Prevalence of signs and symptoms of temporomandibular dysfunction in male adolescent athletes and non-athletes

Bennett Angle, Condylar and Jaw Movements in Asymptomatic Athletes with a History of a Blow to One Side of the Mandibula

Sports activities may induce long-lasting changes in mandibular trajectories. The aim was to compare condylar and mandibular movements in athletes with orofacial injuries with values measured in non-injured athletes. The group of 132 athletes without mandibular injury included asymptomatic athletes with a history of a blow to the right side (N = 43) and the group included asymptomatic athletes with a history of a blow to the left side (N = 41) of the mandible. The injured athletes suffered from stiffness/pain and/or limitation of jaw movements. The symptoms disappeared shortly after the injury. Athletes with a history of injury have smaller mean values of Bennett angle on the side of impact, and Bennett angle on the opposite side is greater than the mean found in non-injured athletes. Significantly smaller Bennett angle values in athletes with a history of a blow to one side of the mandible are due to the adaptability of the orofacial system. The larger Bennett angle on the opposite side of the injury is also due to the adaptive mechanism of the TMJ. Clinical Relevance: An individualized approach to TMJ values is mandatory in restorative procedures in every patient, especially in patients with a history of trauma to the orofacial system.

TMJ Disorders in Athletes

ABSTRACT

Temporomandibular joint dysfunction is common in both the general population and athletes with a much higher incidence in women than in men. We review current research on temporomandibular joint disorders, discuss relevant risk factors, manifestations of temporomandibular disorders in athletes, and treatment options. Certain sports, particularly contact sports, pose an increased risk for problems with the temporomandibular joint. The stress of athletic performance also may be a contributing factor. Mouthguards should be encouraged for prevention of injury and physical therapy is the most effective treatment.

Effects of Contact Sports on Temporomandibular Disorders: An Observational Study

The study investigated the prevalence of temporomandibular disorders in 100 competitive athletes in contact sports, equally grouped by the practiced game: Soccer (SoG), Rugby (RG), American Football (AFG), Boxing (BoG), Basketball (BaG), compared to a randomly control group of 20 non-athletes (CG). Symptoms and signs were examined according to the standardized Diagnostic Criteria for Temporomandibular Disorders through a questionnaire and clinical evaluation. Arthralgia showed significant differences between RG and CG and between AFG and CG (p < 0.05). Study groups reported masticatory muscle pain during function, neck and shoulder pain more frequently than CG, except for BoG. Closing click was significantly more present in study groups than CG, while crepitation was significantly higher only in RG and AFG. The deviation was wider in SoG, RG and AFG compared to CG (p < 0.05). Tukey’s multiple comparisons test showed a statistically significant reduction in right laterotrusion in RG vs. CG (p < 0.05); the comparison showed a decrease in right laterotrusion in RG vs. SoG and BoG (p < 0.05), a decrease in endfeel in RG vs. CG, BaG and AFG (p < 0.05). The data seem to support a relationship between the prevalence of TMD symptoms and signs in competitive athletes in contact sports, especially in RG and AFG compared to CG.

Impact of sports on temporomandibular dysfunction: a comparison of competitive and recreational female athletes as well as female non-athletes

Objectives

The present study was conducted to investigate the correlation between (competitive) sports and the occurrence of temporomandibular dysfunctions (TMD) by comparing the prevalences in competitive, recreational, and non-athletic women.

Materials and methods

A total of 138 women between the ages of 18 and 45 were interviewed about symptoms of TMD by means of a questionnaire. Based on their athletic performance level, the participating women were classified as competitive athletes, recreational athletes, or non-athletes (each group n = 46).

Results

Symptoms of TMD were notably less frequent in competitive female athletes (52.2%) than in recreational female athletes (63.0%) and female non-athletes (60.9%). With increasing training load, the prevalence of TMD decreased in both the competitive and recreational female athlete groups.

Conclusions

Athletic activity in general seems to have a positive effect on the occurrence of TMD. Competitive female athletes appear less likely to suffer from symptoms of TMD than recreational athletes and non-athletes. One possible explanation for this could be the better supervision by qualified trainers and physiotherapists in competitive sports.

Clinical relevance

Patients should be motivated to engage in sports as a protective measure against symptoms of TMD. However, it is important to ensure that they are properly instructed by experienced personnel in order to avoid unphysiological strain and negative consequences.

Effects of competitive sports on temporomandibular dysfunction: a literature review

OBJECTIVES

The German Society of Craniomandibular Function and Disorders recommends that patients suffering from temporomandibular dysfunctions should practice sports in order to compensate for everyday stress. This raises the question as to what extent competitive athletes develop temporomandibular dysfunctions or whether their athletic activities protect them. With the present literature review, the authors intend to give an overview of the currently available publications on this topic.

MATERIALS AND METHODS

A literature research in the PubMed and Google Scholar databases was performed to filter out the currently available publications on the topic 'sports, and temporomandibular dysfunction.

RESULTS

Out of 114 available articles, seven met the inclusion criteria. Two other relevant articles were found in the list of references, so that in total, nine publications were picked for the review. In case numbers ranging from eight to 347 subjects, a temporomandibular dysfunction was detected with a prevalence between 11.7% and 100% for athletes and between 11.11% and 14.3% for non-athletes. Different kinds of sports were evaluated, all of them contact sports: basketball, handball, wrestling, boxing, karate, mixed martial arts, field hockey, water polo, and soccer. One study compared athletes with and without consumption of anabolic steroids, regardless of the type of sport. The level of athletic performance varied across the different studies.

CONCLUSIONS

Currently, studies dealing with the effect of competitive sports on temporomandibular dysfunction are scarce. Inconsistent methodological procedures permit only limited comparability.

CLINICAL RELEVANCE

A general trend, however, can already be discerned: professional athletes suffer from temporomandibular dysfunctions more frequently than non-athletes.

Prevalence of anamnestic symptoms and clinical signs of temporomandibular disorders in adolescents-Results of the epidemiologic LIFE Child Study

BACKGROUND

Prevalence values for symptoms and signs of temporomandibular disorders (TMD) in adolescents vary within the literature due to differences in set-ups of examination protocols.

OBJECTIVES

The objective was to present prevalence values for symptoms and signs of TMD in German adolescents that were observed within a standardised examination. Prevalence values comparing gender or pubertal status should be investigated.

METHODS

A cross-sectional sample of the LIFE Child Study aged 10 to 18 was examined. A questionnaire gathering anamnestic symptoms of TMD was completed, and an examination according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was performed by trained dentists. Pubertal status according to Tanner stages was documented. Descriptive statistics, Mann-Whitney U and Wilcoxon signed-rank tests were performed.

RESULTS

A total of 1.116 participants (mean age 12.9 years, 51.4% female) were consecutively recruited. Most prevalent anamnestic symptoms were headaches (55.7%) and temporomandibular joint (TMJ) sounds (17.6%). The major clinical sign was TMJ sounds (31.9%). Both the examination of muscles or TMJs showed that pain to palpation was statistically significantly higher than familiar pain (P < .001). Gender comparisons revealed higher prevalence values and an increase in TMD symptoms and signs during pubertal development in females.

CONCLUSION

The prevalence of self-reported headaches, as well as anamnestic and clinical TMJ sounds, was high in German adolescents. Prevalence values for pain to palpation and familiar pain obtained relevant differences. Considering the DC/TMD, females are more affected by TMD signs and symptoms that increase during pubertal development, than male adolescents.

Obesity, sedentarism and TMD-pain in adolescents

BACKGROUND

Obesity is a chronic and prevalent disorder, affecting individuals of all age. Previous evidence suggests that it is associated with some types of chronic pain, especially musculoskeletal pain. In addition, sedentarism is also associated with an increase of the inflammatory factors and chronic pain. So, we conducted a cross-sectional study to evaluate the association between obesity, sedentarism and the presence of TMD-pain in adolescents.

METHODS

Temporomandibular Disorders were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Obesity was assessed by the body mass index (BMI), bioimpedance (BIA), skinfold (triceps and subscapular) and circumferences (arm and abdominal). The level of physical activity was rated according to the instrument adopted by the Brazilian National School Health Survey. Descriptive statistics, univariate logistic regression and odds ratios (OR) with 95% confidence intervals (CI) were used to study the associations of interest.

RESULTS

The sample consisted of 690 individuals with a mean age of 12.7 (±0.76) years of whom 389 (56.4%) were girls. Of the total, 112 (16.2%) had TMD-pain, 110 (15.9%) were obese according to BMI, 74 (10.8%) according to BIA, and 127 (18.4%) following the skinfolds and circumferences assessments. There was no significant association between TMD-pain and obesity according to BMI (P = 0.95), BIA (P = 0.16), skinfold and circumference (P = 0.22), and neither with sedentarism (P = 0.94).

CONCLUSION

Obesity and sedentarism were not associated with the presence of TMD-pain in adolescents.

Relationship between growth, maturation and musculoskeletal conditions in adolescents: a systematic review

Objective

To determine whether there is a relationship between physical growth and development, as determined by markers of biological maturation, and musculoskeletal conditions in adolescents.

Design

Systematic review.

Data sources

Electronic databases (PubMed, EMBASE and the Cumulative Index to Nursing and Allied Health Literature) were searched up to 6 September 2017.

Eligibility criteria for selecting studies

Studies that evaluated the association between biological maturation or growth and musculoskeletal conditions in adolescents (chronological age 10–19 years).

Results

From 20 361 titles identified by the searches, 511 full-text articles were retrieved and assessed for eligibility; 56 studies, all at high risk of bias, evaluating the relationship between maturation and/or growth and musculoskeletal conditions were included. A total of 208 estimates of association were identified across the included studies, which generally indicated no association or an unclear association between maturation, growth and musculoskeletal conditions.

Summary/Conclusions

While the relationship between maturation, growth and musculoskeletal conditions remains plausible, the available evidence is not supportive. The current body of knowledge is at high risk of bias, which impedes our ability to establish whether biological maturity and growth are independent risk factors for musculoskeletal conditions.

Prevalence of diagnosed temporomandibular disorders: A cross-sectional study in Brazilian adolescents

Background

The prevalence of signs and symptoms of temporomandibular disorders (TMD) increases during adolescence and adulthood. Few studies have examined TMD prevalence in Brazilian adolescents.

Aim

To investigate the prevalence of TMD in Brazilian adolescents.

Methods

A representative population-based sample of 934 adolescents (10–14-years-old) was examined. TMD screening was performed using a questionnaire by the American Academy of Orofacial Pain. TMD diagnoses used research diagnostic criteria for temporomandibular disorders (RDC/TMD—Axis-I). Examinations were performed by a single calibrated examiner (kappa > 0.80).

Results

The prevalence of TMD symptoms was 34.9%; the most frequently reported symptoms were headache and neck ache (20.9%), followed by joint sounds (18.5%). Myofascial pain was the most prevalent type (10.3%), followed by disc displacement with reduction (8.0%) and arthralgia (3.5%). There was a significant association between sex and TMD symptoms; prevalence was significantly higher in girls (RP = 1.37; 95% CI = 1.14–1.65; p = 0.001). Myofascial pain of TMD and displacement with reduction were more prevalent in girls (RP = 1.76; p = 0.007 and RP = 2.06; p = 0.004, respectively).

Conclusion

TMD symptoms were present in 34.9% of adolescents, with myofascial pain being the most prevalent type (10.3%). TMD was significantly more common in girls. Routine pediatric dental care should include a TMD screening.

Professional karate-do and mixed martial arts fighters present with a high prevalence of temporomandibular disorders

BACKGROUND/AIM

Facial trauma in sports has been associated with temporomandibular disorders. Because of the intensity and duration of training needed for elite-level competitions, high-performance athletes can have two to five times more traumatic injuries than recreational athletes. This study aimed to investigate the prevalence of temporomandibular disorders in high-performance martial arts fighters and compare it with the prevalence in recreational athletes and non-athletes.

MATERIAL AND METHODS

The Research Diagnostic Criteria for Temporomandibular Disorders was used to diagnose and classify professional karate-do practitioners (group I; n = 24), amateur karate-do practitioners (group II; n = 17), high-performance mixed martial arts fighters (group III; n = 13), and non-athletes (n = 28). The groups were compared with the chi-square test and tested for the difference between two proportions using a significance level of 5% (P < 0.05).

RESULTS

The prevalence of temporomandibular disorders in groups I (54.2%; P = 0.003) and III (61.5%; P = 0.002) was significantly higher than in group IV (14.3%). The prevalence in group II was similar to that in group IV (P > 0.05). A diagnosis of arthralgia from disk displacement was made more frequently in groups I (45.8%; P = 0.013) and III (38.5%; P = 0.012) than in group IV (7.1%). The chronic pain associated with TMD was low intensity and low disability.

CONCLUSIONS

While there was a high prevalence of temporomandibular disorders in the professional athletes in our study, the prevalence of the condition in recreational athletes was similar to that in individuals who did not practice martial arts.

Risk of headache, temporomandibular dysfunction, and local sensitization in male professional boxers: a case-control study

OBJECTIVE

To evaluate differences in the incidence of headache, trigeminal nerve mechanosensitivity, and temporomandibular functionality in professional male boxers (exposed to repetitive craniofacial trauma) who were actively training and without severe previous injuries compared with handball players.

DESIGN

Case-control study.

SETTING

University-based physical therapy research clinic.

PARTICIPANTS

Eighteen boxers (mean age, 23±4.61y) as the cases group, and 20 handball players as the comparison group (mean age, ±2y, and sex matched), were included. All participants (N=38) completed the assessment protocol.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Measurements were taken of the headache impact (Headache Impact Test-6) and the pressure pain threshold over the trigeminal nerve sensory branches, the masseter muscle, and the tibialis anterior muscle. The secondary outcome measure included the temporomandibular function (Helkimo Clinic Index).

RESULTS

The boxers showed slight mandibular function impairment, local muscular and neural sensitization, and a higher impact from headaches than did the handball players. The between-group comparison found significant differences in all outcome measures (P<.05), except in the tibialis anterior muscle pressure pain threshold on the dominant (P=.958) and the nondominant (P=.453) sides.

CONCLUSIONS

Professional male boxers seem to suffer a greater headache impact and local sensitization of the craniomandibular region than do professional handball players. It cannot be determined whether these findings are short-lasting, as a result of the training activity, or long-lasting.

[The role of occlusal disorders in development of temporomandibular joint dysfunction]

Currently Temporomandibular joint (TMJ) dysfunction is a very highly discussed topic by both researchers and clinicians. the incidence of the of TMJ is dysfunctions still not very well established because of heterogeneity of the diagnostic criteria used by different authors. This article is dedicated to the analysis of basic theories of the etiology of the aforementioned pathology, including overview of main pathophysiological mechanisms of the TMJ, dysfunctions occlusive disorders in particular. The main problem being analyzed is the use and efficacy of the electronic axiography in successful diagnostic and therapy of the TMJ dysfunction.

Prevalence of signs and symptoms of temporomandibular dysfunction in female adolescent athletes and non-athletes

OBJECTIVES

To compare the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) in female adolescent athletes and non-athletes and to examine the association between signs and symptoms of TMD in female adolescents in different Tanner stages.

METHODS

The subjects were 89 female basketball and handball players ages 10-18 years and 72 female non-athlete adolescents ages 10-19 years selected from the Department of Pediatrics (School of Medicine, Federal University of São Paulo) as a control group. A survey was used to assess the signs and symptoms of TMD. According to the answers on the survey the adolescents were classified in two categories: no signs or symptoms present (score A-absent), at least one sign or symptom present (score P-present). The ones who got score "P" were submitted to a standardized functional examination of the masticatory system by four previously calibrated examiners. Pubertal status was assessed based on physical examination by physicians from our Division. The adolescents were classified according to Tanner stages into three subgroups: subgroup 1 (before the growth spurt), subgroup 2 (growth spurt period), subgroup 3 (end of growth spurt). Significant differences between athletes and non-athletes were assessed for categorical variables (Chi-square and Fisher's exact test) and for continuous variables (Mann-Whitney test). The level of significance used was 5%. There was significant agreement between raters, kappa-values (0.621-1.000) and ICC values (0.757-0.899).

RESULTS

There was no significant difference between the athletes and non-athletes in exhibiting at least one sign or symptom of TMD (p=0.301). When comparing the adolescents who presented at least one symptom of TMD to the different subgroups of Tanner stages no statistically significant differences were found (p=0.124).

CONCLUSION

The lack of significant differences among female adolescent athletes and non-athletes and among the subgroups of Tanner stages may suggests that although contact sports increase the risk of temporomandibular joint lesions and estrogen levels are risk factor for onset of TMD, they do not impact significantly on the onset of this disorder, when considered alone.