Association between temporomandibular disorders and pubertal development: A systematic review

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.

Section: Discussionsupporting

confidence: 86%

“…Regarding the prevalence of TMD, the most ambivalently discussed risk factors are cultural background, gender, psychosocial factors, general health and pubertal development or age, respectively . The study results are heterogeneous but define a tendency of female adolescents presenting higher prevalence values .…”

Section: Introductionmentioning

confidence: 89%

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

Rauch

Schierz

Körner³

et al. 2019

“…As adolescents and young adults form the majority of patients seeking orthodontic treatment, there could be a possible age bias due to the larger number of adolescent/young adults investigated in the studies compared with children and mature adults. As a recent systematic review has shown that TMD prevalence increases during puberty, a developmental stage where orthodontic treatment is often performed, the importance of TMD‐related diagnostic screening and monitoring cannot be overemphasised.…”

Section: Discussionmentioning

confidence: 99%

“…TMD prevalence rises during adolescence, and depending on methodology, it ranges from 7% to 30% . The higher TMD occurrence has been associated with hormonal, physical and psychosocial changes during pubertal development . The OPPERA studies have confirmed the multifactorial aetiology of TMD and their consistency with a biopsychosocial model of illness .…”

Section: Introductionmentioning

confidence: 96%

Prevalence of temporomandibular disorders in patients seeking orthodontic treatment: A systematic review

Lai

Yap

Türp

2019

The objective of this systematic review was (a) to establish the prevalence of temporomandibular disorders (TMDs) in patients seeking orthodontic treatment and (b) to determine the association between the presence of TMD and sex, age and malocclusion. A systematic literature search was performed according to PRISMA guidelines from 1969 to 2019 using the PubMed and LIVIVO databases. Eight study articles met the inclusion and exclusion criteria. An additional three contributions were identified through manual searching of the reference lists of retrieved articles.The methodological quality of the 11 articles was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for prevalence studies. TMD prevalence ranged from 21.1% to 73.3%. The frequency of painful TMD signs/symptoms varied from 3.4% to 65.7%, while non-painful signs/symptoms ranged from 3.1% to 40.8%. The percentage of males and females presenting with TMD varied from 10.6% to 68.1% and 21.2 to 72.4%, respectively. In all studies, TMD prevalence was higher among females. The majority of articles reported more TMD signs/symptoms in individuals older than 18 years as compared to younger ones (≤18 years). While in four studies no association between TMD and malocclusion was found, another three investigations indicated that TMD may be related to certain occlusal traits. The TMD prevalence in patients seeking orthodontic treatment was high, with many individuals presenting painful TMD signs/symptoms. Female and older patients appear to have a greater occurrence of TMD. Although no strong association between TMD and malocclusion was established, several occlusal traits were implicated. K E Y W O R D Sage, malocclusion, orthodontics, sex, temporomandibular disorders | 271 LAI et AL.

“…Children are also affected by TMDs, but probably less often 3 . An increased incidence of TMD during pubertal development is possibly associated with the hormonal, physical and/or psychosocial alterations during this period 4 . Because most studies of children have involved subjects aged 12 years and older, the prevalence or incidence of TMDs among schoolchildren aged 8‐12 years cannot be reliably estimated.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8‐12 years

Katsikogianni

Schweigert‐Gabler²,

Krisam

et al. 2020

Background and Objective: Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/ TMD) is sufficient for use among schoolchildren aged 8-12 years. Methods: This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8-12 years, with and without TMD symptoms, selected randomly from the Rhein-Neckar district. Self-reporting of non-dental facial pain was used as the reference standard, against which we calculated the following for the pain-related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver-operating characteristic (AUROC) curve displaying sensitivity and specificity. Results: Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs). Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jawopening limitations, as they occurred too rarely in our sample. Conclusion: In this study, the diagnostic accuracy of the DC/TMD for TMD-related pain in children was lower than that recorded for adults in previous studies.