Temporomandibular Joint Disorders in Females with Adolescent Idiopathic Scoliosis: Long-Term Effects of Milwaukee Brace Treatment

Abstract

Patients with adolescent idiopathic scoliosis (AIS) more frequently suffer dysfunctions of dento-skeletal complex. To our knowledge, no study has ever evaluated the temporomandibular joint disorders (TMD) of AIS patients at least 23 years after the completion of Milwaukee brace treatment. We aimed to provide a complex assessment of TMD and AIS patients treated with a Milwaukee brace, in a minimum 23-year follow-up, using radiological, clinical, and socio-demographical data, and to adapt the TMD Disability Index Questionnaire (TMDQ) and Fonseca’s questionnaire (FQ) to Polish conditions. In total, 42 healthy females and 30 AIS patients with a minimum of 23 years after a completed Milwaukee brace treatment were asked to complete the Polish version of (TMDQ-PL) and (FQ-PL). AIS patients present higher TMD levels than healthy controls. Significant differences exist between TMDQ-PL and FQ-PL (both in total scores and particular sub-sections), and AIS patients. Clinical and radiological factors affected the TMDQ-PL and FQ-PL results. Adult patients with scoliosis treated conservatively present limitations in everyday activities connected with the temporomandibular joint (TMJ). The variety of curve-related factors in a long-term follow-up of wearing the Milwaukee brace influence TMJ.

Relationship between stomatognathic alterations and idiopathic scoliosis: a systematic review with meta-analysis of observational studies

“…A total of 14 studies ( 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ) met the eligibility criteria and were included in the review ( Fig. 1 ).…”

“…Two studies ( 35 , 46 ) including 59 IS patients and 71 controls evaluated the presence of TMD by measuring the mean Fonseca Anamnestic Index in both groups. The SMD (1.153, 95% CI = 0.780 to 1.527; P < 0.0001) was significant but indicated a very small effect with a higher dysfunction in IS patients.…”

“…However, our findings can be interpreted in the context of some longitudinal investigations in which the causal relationship can be glimpsed. In fact, one of the papers included in our review ( 35 ) provided data from a retrospective cohort of subjects with hereditary orthodontic anomalies in which a prevalence of scoliosis of 20% was found, which is 14 times higher than the prevalence in the population of reference, estimated at 1.4%. In isolated studies such as this one, some degree of causation can be estimated as long as the orthodontic abnormalities were present before the onset of the scoliotic curve.…”

“…Two studies (35,46) including 59 IS patients and 71 controls evaluated the presence of TMD by measuring the mean Fonseca Anamnestic Index in both groups.…”

Non-Pharmacological Pain Treatment of Patients with Myofascial Pain Syndrome of the Masticatory Muscles—Case Series

“…The etiology of TMDs is multifactorial. Temporomandibular disorders have a wide range of causes, among which the most common are severe malocclusions, stress, anxiety, mandibular instability, postural imbalance, pathological conditions, and parafunctional habits [8][9][10]. Parafunctional habits, such as bruxism and clenching, cause constant micro trauma in the temporomandibular joint, inducing pain in the affected areas [11].…”