Cephalometric deviations present in children and adolescents with temporomandibular joint disorders

Abstract

INTRODUCTION: Temporomandibular disorders (TMD) have proved to be a risk factor for developing hyperdivergent facial growth patterns. OBJECTIVE: The aims of this study were: (1) Assess differences between the cephalometric measurements in children with articular TMD and a control group, before and after mandibular growth peak according to cervical vertebral maturation; and (2) Identify a predictive model capable of differentiating patients with TMD and control group patients based on early cephalometric characteristics. METHOD: The study included children and adolescents with maximum age of 17 years, divided into experimental group (n=30) diagnosed with articular TMD-according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for children and adolescents-subdivided according to growth stage, called pre-peak (n=17) and post-peak (n=13) and control group (n = 30), matched by gender, skeletal maturity stage of the cervical vertebrae and classification of malocclusion. Lateral cephalometric and craniofacial structures were traced and their relations divided into: Cranial base, maxilla, mandible, intermaxillary relations, vertical skeletal relations and dental relations. Differences between the means for each variable were evaluated by applying the statistical Student t test for independent samples. RESULTS: The means of the variables analyzed in the pre-peak showed no statistically significant differences. However, analysis of post-peak showed that the experimental group displayed decreased SNA and SNB and increased SN.Gn and 1.NB (p<0.05). CONCLUSION: It was possible to identify a predictive model able to differentiate patients with TMD and asymptomatic controls from early cephalometric characteristics

Disc Displacement of the Temporomandibular Joint and Facial Asymmetry in Children and Adolescents: A Systematic Review and Meta-Analysis

“…In the five studies from the quantitative synthesis, a total number of 515 subjects were included. Seven studies used the MRI method for disc position classification, whereas just one study used temporomandibular disorders investigation criteria for a diagnosis (RDC/TMD) [ 24 ]. Radiographic evaluation used lateral cephalogram in four studies [ 24 , 25 , 26 , 27 ], and posteroanterior cephalogram in five studies [ 3 , 4 , 26 , 28 , 29 ], Trpkova et al [ 26 ] used both methods.…”

“…Seven studies used the MRI method for disc position classification, whereas just one study used temporomandibular disorders investigation criteria for a diagnosis (RDC/TMD) [ 24 ]. Radiographic evaluation used lateral cephalogram in four studies [ 24 , 25 , 26 , 27 ], and posteroanterior cephalogram in five studies [ 3 , 4 , 26 , 28 , 29 ], Trpkova et al [ 26 ] used both methods. Bilateral DD was reported in four studies [ 3 , 25 , 26 , 28 ], unilateral DD was reported in [ 3 , 4 , 26 , 28 , 29 ], while two studies did not report the presence of either unilateral or bilateral DD [ 24 , 27 ].…”

“…Only one study out of the three included had a statistically significant result pointing in the same direction. Omitting Bastos study [ 24 ] in the leave-one-out sensitivity analyses modified the pooled result to be significant, but the exclusion of any of the other studies did not have the same effect ( Supplementary Figure S8 ).…”

“…The Newcastle Ottawa Scale (NOS) was engaged to evaluate the scientific research ( Table 3 ). The case and control definitions were adequately followed in the majority of the studies since they used MRI to diagnose the disc position, except for one study that used research diagnostic criteria for temporomandibular disorders [ 24 ]. The case representativeness was reported in only two studies that either used a consecutive sample [ 4 ] or all the subjects in their database [ 3 ].…”

“…The comparability of the groups was partially assured by five studies since they studied only female subjects [ 25 , 26 , 27 , 28 , 29 ]. Only one study matched the groups by gender, Angle’s categorization of misaligned teeth, and the cervical vertebra development score [ 24 ]. All the studies can be considered to have an appropriate exposure ascertainment by using cephalometric measurements.…”