Distribution of craniomandibular disorders, occlusal factors and oral parafunctions in a paediatric population

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ABSTRACT

Aim

The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in
a paediatric population.

Methods

The clinical study population comprised patients with TMJ disorders who were being treated in the
orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded
for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models
were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid,
suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine
presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated
according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded
according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal,
overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant).

Results

A substantial
number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism,
onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most
representative symptoms.

Conclusion

The identification and recognition of factors, such as malocclusions and parafunctions, are
considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the
stomatognathic system.

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