Signs Of Temporomandibular Dysfunction Research Articles

Impact of oral health on the quality of life of public servants: an analysis of associated factors.

Oral health encompasses functional and aesthetic aspects that directly impact an individual's daily activities. To analyze the impact of oral health conditions and related factors on the quality of life of public servants. This cross-sectional study was conducted with a sample of 89 public servants, both permanent and outsourced, from a federal public university in northeastern Brazil. Outcome was the impact of oral health on daily activities, determined by the Oral Impacts on Daily Performance indicator, and independent variables were sociodemographic characteristics, normative oral health conditions, access to and use of dental services, self-reported oral morbidity, self-perception of oral health, and absenteeism because of dental reasons. All data were analyzed using descriptive and analytical statistics, using the chi-squared test for heterogeneity and linear trend. The significance level used was set at 5%, with a 95% CI. Participants experienced at least one day of work impaired by dental problems in the six months prior to the survey. Prevalence of dental absenteeism was 7.9%. Variables associated with the impact of oral health on daily activities included gender, toothache, toothache intensity, self-reported oral health, awake bruxism, self-reported need for dentures, number of natural teeth in the upper and lower arches, and signs of temporomandibular dysfunction. Sociodemographic, clinical, and subjective oral health variables influence the impact of oral health on the daily activities of public servants.

Symmetrical dental occlusion blocking \u2013 changes of body sway and weight distribution in healthy subjects across 4 age decades

ObjectivesSymmetrical dental occlusion blocking is used in dentistry as a quick diagnostic tool to test for potential influences of the craniomandibular system on body sway and weight distribution. This study presents the changes of body sway and pressure distribution in healthy subjects, free of a temporomandibular dysfunction (TMD). Immediate effects between occlusal blocking and rest position on body sway and body weight distribution in general, as well as for both genders and for four age decades will be evaluated.Materials and methods725 (396f/329 m) subjects (neither subjective signs of TMD nor acute/chronic complaints in the musculoskeletal system) volunteered (21 to 60 years) while both genders were divided into four age groups according to decades. A pressure measuring platform was used. Body sway and weight distribution were recorded in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking (bicuspid region) by cotton rolls.ResultsBoth, the frontal sway and the sagittal sway reduced by 0.67 mm (t(724) = − 3.9 (p < 0.001)) and by 0.33 mm (t(724) = − 3.4 (p < 0.001)). The relative pressure under the left forefoot increased by 0.33% (t(724) = 2.88 (p < 0.001)) and the relative pressure overall under the forefoot increased by 0.67% (t(724) = − 3.4 (p < 0.001)). Gender-specific, age-specific and BMI-specific reactions could not be identified.ConclusionsSubjects, free of any TMD and with no complaints of the musculoskeletal system, show small changes of the body sway and weight distribution when biting symmetrically on a cotton roll. These changes are independent of age, gender or body mass index (BMI). Due to the relative large sample size, the presented results can also be seen as norm values when body sway is used as an additional assessment of a TMD.

Relationship between Pathological Occlusal Changes and the Signs and Symptoms of Temporomandibular Dysfunction.

This study aimed to investigate whether there is a correlation between pathological occlusal changes and the signs and symptoms of temporomandibular dysfunction (TMD). This cross-sectional, quantitative, non-randomized clinical trial was conducted on 150 participants. We examined adult patients of both genders with occlusal interference, malocclusion and dental absence in the posterior region of the dental arch that were associated or not associated with painful symptoms. The questionnaire was administered, and the intra- and extra-oral clinical examination was performed on each patient, including the evaluation of the temporomandibular joint (TMJ) to investigate the presence of dysfunction. The mean age of the participants was 33 years (±2.3), and 103 (68.7%) of them were women and 47 (31.3%) were men. Tooth loss and malocclusion were more prevalent in females. Tooth loss showed a statistically significant association with all the signs and symptoms of TMD (p=0.02). Patients with multiple teeth losses experienced preauricular pain during mandibular opening and closing. There was no association between malocclusion with tooth loss and the signs and symptoms of TMD in 65 patients (p>0.05). Only in the patients with Class II malocclusion there was a significant association with 2 signs of TMD (crackling and bruxism). There was no association between malocclusion and tooth loss with the signs and symptoms of TMD. The signs and symptoms of TMD were more frequent in the patients who presented multiple teeth loss without malocclusion.

USE OF TRANSCUTANEOUS NERVOUS ELECTRIC STIMULATION IN A PATIENT WITH TEMPOROMANDIBULAR DYSFUNCTION: CASE REPORT

Temporomandibular dysfunction (TMD) is a term used to describe changes involving muscle, temporomandibular joint (TMJ) and associated structures disorders. An adequate anamnesis, clinical examination and images are necessary for a correct diagnosis. Thus, the objective of this study is to present the case of a 48-year-old woman, a bruxer, who sought the TMD service of a dentistry institution referring to pain in the bilateral TMJ region. After initial examinations, pain was observed on muscle palpation in the masseter region and reciprocal clicking. Panoramic radiography and magnetic resonance imaging were requested and the patient was referred to the physiotherapy clinic to perform manual therapy and transcutaneous electrical nerve stimulation (TENS), associated with the use of repositioning plate. One week after the beginning of the treatment, pain improvement was reported and there was continuity of pain for a period of 3 months, thus remission of TMD signs and symptoms.

Prevalance of Correlation Between Temporomandibular Dysfunction and Occupational Stress in White Collar Professionals

Aims: Occupational stress (OS) is regarded as associated factor for causing temporomandibular joint temporomandibular dysfunction (TMD). However, there is little knowledge on the relationship between incremental OS and its role in causing TMD. The purpose of the study is to determine the relationship between OS and TMD. This study will help to provide the basic data to improve the conditions at the worksite and enhance the quality of life. Materials and Methods: A cross-sectional study was conducted among 100 white-collar professionals (WCPs) in Karad. To determine the prevalence of TMD, the scaled named Anamnestic Index by Fonseca was used. OS was assessed by the OS Index Scale. Data obtained from the outcome measures were analyzed using InStat, adopting a 5% significance level. Brief analysis was made, and the Pearson correlation test was used to find the correlation between TMD and OS. Results: The results obtained by OSI stated that majority of WCP experienced moderate stress (67%) highest among teachers. Fifty-three percent prevalence of TMD was noted, highest among teachers. The major correlation noted in moderate OS group (38%) majorly affecting teachers. The gender-wise findings noted females (53%) were more prone. Age-wise findings stated more prevalence among 31–40 years (56%). Conclusion: The results of this study show that a significant percentage of population had signs of TMDs, and there are high chances they may develop symptoms in the future. It is necessary to prevent the OS in WCP by improving working conditions, emotional stability, and frequent postural changes. Further studies are necessary for documentation of these preventive measures.

Effect of the dry needling vs manual myofascial therapy at the trigger points in temporomandibular dysfunction

Introduction: The etiology of Temporomandibular Dysfunction (TMD) is multidimensional, considering biomechanical, neuromuscular and biopsychosocial [1]. TMDs are defined in subgroups as problems involving temporomandibular joint (TMJ), masticatory system muscles, and musculoskeletal structures associated with the head and neck [2]. The most relevant signs of TMD are the presence of joint sounds (clicking and crepitation), reduced mouth opening, and disrupted jaw movements. However, pain is the primary problem of this pathology, and it is typically the reason these patients request medical care [3]. The muscular etiology TMD includes the myofascial pain syndrome, which is characterized by the presence of trigger points (TP). The intervention of physical therapy in TP involves myofascial manual therapy and dry needling [4]. The purpose of this study was to investigate the effect of physiotherapy technique for the treatment of muscular TMD by applying manual myofascial therapy and dry needling. Material and Methods: This was a quasi-experimental study that enclosed a group of 15 individuals with a diagnosis of TMD, selected as sample through the questionnaire of Diagnostic Criteria for Research in Temporomandibular Dysfunction (RDC/TMD) and the Fonseca questionnaire, in which they have at least level II of severity. The subjects were randomized into two groups: group one (G1) was submitted to myofascial manual therapy and group two (G2) was submitted to dry needling. Subjects had the pressure pain threshold (PPT) and pain intensity (VAS) evaluated, through algometry and EVA scale respectively, at beginning (M0) and one hour (M1) after being submitted to interventions. This study follows all the principles of the Declaration of Helsinki. Results: The results indicate that both therapies increase the PPT and decrease the VAS, with statistic significantly differences (p < 0.05) between M0 and M1 within both groups. When comparing techniques, no significant differences were observed. Discussion and conclusions: Myofascial manual therapy and dry needling focused in masseter and temporal promoted an increased in the PPT values and a decrease in the VAS value after a single session on patient’s symptoms with TMDs. However, further studies with larger samples should be carried out in order to analyze which technique presents superior results.

Mandibular repositioning in adult patients — an alternative to surgery? A two-year follow-up

Abstract Background Adult patients presenting with skeletal discrepancies may refuse surgical intervention. Materials and methods Thirty-two patients who declined orthognathic correction of their maxillo-mandibular dysplasia and who were without signs of temporomandibular dysfunction (TMD) were offered mandibular repositioning as a non-invasive alternative. Simulating a skeletal correction, it was explained that the approach was based on results described in case reports. Before commencing treatment, initial records, lateral and frontal head films, study casts and photos were obtained (T0) and the mandible was repositioned to camouflage a retrognathic skeletal discrepancy or a mandibular transverse asymmetry by means of an occlusal build-up using Triad™ gel. Results Three months later (T1), 23 patients had adapted to the new occlusion reflected by an absence of functional disturbance and without fracture of the composite occlusal build-up. Mandibular position in these patients was maintained by additional orthodontic treatment and an adjustment of the occlusion to the built-up postured position (T1). The skeletal changes occurring during repositioning were assessed on sagittal and frontal head films while intra-articular changes occurring during a two-year follow-up period (T2) were evaluated on images constructed from CBCT scans. No significant change, either in the direction of relapse or in the direction of further normalisation of condylar position, were observed during the two-year observation period. Conclusion Mandibular repositioning is a non-invasive intervention that may be considered a valid alternative to surgery in selected patients. Morphological variables from the radiographs taken at T0 and the results of the initial clinical evaluation of dysfunction yielded only vague and insignificant indicators regarding the predictability of the adaptation. A CBCT scan at T0 might have contributed to the identification of the patients who would likely accept the repositioning.

Le repositionnement mandibulaire : une alternative à la chirurgie chez des patients adultes ? Un suivi sur deux ans

A number of adult patients with skeletal discrepancies refuse surgical intervention. The aim was to assess the reaction to mandibular repositioning in simulating a skeletal correction in such patients. 32 consecutive patients without any signs of temporo-mandibular dysfunction (TMD) were offered mandibular repositioning, as a non-invasive alternative and it was explained to them that the approach was based on the results described in case reports. Before initiating any treatment initial records, headfilms, study casts and photos were taken (T0) and the mandible was repositioned to camouflage the skeletal discrepancy by means of an occlusal built-up in Triad® Gel. Three months later (T1) 23 patients had adapted to the new occlusion reflected in absence of functional problems and lack of fracture of the built-up. In these patients the mandibular position was maintained by orthodontics adjusting the occlusion to the built-up position (T1). The skeletal changes occurring during repositioning were assessed on sagittal and frontal head films while intra-articular changes occurring during a 2-year follow-up period (T2) were evaluated on images constructed from CBCT images. No significant changes, neither in the direction of a relapse nor in the direction of further normalization of the condylar positioning, were observed during the 2-year observation period. Repositioning is a non-invasive intervention and may be considered a valid alternative to surgery in some patients. Morphological variables from the radiographs taken at T0 and the results of the initial clinical evaluation of dysfunction yielded only vague and insignificant indications regarding the predictability of adaptation to the repositioning.

Idiopathic condylar resorptions: 3-dimensional condylar bony deformation, signs and symptoms.

Our aim was to describe 3-dimensional condylar deformation of the temporomandibular joint (TMJ) and symptoms and signs of temporomandibular dysfunction (TMD) in patients with idiopathic condylar resorption (ICR). We included 25 patients with ICR and 25 controls. We performed cone-beam computed tomographic scans and analyzed condylar width, length, and height as well as the condylar axial angle and the condylar neck angle. TMJ cross sections were evaluated for degenerative characteristics and location of bony deformations. Furthermore, symptoms and signs of TMD were described in the ICR group. In the ICR group, we found statistically significantly reduced condylar width (mean difference, 2.0mm), height (mean difference, 4.9mm), and condylar axial angle (mean difference, 10.6°); 84% of the TMJs had a posterior condylar neck angle (control group, 22%). The most common degenerative changes were noncongruent shape of the condyle-fossa relationship (72%), condylar resorption (56%), and nonintact cortex (40%). More than 70% of the joints with bony deformations showed changes along the entire condylar head. Most patients with ICR showed symptoms and signs of TMD; nevertheless, 12% had no signs or symptoms of TMD. ICR in the TMJ changes the shape and reduces the size of the condyle. Deformity locations are unspecified, and the entire condyle is often affected. Most patients with ICR have signs or symptoms of TMD; however, a small group was asymptomatic and without clinical signs.

Does a Temporary Leg Length Discrepancy have an Influence on Upper Body Posture and Lower Jaw Position in Competitive Athletes?

The purpose of this study was to examine the linkage between the musculoskeletal and the craniomandibular system in competitive athletes. Therefore the upper body posture and lower jaw position were investigated while a temporarily induced leg length discrepancy (LLD) during standing was induced. In this study 34 competitive athletes (2 women/32 men) who had no signs of temporomandibular dysfunction according to their own statements were investigated. The measurement of the upper part of the body posture was performed with a three-dimensional back scanner. Afterwards the condylar position was registered by using a homologated and approved electronic registration device. In order to induce the leg length discrepancy, wooden panels measuring 1 and 3 cm thickness were placed unilaterally under one foot. The statistical analysis of the three-dimensional back measurement was carried out using the Friedman and Wilcoxon matched pairs tests with Bonferroni-Holm correction. The results showed in comparisons of the lateral trunk a decline (p ≤ 0.05), of the height of the shoulder girdle (p ≤ 0.05) and, in every pair comparison, of the height of the pelvis area significant correlations between the body posture and the experimentally induced leg length discrepancy. The biggest changes can be observed in the area of the height of the pelvis in the transverse plane. The alterations in statics can be found at the ipsilateral as well as the contralateral side of the body, whereby changes are dependent of the parameter. Moreover, the position of the left condyle in space changes significantly (p ≤ 0.05). The results illustrate functional correlations of the musculoskeletal system through muscular, neurological and fascia based processes. Furthermore, they show that athletes who have a distinctive supporting and postural musculature possess a good body demeanor as well as a fast musculoskeletal compensation by way of the sensorimotor system correspondent to the heightened side of the body. The theory of the ascendant chain spanning from limb to shoulder girdle and further to mandibular condyles can be demonstrated. Athletes with strong postural muscles can quickly compensate through the use of the somatic nervous system.

Associação entre funções estomatognáticas, oclusão dentária e sinais de disfunção temporomandibular em mulheres assintomáticas

OBJETIVO: verificar a associação entre funções estomatognáticas de mastigação e deglutição, oclusão dentária e sinais de disfunção temporomandibular em mulheres assintomáticas. MÉTODOS: as funções estomatognáticas foram avaliadas pelo exame miofuncional orofacial; o exame da oclusão dentária compreendeu: classificação de Angle; medidas de sobrepasse horizontal e vertical; presença de mordida aberta e cruzada; e a avaliação da articulação temporomandibular foi realizada pelo instrumento Critérios de Diagnóstico para Pesquisa de Desordens Temporomandibulares. RESULTADOS: foram avaliadas 43 mulheres com idade média de 23,7 anos. O exame miofuncional orofacial demonstrou alterações no padrão de mastigação (30,2%) e contrações atípicas na mastigação (18,6%) e deglutição (58,1%). Quanto à oclusão dentária, houve predomínio de classe I de Angle (74,4%), porém nenhuma voluntária apresentou uma oclusão ideal. A avaliação da articulação temporomandibular apresentou amplitude de movimento dentro da normalidade, presença de desvio na abertura da boca (60,5%) e diagnóstico de disfunção temporomandibular (16,3%). Houve associação significante entre presença de ruídos articulares e diagnóstico de disfunção temporomandibular e contrações atípicas na deglutição; padrão de abertura e contrações atípicas na mastigação; e não houve associação entre a Classe Oclusal de Angle, padrão de mastigação e disfunção temporomandibular. CONCLUSÃO: voluntárias assintomáticas apresentaram alterações das funções estomatognáticas, como contrações atípicas durante a deglutição e mastigação, as quais foram associadas com a presença de ruídos articulares e padrão de abertura da boca. Tais achados podem ser atribuídos a desequilíbrios e incoordenação dos músculos envolvidos nessas funções. Nenhuma voluntária apresentou oclusão ideal e não foram encontradas associações com esta condição.

Fibromyalgia: dental aspects

Fibromyalgia is a disease accompanied by diffuse chronic pain for >3 months and tenderness on palpation in at least 11 of 18 anatomic points (American College of Rheumatology criteria). Gnathalgia was also included in the revised fibromyalgia criteria in 2010. Some patients have facial pain spots, symptoms and signs of temporomandibular dysfunction in combination with chronic fatigue and sleep disorder. The paper presents the results of an anonymous questionnaire survey in patients with a valid diagnosis of fibromyalgia. The patients with this disease require a follow-up by a family physician, a rheumatologist, and a dentist.

Is the Frequency of Temporomandibular Dysfunction Different in Various Mandibular Fractures?

Trauma has been considered an important factor of temporomandibular dysfunction (TMD) etiology. The aim of the present study was to compare the frequency of TMDs in various mandibular fractures. This was a retrospective cohort study. Mandibular fractures were subcategorized into 3 groups: group 1 had a unilateral condylar fracture, group 2 had a unilateral condylar fracture with a fracture of the contralateral body or angle of the mandible, and group 3 had a unilateral fracture of the body or angle of the mandible. TMD signs (click, pain) and maximum mouth opening (MMO) were the outcomes of the study, and fracture pattern was considered a predictor factor. Age, gender, and fixation methods were study variables. A χ(2) test was applied to compare TMD signs among groups. One-way analysis of variance was applied to compare MMO and age among groups. Ninety-nine patients in the 3 groups were examined for TMD signs. Results showed that 54.54% of patients in group 1, 69.69% of patients in group 2, and 24.24% of patients in group 3 had click in the temporomandibular joint (TMJ; unilaterally or bilaterally). Analysis of the data showed a significant difference among groups (P < .05). According to the results, 24.24% of patients in group 1, 73.91% of patients in group 2, and 12.12% of patients in group 3 had pain at the TMJ (unilaterally or bilaterally). There was a significant difference among groups for pain (P < .05). Analysis of the data did not show any difference for MMO among groups (P > .05). Patients who had a condylar fracture and a contralateral angle or body fracture seemed to have more TMD signs than those with a unilateral fracture.

Can a high-velocity low-amplitude thrust manipulation of C1-2 affect active depression of the temporomandibular joint in a symptomatic population?

BackgroundThe temporomandibular joint (TMJ) is arguably one of the most complex joints in the human body but its intricate structure and mobile nature make dysfunction in this region extremely common. With a reported prevalence of up to 85% of the general population experiencing at least one sign of temporomandibular dysfunction (TMD) at some point in their lives, a wide range of treatment options must be available to manage the array of disorders that may occur at this joint, in order to provide a tailored approach to suit the individuality of patients. The TMJ has a close topographical and functional relationship with the upper cervical spine (Csp) and dysfunction in one area is often concomitant with reduced function in the other. There is significant research supporting the use of physical therapy for Csp dysfunction but more definitive research needs to objectively assess the effectiveness of cervical treatment for TMD and the reciprocal approach. AimTo investigate whether it is possible to affect active depression of the TMJ via a High-Velocity Low-Amplitude Thrust (HVLAT) technique of the C1-2 spinal segment within a symptomatic population, in order to contribute to the current knowledge base. MethodsA pilot study for a single-blind, randomised controlled trial (RCT), was carried out using 30 volunteers with current TMD symptoms, as defined by the National Health Service. The volunteers were randomly assigned to either the intervention or control group and their TMJ and upper Csp range of motion (ROM) were assessed three times pre- and post-intervention. The Csp was assessed via expert palpation and passive range of motion (PROM) testing and the TMJ was assessed using Silicon Coach video analysis software. The treatment consisted of an HVLAT technique of the C1/2 spinal segment and the control group did not receive any treatment. The data was analysed using Statistical Package for Social Sciences (SPSS) software via parametric t-tests. ResultsThe results of the study demonstrated a statistically significant increase in TMJ AROM from baseline to post intervention (p < 0.01) in both dimensions of measurement (nose to chin and mandibular angle) for those in the treatment group. There was no change in TMJ AROM in either dimension in those assigned to the control group. ConclusionThis study demonstrated that an HVLAT of the C1/2 spinal segment significantly increases active depression of the TMJ in a symptomatic population. Larger RCTs of this nature are recommended, with the use of a TMD assessment tool in order to investigate the effect of this technique on particular sub-groups of TMD.

Prevalence of signs and symptoms of temporomandibular dysfunction in female adolescent athletes and non-athletes

ObjectivesTo compare the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) in female adolescent athletes and non-athletes and to examine the association between signs and symptoms of TMD in female adolescents in different Tanner stages. MethodsThe subjects were 89 female basketball and handball players ages 10–18 years and 72 female non-athlete adolescents ages 10–19 years selected from the Department of Pediatrics (School of Medicine, Federal University of São Paulo) as a control group. A survey was used to assess the signs and symptoms of TMD. According to the answers on the survey the adolescents were classified in two categories: no signs or symptoms present (score A-absent), at least one sign or symptom present (score P-present). The ones who got score “P” were submitted to a standardized functional examination of the masticatory system by four previously calibrated examiners. Pubertal status was assessed based on physical examination by physicians from our Division. The adolescents were classified according to Tanner stages into three subgroups: subgroup 1 (before the growth spurt), subgroup 2 (growth spurt period), subgroup 3 (end of growth spurt). Significant differences between athletes and non-athletes were assessed for categorical variables (Chi-square and Fisher's exact test) and for continuous variables (Mann–Whitney test). The level of significance used was 5%. There was significant agreement between raters, kappa-values (0.621–1.000) and ICC values (0.757–0.899). ResultsThere was no significant difference between the athletes and non-athletes in exhibiting at least one sign or symptom of TMD (p=0.301). When comparing the adolescents who presented at least one symptom of TMD to the different subgroups of Tanner stages no statistically significant differences were found (p=0.124). ConclusionThe lack of significant differences among female adolescent athletes and non-athletes and among the subgroups of Tanner stages may suggests that although contact sports increase the risk of temporomandibular joint lesions and estrogen levels are risk factor for onset of TMD, they do not impact significantly on the onset of this disorder, when considered alone.

Association of Temporomandibular Joint Dysfunction, Condylar Position and Dental Malocclusions in Davangere Population

To study the association between dental malocclusions and temporomandibular joint dysfunction.To study the association between dental malocclusions and condylar position.To study the association between temporomandibular (TM) joint dysfunction and condylar position. The subjects were divided into four groups for dental malocclusions viz. class I malocclusion with or without TM dysfunction, class II division 1 malocclusion with or without TM dysfunction, class II division 2 malocclusion with or without TM dysfunction and class III malocclusion with or without TM dysfunction. Once the patient fulfilled the criteria, the presence or absence of signs of TM dysfunction were elicited from the patient. It shows the association between TM dysfunction signs and left and right condylar positions. It shows the association between TM dysfunction symptom and left and right condylar positions. It shows the association between dental malocclusions and TM dysfunction signs and symptom. It shows the association between dental malocclusions and left and right condylar positions. There was an association between TM dysfunction signs and left and right condylar positions. But, there was no association between TM dysfunction symptoms and left and right condylar positions. There was an association between dental malocclusions and TM dysfunction signs. But there was no association between dental malocclusions and TM dysfunction symptoms. There was an association between dental malocclusions and left condylar position, but there was no association between dental malocclusion and right condylar position. This study indicates that malocclusions and factors of condylar position should be seen as merely cofactors in the sense of one piece of the mosaic in the multifactorial problem of TM dysfunction. TM dysfunction factors that showed significant effects to various malocclusions through this study . This study shows clinical significance of association of various types of dental malocclusions to different conylar positions and TM dysfunction signs and symptoms. Before treating orthodontic patients, one should evaluate and treat the TM disorders for better prognosis.

Prevalence of temporomandibular dysfunction in orthodontic treatment

The aim of our study was to investigate the prevalence of temporomandibular dysfunction (TMD) during orthodontic treatment. the study investigated all the patients receiving orthodontic treatment in the dentofacial orthopedic department in Casablanca in the course of the different stages of treatment over a 4-month period. We looked for a possible association between the presence of at least one sign of TMD, the Helkimo anamnesis index, the clinical Helkimo index and the following factors: age, gender, extractions, or not, of premolars, duration, type and stage of orthodontic treatment, molar and canine class, crowding, overjet, overbite and unilateral crossbite. Data were analysed using Epi-info 6.0.fr software. The analysis of the results was done using the Chi(2) test (P<0.05). no statistically significant association could be established between TMD and the various factors under investigation with the exception of the association between gender and the Helkimo anamnesis index, stage of treatment and the Helkimo anamnesis index and the Angle molar class and the Helkimo clinical index.

Prevalence of signs and symptoms of temporomandibular dysfunction in male adolescent athletes and non-athletes

Purpose The aim of the study was to compare the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) in male adolescent athletes—basketball players and non-athletes and to examine the association between signs and symptoms of TMD in male adolescents in different Tanner stages. Methods The subjects were 46 male basketball players ages 10–13 years and 41 male adolescent non-athletes ages 10–18 years selected from the Department of Pediatrics (School of Medicine, Federal University of São Paulo) as a control group. A questionnaire was used to assess the signs and symptoms of TMD. According to the answers on the questionnaire the adolescents were classified in two categories: no signs or symptoms present (score A—absent), at least one sign or symptom present (score P—present). The ones who got score “P” were submitted to a standardized functional examination of the masticatory system by the same examiner. Pubertal status was assessed based on physical examination by physicians from our Division. The adolescents were classified according to Tanner stages into three subgroups: subgroup 1 (before the growth spurt), subgroup 2 (growth spurt period), subgroup 3 (end of growth spurt). Significant differences between athletes and non-athletes were assessed using non-parametric Wilcoxon test for continuous variables and the Fisher's exact test for categorical variables. The level of significance used was 5%. Results There was no significant difference between the athletes and non-athletes in exhibiting at least one sign or symptom of TMD ( p = 0.1148). When comparing the adolescents who presented at least one symptom of TMD to the different subgroups of Tanner Stages no statistically significant differences were found ( p = 0.8357). Conclusion The lack of significant differences among male adolescents athletes and non-athletes may be caused by the size of the sample, the age of the athletes or by a probable protective action of testosterone levels in male athletes. The lack of statistical difference comparing the adolescents who presented at least one sign or symptom of TMD to subgroups of Tanner is probably because estrogen is the risk factor hormone and the levels of estrogen in male adolescents are very low.

Prevalence of Signs of Temporomandibular Joint Dysfunction in Asymptomatic Edentulous Subjects: A Cross-Sectional Study

Patients having complete dentures with reduced vertical dimension generally do not manifest Temporomandibular Joint problems. It is not understood as to why the closure of jaws in dentulous individuals can predispose to Temporomandibular Joint problems, while the same etiology in edentulous subjects does not cause any concern. This study was planned to find out the prevalence of various Temporomandibular Joint dysfunction signs in subjects who were edentulous for a period of 6months to 2year. The various signs were obtained from a population of 100 healthy asymptomatic edentulous subjects by a questionnaire and then were clinically examined for the presence or absence of signs of Temporomandibular Joint dysfunction. 59% of the subjects exhibited one or more signs of Temporomandibular Joint dysfunction, 41% of the subjects did not show any signs of Temporomandibular Joint dysfunction. 56.6% of males reported signs of Temporomandibular Joint dysfunction when compared with females which was 62.5%. 43.3% of males did not show any signs of Temporomandibular Joint dysfunction when compared with those of the females which was 37.5%. The number of subjects who showed two signs was 29%, subjects who had only one sign was 25%. It was found that dysfunction was prevalent among both men and women in more than half of the asymptomatic subjects examined. 59% had one or as many as three signs of Temporomandibular dysfunction. The most commonly seen Joint dysfunction was the joint sounds which was 47%

Risk Indicators for Signs and Symptoms of Temporomandibular Dysfunction in Children

The aim of this study was to determine the risk indicators for signs and symptoms of temporomandibular dysfunction (TMD) in children between 4 and 12 years of age. One hundred six patients were assessed for the following variables: (1) signs and symptoms of TMD (deviation when opening mouth, joint noises, limitation of movement, pain in the mandible or during movement), (2) dentition and occlusal abnormalities, and 3) habits (pacifier sucking, nonnutritive sucking, finger sucking, nail biting, and teeth grinding (bruxing). Multivariate logistic regression was performed with the level of significance set at P < 0.05. The prevalence of at least one sign or symptom of TMD in the present sample was 12.26% (n = 13). Only bruxing (P = 0.01, odds ratio 6.08, CI 1.51-24.51) and posterior crossbite (P = 0.03, odds ratio 5.74, CI, 1.18-27.85) achieved statistical significance in the multivariate regression model and were considered risk indicators for signs and symptoms of TMD. Children with bruxing or clenching habits and those with posterior crossbite have a greater likelihood of developing signs and symptoms of TMD.