Oral parafunctions and positive clinical examination findings. 2005

Giedre Kobs, and Olaf Bernhardt, and Thomas Kocher, and Georg Meyer
Institute of Stomatology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

BACKGROUND 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. OBJECTIVE 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 muscle tension and joint pain. 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). CONCLUSIONS 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.

UI MeSH Term Description Entries
D008297 Male Males
D008410 Masticatory Muscles Muscles arising in the zygomatic arch that close the jaw. Their nerve supply is masseteric from the mandibular division of the trigeminal nerve. (From Stedman, 25th ed) Masticatory Muscle,Muscle, Masticatory,Muscles, Masticatory
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009119 Muscle Contraction A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. Inotropism,Muscular Contraction,Contraction, Muscle,Contraction, Muscular,Contractions, Muscle,Contractions, Muscular,Inotropisms,Muscle Contractions,Muscular Contractions
D010173 Palpation Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. Palpations
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D002012 Bruxism A disorder characterized by grinding and clenching of the teeth. Bruxomania,Teeth Grinding Disorder,Disorder, Teeth Grinding,Grinding Disorder, Teeth,Teeth Grinding Disorders
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005157 Facial Pain Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES. Craniofacial Pain,Myofacial Pain,Orofacial Pain,Pain, Facial,Face Pain,Neuralgic Facial Pain,Facial Pain, Neuralgic,Pain, Craniofacial,Pain, Face,Pain, Myofacial,Pain, Neuralgic Facial,Pain, Orofacial
D005260 Female Females

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