescents (ages 12-18years). The stabilising occlusal appliance had superior treatment outcome compared to relaxation therapy or brief information. The general absence of standardised studies concerning children/adolescents with TMD pain states the evident need for further systematic prevalence and treatment evaluations. Considering this, it is not possible to achieve any evidence-based treatment strategies or guidelines for children and adolescents with TMD.

Association between parafunctional habit and sign and symptoms of temporomandibular dysfunction

Introduction: Temporomandibular disorder (TMD) is a group of condition affecting the temporomandibular joint, masticatory muscles, and the adjacent structures. The etiology of TMD in children and adolescents is considered multifactorial in nature and has been related to trauma, malocclusion, and parafunctional habits. Aim: The aim of this study is to find whether harmful oral habits are associated with sign and symptoms of TMD among adolescents in Wardha district. Materials and Methods: A short-span study was conducted in Wardha, Maharashtra. A self-administered based study was done among 200 adolescents which comprised of 107 females and 93 males. Data were collected using self-administered questionnaire and clinical oral examination that was conducted. The questionnaire was consist of knowledge responses (yes/no) and attitude responses (never, rarely, sometimes, often, and always). Chi-square test was used to perform statistical analysis and level of significance was set at P

Análisis clínico de la prevalencia de trastornos témporomandibulares en niños de 8 a 12 años de edad de la Escuela Diego Abad de Cepeda de la ciudad de Quito

El presente estudio se realizó con el fin de conocer la prevalencia de trastornos témporomandibulares en niños de 8 a 12 años de la Escuela “Diego Abad de Cepeda” de la ciudad de Quito. La investigación se realizó en 228 niños que se distribuyeron en 128 mujeres y 100 hombres y bajo el método de observación se determinaron signos de trastornos témporomandibulares. Los trastornos que se evaluaron fueron dolor, limitación en apertura, deflexión, ruidos articulares y discrepancia entre relación céntrica y oclusión céntrica. El 49% de la población mostró al menos uno de los trastornos, siendo más prevalente en el sexo femenino con el 64%. Los trastornos más prevalentes en la población examinada fueron dolor con el 32% y ruidos articulares con el 25%. Los trastornos se encontraron con más frecuencia en aquellos niños que tuvieron uno o más hábitos perniciosos, apiñamiento y maloclusiones como mordida profunda, mordida abierta y mordida cruzada. Los resultados que se obtuvieron en el presente estudio nos ayudan a confirmar que los trastornos témporomandibulares pueden afectar también a los niños y nos impulsa a los odontólogos a aprender más sobre la articulación témporomandibular para saber tratarla adecuadamente.