Incidence of Systemic Joint Hypermobility and Temporomandibular Joint Hypermobility in Pregnancy

Abstract

The purpose of this study was to establish a possible correlation between systemic hypermobility and temporomandibular hypermobility during pregnancy. One hundred (100) healthy pregnant women were evaluated: 7% in the first trimester (1T), 38% in the second trimester (2T), and 55% in the third trimester (3T) of gestation. In the series, the authors analyzed systemic joint hypermobility (SJH), range of mandibular movement (MMR), head and shoulder posture, head lateralization, and the presence of noise, pain, and parafunction in the temporomandibular joint. They observed that pain is present to a mild degree mostly in the head and ears of all pregnant women who presented with pain. Most of the subjects had some type of parafunction, but only 42.8% had noises. Mild SJH was seen in 50% of the 2T and 3T subjects, and in 28.5% of 1T subjects. Mild mandibular hypermobility was found for jaw opening (46%) and lateralization to the right (44%) or to the left (46%). Most of the subjects had hypomobility for jaw protrusion and retraction. The subjects had head protrusion and anterior posture as a result of the change in their center of gravity brought about by pregnancy. The authors found no association between systemic joint hypermobility (SJH) and temporomandibular hypermobility, although hormonal changes and complex factors during pregnancy may represent a risk factor for both types of mobility change.

Temporomandibular disorder and generalized joint hypermobility: application of diagnostic criteria

“…The GJH was assessed by the Carter and Wilkinson's criteria, modified by Beighton 29 , which have been used in numerous studies 4,6,[11][12][13][14][15][16] about hypermobility. Beighton's score assesses 9 joints by means of 5 tests: passive thumb opposition to the anterior portion of the forearm, until they touch; passive dorsiflexion of the little finger until it comes parallel to the forearm; elbow and knee hyperextension higher than 10 degrees; trunk flexion with the knees completely extended, in such a way that the palms of the hands touch the floor (Figure 1).…”

“…There are reports that this syndrome is more prevalent in women and in individuals of Asian and African descent, and it reduces with aging 8,9 . GJH has been associated with the development of signs and symptoms of TMD [4][5][6][10][11][12][13][14][15][16] . It is known that although the TMJ is among hypermobile joints, it may predispose some patients to subluxation, although not necessarily with pain or dysfunction 4 .…”

Prevalence of temporomandibular disorders in pregnancy

“…contrary, Charlton et al (20) found that high serum estrodiol levels during the third trimester of pregnancy correlated with increased laxity of anterior cruciate ligament by measuring anterior tibial translation. And Silviera et al (21) observed a high incidence of systemic hypermobility which was not correlated with mandibular hypermobility and TMD in pregnancy. In the present study, the prevalence of systemic joint hypermobility was found to be not different between the pregnant and non-pregnant women.…”

Disfunção temporomandibular em gestantes

“…With similar objective, a study evaluating 70 pregnant women 14 has not found higher prevalence of systemic joint hypermobility as compared to non-pregnant women. In addition, and similar to the already mentioned study 13 , it was not possible to establish association between systemic joint hypermobility and TMJ hypermobility. If estradiol and progesterone levels influence orofacial pain experience, a decrease in pain reports may be expected during pregnancy.…”

“…Reported pain rates, which decreased throughout pregnancy, have returned to baseline values in one year after delivery. The same was true to estradiol 13 has studied the possible association of systemic joint hypermobility and temporomandibular joint hypermobility in pregnant women as a way to establish a higher predisposition to the development of TMD. Although not finding an association between both conditions, there has been a prevalence of 46% TMJ hypermobility during mouth opening among pregnant women.…”