1. TMD Prevalence and Associated Factors in Brazilian Children
UFRJ
#117697
BRITO. D.I.; Kuchler. E.C.; Gleiser. R.
AIMS
RESULTS
To verify the prevalence of signs and symptoms of temporomandibular disorders (TMD) in 6-12-years-old Brazilian schoolchildren and to evaluate its relationship with age, gender, ethnicity, bruxism, chewing fatigue or pain, parafunctional habits and headache.
White
46.20%
Black
37.30%
Mixed
16.20%
Other
0.30%
Parafunctional habits
Headache
Bruxism
Chewing pain/fatigue 12 11 10 9 8 7 6
20%
80%
60%
40%
Age (years)
Statistically significant* differences of TMD signs/symptoms across subject ages
* Multivariated logistic regression models
Any TMD sign / symptom ♂ ♀ 12 11 10 9 8 7 6
20%
80%
60%
40%
Age (years)
Presence of any TMD sign/symptom per age
METHODS
Examined TMD sign/symptom
Sex
Total (%)
Male (%)
Female (%)
Mouth opening limitation
1.1 .7 .9
Mouth opening deviation .8
Mouth opening luxation
Pain on passive opening
13.0
12.0
12.5
TMJ Click
16.6
15.8
16.2
TMJ Crepitus
30.7
32.2
31.4
TMJ pain on lateral palpation
10.2
12.3
11.2
TMJ pain on posterior palpation *
17.1
21.7
19.3
Masseter pain on palpation
12.4
15.1
13.7
Anterior temporal pain on palpation
8.9
11.0
9.9
Medium temporal pain on palpation
4.5
5.2
4.9
Posterior temporal pain on palpation
4.7
5.7
Submandibular region pain on palpation
11.6
12.6
Posterior mandibular region pain on palpation
21.6
24.0
22.8
Traits reported by parents
TMJ pain or fatigue
12.8
18.2
15.6
Bruxism
27.3
29.0
28.8
Parafunctional habits *
53.8
67.9
61.2
Headache *
32.1
43.0
37.8
Overall TMD (any examined sign or symptom)*
31.8
37.9
34.8
* p < .05
Randomized sample: children (6-12-years-old, 51.8% ♂) – city of Juiz de Fora, MG, Brazil - Excluded: previous or ongoing orthodontic treatment, participation unwillingness
TMD examination (RDC/TMD axis I + Faces Pain Scale Revised): - Mouth opening limitation - Mouth opening deflection - Luxation - TMJ lateral, posterior and passive pain - TMJ clicking and crepitus - Muscle pain (anterior, medium and posterior temporalis, masseter, submandibular and posteromandibular regions)
Parent interview: - Parafunctional habits, bruxism, chewing fatigue/pain, headache - Informed consent signature (Review board IESC-UFRJ 51/2007)
Pilot: 20 subjects, same age, examined and re-examined - Kappa inter = 0.875; intra = 0.895
Statistical analyses: descriptive + uni and multivariated logistic regression models
Late
Mean
Early
40%
Any sign/symptom
Submandibular region pain
TMJ posterior pain
Crepitus
Clicking
Pain on passive opening
70%
60%
50%
30%
10%
20% 0%
Statistically significant* TMD signs/symptoms increase according to mixed dentition stages
* Multivariated logistic regression models
Statistically significant* ethnical differences
Statistically significant TMD signs/symptoms relationship with possible contributors/outcomes
CONCLUSIONS
40 %
Crepitus
TMJ lateral pain
TMJ posterior pain
Masseter pain
Anterior Temporalis pain
Medium Temporalis pain
Posterior Temporalis pain
Submandibular region pain
Posterior mandibular region pain
Any sign/ symptom
Contributors
Parafunctional habits
---
2.314
(<0.001)
1.640
(0.016)
Bruxism
2.058
(0.009)
Outcomes
Headache
3.605
1.957
(0.001)
3.345
4.133
4.134
3.702
(0.026)
1.950
(0.007)
3.292
1.824
(0.003)
Chewing pain/fatigue
5.708
4.798
3.583
5.959
4.443
4.249
2.914
20.767
Submandibular region pain
30 %
Present results show high prevalence of TMD signs and symptoms among children. It was associated with age, ethnicity, parafunctional habits (including bruxism), reported headache and TMJ pain or fatigue.
Masseter pain
20 %
Medium Temporalis pain
10 %
* Multivariated logistic regression models
0 %
White
Mixed
Black