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

Effects of Contact Sports on Temporomandibular Disorders: An Observational Study

The study investigated the prevalence of temporomandibular disorders in 100 competitive athletes in contact sports, equally grouped by the practiced game: Soccer (SoG), Rugby (RG), American Football (AFG), Boxing (BoG), Basketball (BaG), compared to a randomly control group of 20 non-athletes (CG). Symptoms and signs were examined according to the standardized Diagnostic Criteria for Temporomandibular Disorders through a questionnaire and clinical evaluation. Arthralgia showed significant differences between RG and CG and between AFG and CG (p < 0.05). Study groups reported masticatory muscle pain during function, neck and shoulder pain more frequently than CG, except for BoG. Closing click was significantly more present in study groups than CG, while crepitation was significantly higher only in RG and AFG. The deviation was wider in SoG, RG and AFG compared to CG (p < 0.05). Tukey’s multiple comparisons test showed a statistically significant reduction in right laterotrusion in RG vs. CG (p < 0.05); the comparison showed a decrease in right laterotrusion in RG vs. SoG and BoG (p < 0.05), a decrease in endfeel in RG vs. CG, BaG and AFG (p < 0.05). The data seem to support a relationship between the prevalence of TMD symptoms and signs in competitive athletes in contact sports, especially in RG and AFG compared to CG.

Impact of sports on temporomandibular dysfunction: a comparison of competitive and recreational female athletes as well as female non-athletes

Objectives

The present study was conducted to investigate the correlation between (competitive) sports and the occurrence of temporomandibular dysfunctions (TMD) by comparing the prevalences in competitive, recreational, and non-athletic women.

Materials and methods

A total of 138 women between the ages of 18 and 45 were interviewed about symptoms of TMD by means of a questionnaire. Based on their athletic performance level, the participating women were classified as competitive athletes, recreational athletes, or non-athletes (each group n = 46).

Results

Symptoms of TMD were notably less frequent in competitive female athletes (52.2%) than in recreational female athletes (63.0%) and female non-athletes (60.9%). With increasing training load, the prevalence of TMD decreased in both the competitive and recreational female athlete groups.

Conclusions

Athletic activity in general seems to have a positive effect on the occurrence of TMD. Competitive female athletes appear less likely to suffer from symptoms of TMD than recreational athletes and non-athletes. One possible explanation for this could be the better supervision by qualified trainers and physiotherapists in competitive sports.

Clinical relevance

Patients should be motivated to engage in sports as a protective measure against symptoms of TMD. However, it is important to ensure that they are properly instructed by experienced personnel in order to avoid unphysiological strain and negative consequences.

Masticatory efficiency, bite force and electrical activity of the masseter and temporalis muscles in bodybuilders

Background

This study aimed to compare the masticatory efficiency, the maximum voluntary occlusal bite force (MVOBF) and the electrical activity (EMG) of masticatory muscles of practitioners of upper limb bodybuilding before and after physical activity.

Material and Methods

Twenty healthy individuals (10 men and 10 women, age from 18 to 30 (mean of 24.7 years old) without masticatory system disorders, that regularly practice hypertrophic physical activity were submitted to the analyses of masticatory efficiency, MVOBF, and surface EMG of the temporalis and masseter muscles. The masticatory efficiency was analyzed by comminution of the artificial material (Optocal®) and a sieving method. The MVOBF was measured by a dynamometer, and EMG was evaluated during resting mandibular position, maximum voluntary clenching (MVC), and MVC with a Parafilm M tape between teeth, and free mastication of chewing gum. The analyses were made before (T0) and immediately after the performance of upper limb bodybuilding exercises (T1). The data of masticatory efficiency and MVOBF were submitted to the Student T-test, and their correlations were analyzed by the Pearson correlation test, and the EMG data were submitted to the 2-way repeated measures ANOVA, all tests with a 5% significance.

Results

There was a significant decrease of masticatory efficiency after the training. No statistical difference in the MVOBF and EMG was found, and there was a positive correlation between masticatory efficiency and MVOBF.

Conclusions

Therefore, changes were found for masticatory efficiency only, which decreased after hypertrophic exercise. There was a positive correlation between masticatory efficiency and MVOBF. Key words:Masticatory efficiency, bite force, physical activity, electromyography.

Diagnostic significance of magnetic resonance imaging in distinguishing temporomandibular disorders: a retrospective chart review

Background

This study was to evaluate the diagnostic significance of Magnetic Resonance Imaging (MRI) in distinguishing temporomandibular disorders (TMD).

Methods

A total of 684 patients with TMD were included in the study. Diagnosis for TMD was conducted according to the international criteria. Two professional radiologists were selected for professional training, and the Kappa values were compared for the diagnosis results to determine the consistency of the diagnosis. Then MRI images of these 684 patients were analyzed and the diagnosis results were obtained.

Results

MRI can be used for the diagnosis of TMD. There were significantly more females (518 cases) than males (166 cases) with TMD; Disc displacement with/without reduction is more common in the youth group, with the majority aged 20–30 years. The highest incidence of temporomandibular joint osteoarthrosis is in the 60-year-old age group, followed by the 70-year-old age group.

Conclusions

Bilateral temporomandibular joint MRI can clearly show their changes; there are significantly more female with TMD than male; osteoarthritis has a significant correlation with age.

Effects of competitive sports on temporomandibular dysfunction: a literature review

OBJECTIVES

The German Society of Craniomandibular Function and Disorders recommends that patients suffering from temporomandibular dysfunctions should practice sports in order to compensate for everyday stress. This raises the question as to what extent competitive athletes develop temporomandibular dysfunctions or whether their athletic activities protect them. With the present literature review, the authors intend to give an overview of the currently available publications on this topic.

MATERIALS AND METHODS

A literature research in the PubMed and Google Scholar databases was performed to filter out the currently available publications on the topic 'sports, and temporomandibular dysfunction.

RESULTS

Out of 114 available articles, seven met the inclusion criteria. Two other relevant articles were found in the list of references, so that in total, nine publications were picked for the review. In case numbers ranging from eight to 347 subjects, a temporomandibular dysfunction was detected with a prevalence between 11.7% and 100% for athletes and between 11.11% and 14.3% for non-athletes. Different kinds of sports were evaluated, all of them contact sports: basketball, handball, wrestling, boxing, karate, mixed martial arts, field hockey, water polo, and soccer. One study compared athletes with and without consumption of anabolic steroids, regardless of the type of sport. The level of athletic performance varied across the different studies.

CONCLUSIONS

Currently, studies dealing with the effect of competitive sports on temporomandibular dysfunction are scarce. Inconsistent methodological procedures permit only limited comparability.

CLINICAL RELEVANCE

A general trend, however, can already be discerned: professional athletes suffer from temporomandibular dysfunctions more frequently than non-athletes.

Prevalence of anamnestic symptoms and clinical signs of temporomandibular disorders in adolescents-Results of the epidemiologic LIFE Child Study

BACKGROUND

Prevalence values for symptoms and signs of temporomandibular disorders (TMD) in adolescents vary within the literature due to differences in set-ups of examination protocols.

OBJECTIVES

The objective was to present prevalence values for symptoms and signs of TMD in German adolescents that were observed within a standardised examination. Prevalence values comparing gender or pubertal status should be investigated.

METHODS

A cross-sectional sample of the LIFE Child Study aged 10 to 18 was examined. A questionnaire gathering anamnestic symptoms of TMD was completed, and an examination according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was performed by trained dentists. Pubertal status according to Tanner stages was documented. Descriptive statistics, Mann-Whitney U and Wilcoxon signed-rank tests were performed.

RESULTS

A total of 1.116 participants (mean age 12.9 years, 51.4% female) were consecutively recruited. Most prevalent anamnestic symptoms were headaches (55.7%) and temporomandibular joint (TMJ) sounds (17.6%). The major clinical sign was TMJ sounds (31.9%). Both the examination of muscles or TMJs showed that pain to palpation was statistically significantly higher than familiar pain (P < .001). Gender comparisons revealed higher prevalence values and an increase in TMD symptoms and signs during pubertal development in females.

CONCLUSION

The prevalence of self-reported headaches, as well as anamnestic and clinical TMJ sounds, was high in German adolescents. Prevalence values for pain to palpation and familiar pain obtained relevant differences. Considering the DC/TMD, females are more affected by TMD signs and symptoms that increase during pubertal development, than male adolescents.

Signos y síntomas asociados a trastornos temporomandibulares en niños y adolescentes. Cali, Colombia

Los trastornos temporomandibulares (TTM) en pacientes pediátricos se han estudiado poco. Realizar un diagnóstico oportuno, hace que exista mayor interés por parte de los investigadores para orientar a los odontólogos. El objetivo del estudio fue identificar la presencia de trastornos temporomandibulares registrados en las historias clínicas de pacientes atendidos en la clínica de Odontopediatría de la Universidad del Valle. Se realizó un estudio observacional descriptivo y transversal para evaluar presencia de trastornos temporomandibulares en pacientes, en edades entre 4 a 14 años, que asistieron a las clínicas de Odontopediatría de la Universidad del Valle (Cali-Colombia), durante 2013 y 2016. Se revisaron, 712 historias; 56% de sexo masculino y 44% de  sexo femenino. El 18,11% reportaron la presencia de al menos. Los signos y síntomas asociados con los TTM, los más frecuentes fueron el click bilateral (36,4%), la desviación y deflexión mandibular (27,1%) y dolor a la palpación (24,0%). La subluxación (1,6%) y el chasquido articular en apertura (0,8%) fueron los de menor presencia. Se concluyó que los trastornos de la ATM cada vez son mayores, es importante, realizar investigaciones que involucren los factores de riesgo y/o desencadenantes, la intervención oportuna y el manejo multidisciplinario de esta alteración. 

Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder

BACKGROUND

Rasch analysis has been used in recent studies to test the psychometric properties of a questionnaire. The conditions for use of the Rasch model are one-dimensionality (assessed via prior factor analysis) and local independence (the probability of getting a particular item right or wrong should not be conditioned upon success or failure in another).

OBJECTIVE

To evaluate the dimensionality and the psychometric properties of the Fonseca anamnestic index (FAI), such as the fit of the data to the model, the degree of difficulty of the items, and the ability to respond in patients with myogenous temporomandibular disorder (TMD).

METHODS

The sample consisted of 94 women with myogenous TMD, diagnosed by the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), who answered the FAI. For the factor analysis, we applied the Kaiser-Meyer-Olkin test, Bartlett's sphericity, Spearman's correlation, and the determinant of the correlation matrix. For extraction of the factors/dimensions, an eigenvalue >1.0 was used, followed by oblique oblimin rotation. The Rasch analysis was conducted on the dimension that showed the highest proportion of variance explained.

RESULTS

Adequate sample "n" and FAI multidimensionality were observed. Dimension 1 (primary) consisted of items 1, 2, 3, 6, and 7. All items of dimension 1 showed adequate fit to the model, being observed according to the degree of difficulty (from most difficult to easiest), respectively, items 2, 1, 3, 6, and 7.

CONCLUSION

The FAI presented multidimensionality with its main dimension consisting of five reliable items with adequate fit to the composition of its structure.

Risk factors for temporomandibular disorder: binary logistic regression analysis

Objectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and marital status) on the occurrence of temporomandibular disorder. Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oesteoarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and Classes D/E (very poor social class). The results were analyzed using Pearson’s chi-square test for proportions, Fisher’s exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis. Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of exhibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems. Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems.

Key words:Temporomandibular joint disorders, risk factors, prevalence.