An Analysis of the Temporomandibular Joint Range of Motion and Related Factors in Children and Adolescents

Abstract

This study was designed to establish safe guidelines for pediatric dental practice regarding temporomandibular joint (TMJ) range of motion (ROM) and mouth area (MA). A total of 438 children aged 3–15 years old of homogenous ethnicity participated in the study; the distribution of participants was approximately equal (sex; n = 15; age, n = 30). Maximum mouth opening (MMO), body height, weight, and age of each participant were recorded, and the TMJ ROM including anterior and lateral movements, MA, and mouth width were documented. Males showed higher mouth width, MMO, and MA values than females. MMO and MA increased with age, height, and weight in a statistically significant manner. MMO of 40 mm is reached by the age of 5.2 years, at a height of 105.9 cm and a weight of 18.6 kg. MMO showed a moderate correlation with age, height, weight, and mouth width, and MA moderately correlated with mouth width. Anterior and lateral movements did not show any close relation to these aforementioned factors. The findings of this study suggest that forcible mouth opening over 40 mm should be more cautiously considered , especially in children shorter than 105 cm, lighter than 18 kg and in children under 5 years old.

A Novel Technique to Accurately Measure Mouth Opening Using 3D Electromagnetic Articulography

“…When comparing men and women, they found significant differences in the mouth opening, being greater in men. Park et al [ 18 ] conducted a similar study in children, obtaining similar results. Singh et al [ 19 ] studied the mandibular opening in 756 adults in Yamunanagar City, Haryana, India, and found that the men had a greater mandibular opening (45.36 ± 6.70 mm) than the women (41.27 ± 6.75 mm) with a significant p -value ( p = 0.000).…”

“…Several studies use the definition of distance between edges of front incisors not including overbite [ 5 , 19 , 20 , 40 , 41 ], or including overbite [ 22 , 23 ]. Others consider the vertical distance between edges of frontal incisors [ 18 ], vertical dimension [ 31 ] or distances between edges of canines [ 30 ]. The use of mouth opening angle like an alternative to assess mouth opening has led to developing measurement instruments [ 7 , 24 , 27 , 28 ] or techniques to estimate it [ 25 , 28 ].…”

“…The measurements of distance are usually done by caliper [ 5 ], millimetric ruler [ 18 ] or devices made for this purpose [ 31 ]. For angle measurement, the analysis is limited to one dimension [ 24 ] or static analysis [ 7 , 27 ] and requires large mechanism attached to subject’s head [ 7 , 24 ] modifying the natural movement of jaw.…”

Relationship Between Temporomandibular Ankylosis And Maximum Mouth Opening In Children

“…15 Since children cannot truly describe their discomfort and pain, localize their painful symptoms, or understand questions related to their pain, TMJa can easily go undiagnosed. 10 Thus, early diagnosis and treatment of TMJ ankylosis in children (TMJa) are crucial for both functional and aesthetic outcomes. 16 Limited MO measurements are the clinical manifestations of children with TMJa.…”

“…9 There are many different devices and techniques for MMO measurements in the literature. 9,10,[17][18][19] In these studies, this parameter has been used for different landmarks, such as the distance between the upper-lower incisor, the distance of the alveolar crest, and the most excellent vertical mandibular opening. Moreover, predicting post-op facial profiles is a crucial aspect of surgical procedures.…”