survey on TMJ disorders
Transcript of survey on TMJ disorders
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Introduction: The TMJ
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Cause of TMJ sounds
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Introduction Signs-Symptoms of TMD:
Pain
Headache
Difficulty in range of mandibular movements
Joint sounds Acute malocclusion
Risk factors analyzed
Incisal malrelation
Stress
Pain in Oral cavity
Management of temporomandibular disorders and occlusion 6th
edition : Jeffrey P.Okeson
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Objectives
To investigate the prevalence of signs and
symptoms of TMDs
To study the role of various risk factors indevelopment of signs and symptoms of
TMDs
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Materials and methods
Sample size : 500
Study area:
Age group of sample 18 25 years
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Questionnaire :
1. Do you have any tenderness or pain in jaw muscles
1) Yes 2) No
2. Do you have any difficulty in jaw movements
1)Yes 2) No
3. Do you feel any clicking sounds during jaw movements1) Yes 2) No
4. Are your wisdom teeth erupting
1) Yes, with pain/ cheek bite
2) Yes but no pain/ cheek bite
3) No
4. Are you feeling stressed
1) Yes 2)No
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Clinical examination :
1. Palpation of TMJ : to note joint soundsa) absent b) present
2. Type of molar relation
a) Class I b) Class II c) Class III
3. Vertical incisal relationship : overbite
a) 0 4 mm b) >4 mm
4. Horizontal incisal relation : overjet
a) 0 4 mm b) >4 mm
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Prevalence of symptoms in
sample Group 1 : with symptoms of TMDs : 51
Group 2 : with asymptomatic click at TMJ : 187
Group 3 : no symptoms : 262
10%
38%52%
Samples
Symptoms of TMD
with only palpable click
No symptoms
Total : 500
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Results
Finding Symptoms of TMDWith only
palpable clickNo
symptoms
Tenderness,pain of jaw muscles 39 16 7
76 % 9 % 3 %Incisal relation
(over bite >5 mm) 32 54 4563 % 29 % 17 %
Errupting 3rd molarswith pain 30 80 5259 % 43 % 20 %
Stress 19 13 4738 % 72 % 18 %
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Relation between sample with
pain in jaw muscles in 3 groups
51
187
262
39
16
7
0
100
200
300
400
500
Symptoms of TMD with only palpableclick
No symptoms
Subjects frequency
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0
100
200
300
400
500
Symptoms ofTMD
with onlypalpable click
No symptoms
51
187262
32
54
45
Total Subjects overbite >5mm
63%
29%
17%
Relation between sample
with overbite >5mm in 3
groups
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Relation between samples under
stress in 3 groups
0
100
200
300
400
500
Symptoms of TMD with only palpableclick
No symptoms
51
187
262
19
13
47
Total Subjects stress presemt
w
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Relation between samples in 3
groups having erupting 3rd
molars with pain/cheek bite
Symptoms of TMD with only palpable
click
No symptoms
51
187
262
30
80
52
Total Subjects Errurting 3rd molars
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discussion
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Prevalence of TMDs
Epidemiological studies : 20 60 %
A Johansson et al in 2006 :20%
Davids Locker et al in 1988 : 60% Present study : 48%
Increased incisal over bite
Tsolka et al (1995) : no relation R.Celic (2002) : HO, VO > 5 mm: greater chance of TMD
Present study : 63%
Johansson et al; Journal of oral rehabilitation 2006;33;473 481 ;
David Locker; J of Community Dentistry and oral epidemiology vol 16 issue 5;pg 310 313
Cincaglini R et al: J oral Rehabil 26: 248 253, 1999
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Emotional stress
Falace DA (1993) :By sympathetic stimulation
increases muscle tonicity
Present study: 38% with stress had TMD
72% wit asymptomatic click had TMD
PainCarlson CR (1993) : altered function under pain :
protective co contraction
Present study: 59% with stress had TMD
43% wit asymptomatic click had TMD
Farace DA et al : J Orofac Pain;7:15-22, 1993
Carlson et al Pain 55: 397-400 ; 1993
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Asymptomatic sounds
R.Tallents (1993): in asymptomatic volunteers : 44%
had identifiable sounds at TMJ but only 24% had
TMD as per magnetic resonance imaging
M Rohlin et al(1985) : Study in 55 autopsy specimens
: presence of sounds= presence of pathology
R.H.Tallents et al ; J of prosthetic dentistry; march 1993; vol 69 issue 3;Temporomandibular joint sounds in asymptomatic volunteers; pg 298 304
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Clinical significance of
study :
Gives an idea out frequency of signs oftemporomandibular disorders
Helps in understanding significance of
asymptomatic joint sounds at TMJ Better diagnosis of orofacial pain and
discomfort
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Summary
Frequency of risk factors like over bite > than 4
mm, errupting 3rd molars accompanied with pain
were similar in those with symptoms and
subjects with only an asymptomatic click
Stress higher in asymptomatic click
Prognosis of joint sounds
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References
Management of temporomandibular disorders
and occlusion 6th edition : Jeffrey P.Okeson ; pg
130 285
Bells orofacial pain The clinical managementof orofacial pain 6th edition Jeffrey P.Okeson
Functional occlusion from TMJ to smile design :
Peter E Dawson
TMJ and craniofacial pain Diagnosis and
management 2nd edition : James R. Fricton
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References
A. Johansson et al; Journal of oral rehabilitation
2006;33;473 481 ; Risk factors associated with
symptoms of temporomandibular disorders in a
population of 50 and 60 year old subjects
M. Rohlin et al; Journal of oral and maxillofacial sugery
1985; vol 43; issue 3; march 1985;Corellation of TMJ
sounds with joint morphology in 55 autopsy specimens
pg 194 200
Carlson et al : Journal of Orofacial Pain; 1993;Comparison of psycho logic and physiologic functioning
between patients with masticatory muscle pain and
matched controls
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References
R.H.Tallents et al ; J of prosthetic dentistry; march 1993;
vol 69 issue 3; Temporomandibular joint sounds in
asymptomatic volunteers; pg 298 304
David Locker; J of Community Dentistry and oral
epidemiology vol 16 issue 5; Prevalence of symptoms
associated with TMDs in Cannadian population; pg 310
313
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Thank you