www.sbdmj.com - Stomatologija - Baltic Dental and Maxillofacial Journal

Summary

Statement of problem. Oral parafunctional activity can be fatigued and painful masticatory muscles and/or pain in the temporomandibular joints. There is controversial discussion in the literature as to what role parafunctional activity plays in the multi-causal pathologic process.

Purpose. The purpose of this study was to determine any association between the level of parafunctional habits versus the level of mandibular dysfunction and to test the hypothesis that TMD/bruxer patients have significantly increased muscul tention and joint pain.

Material and methods. There were 307 subjects (140 males und 167 females) selected for this investigation. 299 subjects were examined regarding any relationships between clenching and the incidence of muscle sensitivity. The age of subjects ranged from 20 to 54 years old, with a mean age of 35, 4. 114 subjects had at least one sign of temporomandibular disorders (tenderness/pain on palpation of the joints or muscles, TMJ sounds, pain or deviation during maximum mouth opening (active/passive).

Results. 81 subjects admitted to clenching, while 218 said they did not. Among the "non-clenchers", 68.8% had no sensitive muscles, 31.2% indicated sensitive masticatory muscles. Those who clenched their teeth were distributed as follows: 53.1% were diagnosed with bilateral masticatory muscle sensitivity, 46.9% showed no such indications. The two groups were not homogeneously divided, with regard to pain/discomfort (p = 0.001; Fisher's precision test).

Conclusion. This study found a statistically solid relationship between the incidence of "clenching" and muscle palpation findings, as well as between sensitivity in the mandibular joints from lateral and to cranial and dorsal with positive muscle palpation findings. The agreement between sensitivity of the masticatory musculature and the mandibular joint demonstrates that intensive clenching can predominantly lead to pathologic phenomena in the muscles or joints.

Key words: temporomandibular disorders; temporomandibular joint dysfunction; internal derangement; clinical examination; oral parafunctions

Received: 21 05 2005

Accepted for publishing: 22 08 2005

Giedre Kobs - D.D.S., PhD., Institute of Stomatology, Faculty of Medicine, Vilnius University, Lithuania.

Olaf Bernhardt - D.D.S., PhD., assist. Professor, Assistant medical director at the Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, University of Greifswald, Germany.

Thomas Kocher - D.D.S., PhD., Hab. Dr., Professor and Head of the Department of Periodontology, University of Greifswald, Germany.

Georg Meyer - D.D.S., PhD., Hab. Dr., Professor and Head of the Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, University of Greifswald, Germany.

Address correspondence to G. Kobs: Department of Prosthodontics, Institute of Stomatology Faculty of Medicine, Vilnius University, Zalgirio str. 117, Vilnius, Lithuania.



	Baltic Dental and Maxillofacial Journal

September, 2005, Vol. 7, No. 3 CONTENTS SCIENTIFIC ARTICLES Jaw tracking devices - historical review of methods development. Part I 67 - 71 Jaw tracking devices - historical review of methods development. Part II 72 - 76 The masticatory system - an overview 77 - 80 Oral parafunctions and positive clinical examination findings 81 - 83 Testing of the questionnaire on dental care satisfaction in a sample of adult patients visiting dental clinics at Faculty of Odontology, Kaunas University of Medicine. A Pilot study 84 - 89 Secretory function of neutrophilic leukocytes of the patients with periodontal diseases 90 - 94 5 year experience with lower lip cancer 95 - 98 © 2005 Stomatologija		Stomatologija 2005; 7 (3): 81-3 180 KB Oral parafunctions and positive clinical examination findings Giedre Kobs, Olaf Bernhardt, Thomas Kocher, Georg Meyer Summary Statement of problem. Oral parafunctional activity can be fatigued and painful masticatory muscles and/or pain in the temporomandibular joints. There is controversial discussion in the literature as to what role parafunctional activity plays in the multi-causal pathologic process. Purpose. The purpose of this study was to determine any association between the level of parafunctional habits versus the level of mandibular dysfunction and to test the hypothesis that TMD/bruxer patients have significantly increased muscul tention and joint pain. Material and methods. There were 307 subjects (140 males und 167 females) selected for this investigation. 299 subjects were examined regarding any relationships between clenching and the incidence of muscle sensitivity. The age of subjects ranged from 20 to 54 years old, with a mean age of 35, 4. 114 subjects had at least one sign of temporomandibular disorders (tenderness/pain on palpation of the joints or muscles, TMJ sounds, pain or deviation during maximum mouth opening (active/passive). Results. 81 subjects admitted to clenching, while 218 said they did not. Among the "non-clenchers", 68.8% had no sensitive muscles, 31.2% indicated sensitive masticatory muscles. Those who clenched their teeth were distributed as follows: 53.1% were diagnosed with bilateral masticatory muscle sensitivity, 46.9% showed no such indications. The two groups were not homogeneously divided, with regard to pain/discomfort (p = 0.001; Fisher's precision test). Conclusion. This study found a statistically solid relationship between the incidence of "clenching" and muscle palpation findings, as well as between sensitivity in the mandibular joints from lateral and to cranial and dorsal with positive muscle palpation findings. The agreement between sensitivity of the masticatory musculature and the mandibular joint demonstrates that intensive clenching can predominantly lead to pathologic phenomena in the muscles or joints. Key words: temporomandibular disorders; temporomandibular joint dysfunction; internal derangement; clinical examination; oral parafunctions Received: 21 05 2005 Accepted for publishing: 22 08 2005 Giedre Kobs - D.D.S., PhD., Institute of Stomatology, Faculty of Medicine, Vilnius University, Lithuania. Olaf Bernhardt - D.D.S., PhD., assist. Professor, Assistant medical director at the Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, University of Greifswald, Germany. Thomas Kocher - D.D.S., PhD., Hab. Dr., Professor and Head of the Department of Periodontology, University of Greifswald, Germany. Georg Meyer - D.D.S., PhD., Hab. Dr., Professor and Head of the Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, University of Greifswald, Germany. Address correspondence to G. Kobs: Department of Prosthodontics, Institute of Stomatology Faculty of Medicine, Vilnius University, Zalgirio str. 117, Vilnius, Lithuania.