Mandibular movements in children with and without signs and symptoms of temporomandibular disorders

Abstract

his research aimed to evaluate mandibular movements in children with and without signs and symptoms of temporomandibular dysfunction. The sample taken consisted of 99 children aged 3 to 5 years distributed in two groups: I -Absence of signs and/or symptoms of TMD (25 girls/40 boys); II -Presence of signs and symptoms of TMD (16 girls/18 boys). The symptoms were evaluated through an anamnesis questionnaire answered by the child's parents/caretakers. The clinical signs were evaluated through intra-and extraoral examination. Maximum mouth opening and left/right lateral movements were measured using a digital caliper. The maximum protrusive movement was measured using a millimeter ruler. The means and standard deviations for maximum mouth opening in Group I and Group II were 40.82mm±4.18 and 40.46mm±6.66, respectively. The values found for the left lateral movement were 6.96mm±1.66 for Group I and 6.74mm±1.55 for Group II, while for the right lateral movement they were 6.46mm±1.53 and 6.74mm±1.77. The maximum protrusion movements were 5.67mm±1.76 and 6.12mm±1.92, in Groups I and II, respectively. The mandibular movement ranges neither differed statistically between groups nor between genders. FAPESP Process 96/0714-6.

Limites de movimentos mandibulares em crianças

“…No significant difference was observed between genders regarding the measure of excursive mandibular movements, in agreement with previous studies (3,6,8,24). The measures studied seem to follow the same tendency of other physical characteristics that start to differentiate according to gender at puberty since gender differences have been detected in samples of adolescents and adults (2,10,15,19,20).…”

“…The measures obtained in the present study were higher than the means obtained for children aged 1 to 1 and a half years (8) and only the lowest age range presented means close to those of children aged 3 to 5 years (24).…”

“…The increased mandibular range of movement with increasing age ranges (3,6,8,11,24) may be related to anatomical changes, to the maturation of the central nervous system, to skeletal growth and to the maturation of occlusal function and of oral motor control (25)(26)(27)(28)(29)(30).…”

Management of Temporo-Mandibular Disorders in children and adolescents: A literature review

“…Se han publicado varios estudios que tratan sobre los síntomas que presentan los pacientes infantiles con TTM (13). Estos problemas se caracterizan principalmente por la presencia de dolor, tanto en la ATM, la región periauricular y en los músculos masticatarios; además de limitación de la apertura bucal, desviaciones de la mandíbula durante los movimientos de apertura y cierre, chasquidos y/o crepitaciones de la artículación (11).…”

“…Aún no existe un concenso general acerca de los criterios diagnósticos concluyentes para la detección de los problemas articulares en los pacientes pediátricos, aunque la presencia de dolor localizado en el área de la ATM, cefalea, dolor de oídos o de los músculos masticatorios, apertura bucal limitada, desgastes dentarios anormales, y la presencia de ruidos articulares, entre otros, son una manifestación de algún tipo de TTM (13). Asimismo, es frecuente que los TTM en los pacientes pediátricos pasen inadvertidos o no son diagnosticados; esto ocurre principalmente porque entre algunos profesionales de la salud, médicos y odontólogos, pacientes y padres de familia creen que los ruidos articulares, los chasquidos y las crepitaciones causados por disfunciones intracapsulares y otros signos, son considerados "normales" en los niños, o bien, que desaparecen espontaneamente con el paso del tiempo, por lo que no necesitan ser atendidos (32).…”