survey on tmj disorders

7/30/2019 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

survey on tmj disorders

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