Oral Habits of Temporomandibular Disorder Patients With Malocclusion

Abstract

The purpose of this study was to clarify the relationship between oral habits and symptoms of temporomandibular joint disorder in patients who had sought orthodontic treatment by analyzing their present and past history.The subjects were 57 female patients (average age: 23 years and 6 months old) who had visited the "Temporomandibular Disorder Section" in our orthodontic department. Their chief complaints were the symptom of TMJ and the abnormalities of occlusion such as maxillary protrusion, open bite, crowding, mandibular protrusion, cross bite, deep bite, edge-to-edge bite, and spacing. Their present conditions and past histories were examined and evaluated. The most typical primary symptom was joint sound (23 patients, 40.0%). The second was joint sound and pain (15 patients, 26.3%). Of the symptoms present at the time of examination, the most prevalent were joint sound and pain (20 patients, 35.1%). The 48 patients (82.8%) had significant oral habits. Unilateral chewing was seen in 35 patients (72.9%), bruxism in 27 (56.3%), abnormality of posture in 14 (29.2%), habitual crunching in 10 (20.8%) and resting the cheek on the hand in 4 (8.3%), respectively. When comparing the primary symptoms to those at the time of examination, the patients with unilateral chewing and bruxism tended to have more complicated symptoms. In conclusion, the TMD symptoms of the patients with notable oral habits did not change or become worse during a period of about 5 years.

Temporomandibular disorders and parafunctional oral habits: an anamnestic study

“…15,18,31,32,41 The significant presence of diurnal and nocturnal clenching and teeth grinding (nocturnal) in this study, but not other habits, suggests the importance of bruxism on the progression and/or on non-remission of the disorder, being the clenching a more important risk factor than grinding. 6,15,30,31,40,41 And while Choi and Choung Moon 6 have reported that bruxism cannot be a direct risk factor for TMD, there are reports showing that clenching was more often associated with TMJ symptoms and clinically relevant to the occurrence of the same, increasing the risk of manifestation of TMJ pain and noise and losses in the mouth opening. 17,22,24,29,44 Therefore, a likely association between bruxism and TMD signs/symptoms supports the theory that repetitive loads on the masticatory system can cause functional disorders.…”

“…1,27,33 The significant correlation between the frequency and severity of signs and symptoms are an indication that the larger the number of signs and symptoms, the greater the severity perceived by the patient. And, although several authors suggest that the habits accumulation can lead to worsening or contribute to no remission of the present scenario, and deleterious oral habits are among the TMD etiological factors, 15,19,30,31,32 the frequency of habits was not correlated to the frequency or severity of signs and symptoms, according to data analyzed from ProDTMMulti 13 in the current population. In a previous study, it was suggested that, in relation to bruxism, there is an effect of habit in time 30 .…”

“…16,19,30,31,32 Thus, some studies have reported that the amount, frequency, intensity and duration of habits can determine the severity of signs and symptoms of TMD, as they relate to fatigue and muscle pain, in addition to joint compression. 13,15,30 Onychophagy, gum chewing, biting or clenching objects between the teeth, constantly biting cheeks and lips, resting the jaws on the hands, clenching and/or bruxism, among other habits, are commonly reported by TMD patients. 16,31,32 Studies have shown that anamnestic investigation is valid for the identification of TMD 14 and it may also give positive correlations with clinical findings.…”

Kein erhöhtes Risiko für kraniomandibuläre Dysfunktionen und Bruxismus im Kindes- und Jugendalter während der kieferorthopädischen Therapie*

“…Offenbar laufen bei der Eingliederung kieferorthopä-discher Apparaturen ähnliche Muster wie bei der Eingliederung von "Knirscherschienen" ab [29]. Zwar haben Fujita et al [14] bei ihren kieferorthopädischen Patienten keine Verän-derungen von Bruxismusaktivitäten während der Dauer der Behandlung festgestellt, allerdings ist die statistische Power dieser Aussage bei einer Probandenzahl von 57 auch nicht sehr hoch. Es scheint plausibel, dass die temporäre Unterbrechung parafunktioneller Aktivitäten während der kieferorthopädischen Behandlung langfristig als positiver Begleitbefund in Erscheinung tritt.…”

“…Apparently when orthodontic appliances are inserted a similar pattern arises as when occlusal devices are worn [29]. Although Fujita et al [14] reported no changes in bruxing behavior in their orthodontic patients during their treatment period, their claim's statistical significance is rather minimal as they had only 57 probands. It seems reasonable to assume that the temporary interruption of parafunctional activities during orthodontic treatment is a positive secondary feature over the long term.…”