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Risk factors associated with incidence and persistence of temporomandibular disorders
Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Aims: The aim of this study was to analyze whether gender, reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorders (TMD) during a 2 year period.

Methods: The study population comprised 280 dental students at Umeå University, Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment, and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at start. Cases with persistent TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses.

Results: The analyses revealed that reported bruxism and crossbite, respectively, increased the risk of incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk to develop and maintain myofascial pain. Signs of mandibular instability increased the risk of long-standing signs and/or symptoms of TMD.

Conclusion: This 2-year prospective observational study indicated that reported bruxism and variations in dental occlusion were linked to incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-25687OAI: oai:DiVA.org:umu-25687DiVA: diva2:233143
Available from: 2009-09-07 Created: 2009-08-28 Last updated: 2009-12-15Bibliographically approved
In thesis
1. Temporomandibular disorders: incidence, course, and risk factors
Open this publication in new window or tab >>Temporomandibular disorders: incidence, course, and risk factors
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Käkfunktionsstörning : förlopp och riskfaktorer
Abstract [en]

Temporomandibular disorders (TMD) embrace pain and dysfunction in the temporomandibular joint (TMJ) and jaw muscles. TMD is a prevalent condition in the population and constitutes a significant health problem. Knowledge of factors influencing the onset and course of TMD is important in preventive care and development of treatment strategies as well as in clinical decision making. The aim of this thesis was to gain knowledge of whether variations in dental occlusion, bruxism, spinal pain and gender predicted the development and course of TMD.

The study population comprised 371 undergraduate dental students. A questionnaire was used to obtain case histories. Clinical examination included the function of the TMJ, jaw muscles, maximal jaw mobility, the morphological occlusion, and contact patterns in centric and eccentric positions. The examinations were performed at start, and after 12 and 24 months. In total, 280 subjects were examined at all three occasions.

The incidence of TMJ pain and dysfunction was high among both males and females. The course composed onset, recovery and maintenance resulting in a fluctuating pattern. Females were more likely to have persistent TMJ pain and dysfunction than males. The incidence and persistence of jaw muscle signs and symptoms was high and significantly more common in females. A similar fluctuating pattern as for TMJ pain and dysfunction was found. Crossbite predicted onset and persistence of TMJ pain and dysfunction; mandibular instability in centric positions predicted persistent TMJ pain and dysfunction, as well as persistent jaw muscle signs or symptoms. Reported bruxism increased the risk for TMJ pain and dysfunction but did not significantly affect the course of jaw muscle signs and symptoms. Spinal pain at baseline predicted the onset of jaw pain, headaches, and TMD pain. Signs of TMD at baseline predicted the onset of non-pain symptoms of TMD, jaw pain, headaches, and spinal pain.

In conclusion, the results in this thesis show high incidence rates for TMD, headaches, and spinal pain among dental students. Crossbite, mandibular instability, reported bruxism, as well as female gender were identified as contributing risk factors. Spinal pain and TMD mutually predicted each other, indicating common pathophysiological mechanisms and individual vulnerability. The findings support a multidisciplinary approach, and it is recommended that the status and function of the jaw system be considered in patients with spinal pain.

Place, publisher, year, edition, pages
Umeå: , 2009. 68 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 108
Keyword
bruxism, dental occlusion, gender, headaches, longitudinal, myofascial pain, orofacial pain, prospective cohort, risk factors, spinal pain, temporomandibular joint
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-25689 (URN)978-91-7264-832-6 (ISBN)
Distributor:
Klinisk oral fysiologi, 901 87, Umeå
Public defence
2009-09-25, Sal B, By 1D, 9tr, Tandläkarhögskolan, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2009-09-07 Created: 2009-08-28 Last updated: 2009-12-15Bibliographically approved

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