The Relationship Between Malocclusion, Benign Joint Hypermobility Syndrome, Condylar Position and TMD Symptoms

Abstract

The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p < 0.05); 4. hypermobility scale, gender (p < 0.001), malocclusion pattern (p = 0.021); 5. TMJ function impairment, gender (p = 0.043); 6. sagittal malocclusion pattern, right temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

Influência da hipermobilidade articular generalizada sobre a articulação temporomandibular e a oclusão dentária: estudo transversal

“…These signs indicate a possible reduction of proprioception, that is, afferent regulation to muscle stretch receptors owing to ligament laxity. This aspect should be carefully observed in patients with generalized joint hypermobility (GJH), considering that reduction in proprioception can cause hyper-translation of the condyles, generating articular noise and, possibly, internal derangements and joint inflammation (9)(10)(11) . This topic has been addressed in previous studies (7)(8)(9)(10) that reported GJH as a risk factor for the development of TMD signs and symptoms.…”

“…Nociceptive stimuli arising from occlusion and/or TMJ can cause muscular compensatory behaviors, such as changes in the appearance, posture and mobility of lips, tongue, jaw and cheeks, and in the functions of the stomatognathic system (12) . Although GJH is often addressed in research involving TMJ, there are few studies investigating occlusion in these patients (11) . The relationship between occlusion and GJH can be attributed to the fact that joints and bones participate in the fragility of the conjunctive tissue present in GJH (5) .…”

“…Several studies report GJH as a risk factor for the development of signs and symptoms of temporomandibular joint dysfunction (TMD) (7)(8)(9)(10) . Due to ligament laxity and, consequently, to impaired proprioception, it is believed that the TMJ be overloaded, resulting in degenerative changes that can be observed in internal derangements and articular inflammation (9)(10)(11) . In addition to GJH, oromyofacial disorders may also disrupt the function of the TMJ or be manifested as a result of TMD.…”

Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position

“…2 However, the influence of the occlusion is not completely understood. 1,2,3 declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.…”

Evaluation of Changes in TMJ Position for Angle Class I Malocclusion After Orthodontic Treatment by Using Cephalometric Radiograph

“…Dental occlusion had been known as an important factor to cause temporomandibular joint disorder (TMD), but now it become less importance as a contributory factor. 35 Up to the present, a lot of scientific research showed that orthodontic treatment did not directly related to temporomandibular joint disorder (TMD). 36,37,38 Lastly, TMJ position is difficult to measure accurately due to several of reasons.…”