Signs and Symptoms of Temporomandibular Joint Disorders Related to the Degree of Mouth Opening and Hearing Loss

Orthopaedic Surgeon, Professor of Anatomy-Histology-Embryology, Medical School, University of Ioannina, Greece. .
BMC Ear Nose and Throat Disorders 05/2011; 11(1):5. DOI: 10.1186/1472-6815-11-5
Source: PubMed


The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders (TMD) have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms, and hearing loss.
The study involved 464 healthy Greek university students (156 men and 308 women) with a mean age of 19.6 years. Age, gender and maximum mouth opening was recorded. Mouth opening was measured using Vernier calipers. An anamnestic questionnaire was used to stratify the subjects into four groups based on TMD severity. Aural symptoms and an audiogram were recorded for each subject too. Data were analyzed using multifactor ANOVA, chi-square, t-test, Mann-Whitney and Kruskal-Wallis tests.
The overall incidence of TMD signs and symptoms was 73.3%. The incidence and severity was greater in females than males (p-value 0.0001 < 0.05). The number of aural symptoms was associated to the TMD severity (p-value 0.0001 < 0.05) as well as maximum mouth opening (p-value 0.004 < 0.05). Audiometry showed that moderate and severe TMD was associated with hearing loss of median and low tones respectively (p-value 0.0001 < 0.05). TMJ pain (p-value 0.0001 < 0.05), TMJ ankylosis (p-value 0.0001 < 0.05), bruxism (p-value 0.0001 < 0.05) and ear itching (p-value 0.0001 < 0.05) were also found to be statistically different between TMD and non-TMD subjects.
TMD signs and symptoms were more common and severe in females than males. TMD severity is correlated with the degree of mouth opening and the number of aural symptoms. The absence or presence of mild TMD are associated with normal audiograms while moderate and severe TMD are related to hearing loss in median and low tones respectively. Bruxism, joint ankylosis, joint pain and ear itching were more common in TMD than non-TMD patients.

Download full-text


Available from: Aristidis H Zibis, Jan 29, 2014
  • Source
    • "Temporomandibular disorder (TMD) is a term used for a set of conditions that affect the temporomandibular joint and orofacial musculature (1,2). TMD can cause stiffness, joint noises, restricted mandibular movements and orofacial pain (3). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and marital status) on the occurrence of temporomandibular disorder. Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oesteoarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and Classes D/E (very poor social class). The results were analyzed using Pearson’s chi-square test for proportions, Fisher’s exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis. Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of exhibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems. Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems. Key words:Temporomandibular joint disorders, risk factors, prevalence.
    Full-text · Article · Dec 2013 · Medicina oral, patologia oral y cirugia bucal
  • Source
    • "The frequency of otalgia in patients with TMD reported 5% to 42% [10]. Kitsoulis found that 10.8% of TMD subjects reported ear pain, and that 75% of those TMD subjects had severe TMD [11]. The association between aural symptoms and TMD symptoms has been variously related to the position of the mandible and TMJ, retrusion of the condyles and spasm of the tensor tympani and stapedius muscles [12]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan. Methods A personal interview survey was conducted on first-year university students (n = 1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Results Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319), pain in the TMJ only (Group II, n = 21), difficulty in mouth opening only (Group III, n = 18), clicking and pain (Group IV, n = 29), clicking and difficulty in mouth opening (Group V, n = 48), difficulty in mouth opening and pain (Group VI, n = 11), and combination of three symptoms (Group VII, n = 97). The control group (n = 1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR = 12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. Conclusions TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.
    Full-text · Article · Feb 2013 · BMC Musculoskeletal Disorders
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: MACHADO DE CARVALHO, GUILHERME ; CAIXETA GUIMARÃES, ALEXANDRE ; VEGA, FÁBIO ; IWAKURA, CÁSSIO ; RIZZATO PASCHOAL, JORGE ; NIZAM PFEILSTICKER, LEOPOLDO . Surgical disaster in temporomandibular joint: Case report. Revista Española de Cirugía Oral y Maxilofacial, v. 2, p. 2, 2012.
    Full-text · Article · Apr 2011
Show more