Aim: This study aims to investigate the occurrence of malocclusion in patients with orofacial pain and temporomandibular disorders (TMDs).
Materials and methods: A total of 437 standard orthodontic screening forms at a craniofacial pain TMD center were utilized to collect the data for this retrospective study. In addition to patient's demographics and Angle's molar classification, the following data were collected: Overjet (OJ), overbite (OB), mandibular range of motion, and whether or not there was a posterior crossbite or prior history of orthodontic therapy. Analysis of variance (ANOVA) and chi-square tests were then used to detect any statistical significant difference of the secondary variables’ distribution among the three malocclusion groups.
Results: The majority of the studied population sample had a class I molar relationship (70.9%), followed by class II (21.1%) and class III molar relationship (8%). Overjet and OB were significantly increased for class II molar relationship group (p < 0.001), where no statistical differences could be identified for the mandibular range of motion between the groups. The prevalence of right and left posterior crossbite was about 12% for both, and most of the crossbites presented within class I molar group.
Conclusion: Class I followed by class II molar relationships were found to be the most occurring relationship in the studied population. Posterior crossbite presented in 12% of cases and mostly affected subjects with class I molar relationship.
Clinical significance: These findings would aid in recognizing the studied population's orthodontic presentation and support the assessment of their transverse interventional needs.
Racich MJ. Orofacial pain and occlusion: is there a link? An overview of current concepts and the clinical implications. J Prosthet Dent 2005 Feb;93(2):189-196.
Graff-Radford SB. Regional myofascial pain syndrome and headache: principles of diagnosis and management. Curr Pain Headache Rep 2001 Aug;5(4):376-381.
Angle E. Treatment of malocclusion of the teeth and fractures of the maxillae: Angle's system. 6th ed, Philadelphia (PA): SS White Dental Manufacturing Co; 1900.
McCollum B. Fundamentals involved in prescribing restorative dental remedies. Dent Items Interest 1939;(61):522-533.
Farrar WB, McCarty WL, Jr. Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ. J Prosthet Dent 1979 May;41(5):548-555.
Pullinger AG, Montiero AA, Lui S. Etiological factors associated with temporomandibular disorders. J Dent Res 1985;64(Special Issue):269, Abst. No. 848.
Irby WB, Zetz MR. Osteoarthritis and rheumatoid arthritis affecting the temporomandibular joint. In: Laskin Dea, editor. The president's conference on the examination, diagnosis and management of temporomandibular disorders. Chicago: Am Dent Assoc Press; 1983. pp. 106-111.
Westling L. Craniomandibular disorders and general joint mobility. Acta Odontol Scand 1989 Oct;47(5):293-299.
Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent 1981 May;45(5):545-549.
Rugh JD, Ohrbach R. Occlusal parafunction. In: Mohl ND, Zarb GA, Carlsson GE, Rugh JD, editors. A textbook of occlusion. Chicago: Quintessence; 1988. pp. 249-261.
Monaco A, Spadaro A, Cattaneo R, Giannoni M. Effects of myogenous facial pain on muscle activity of head and neck. Int J Oral Maxillofac Surg 2010 Aug;39(8):767-773.
Sipila K, Ensio K, Hanhela H, Zitting P, Pirttiniemi P, Raustia A. Occlusal characteristics in subjects with facial pain compared to a pain-free control group. Cranio 2006 Oct;24(4):245-251.
Rauhala K, Oikarinen KS, Jarvelin MR, Raustia AM. Facial pain and temporomandibular disorders: an epidemiological study of the Northern Finland 1966 Birth Cohort. Cranio 2000 Jan;18(1):40-46.
Sonnesen L, Bakke M, Solow B. Malocclusion traits and symptoms and signs of temporomandibular disorders in children with severe malocclusion. Eur J Orthod 1998 Oct;20(5): 543-559.
Thilander B, Rubio G, Pena L, de Mayorga C. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod 2002 Apr;72(2):146-154.
Bilgic F, Gelgor IE. Prevalence of temporomandibular dysfunction and its association with malocclusion in children: an epidemiologic study. J Clin Pediatr Dent 2017; 41(2): 161-165.
Nerder PH, Bakke M, Solow B. The functional shift of the mandible in unilateral posterior crossbite and the adaptation of the temporomandibular joints: a pilot study. Eur J Orthod 1999 Apr;21(2):155-166.
Thilander B, Bjerklin K. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment? Eur J Orthod 2012 Dec;34(6):667-673.
Duarte Gaviao MB, Durval Lemos A, Diaz Serra M, Riqueto Gambareli F, Nobre Dos Santos M. Masticatory performance and bite force in relation to signs and symptoms of temporomandibular disorders in children. Minerva Stomatol 2006 Oct;55(10):529-539.
Fushima K, Inui M, Sato S. Dental asymmetry in temporomandibular disorders. J Oral Rehabil 1999 Sep;26(9):752-756.
Proffit WR, Fields HW, Jr., Moray LJ. Prevalence of malocclusion and orthodontic treatment need in the United States: estimates from the NHANES III survey. Int J Adult Orthodont Orthognath Surg 1998; 13(2): 97-106.
Hatch JP, Rugh JD, Sakai S, Saunders MJ. Is use of exogenous estrogen associated with temporomandibular signs and symptoms? J Am Dent Assoc 2001 Mar;132(3):319-326.
Grosfeld O, Jackowska M, Czarnecka B. Results of epidemiological examinations of the temporomandibular joint in adolescents and young adults. J Oral Rehabil 1985 Mar;12(2):95-105.
Matsuka Y, Yatani H, Kuboki T, Yamashita A. Temporomandibular disorders in the adult population of Okayama City, Japan. Cranio 1996 Apr;14(2):158-162.
Feteih RM. Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi Arabian adolescents: a research report. Head Face Med 2006 Aug;16(2):25.
Bosio JA, Burch JG, Tallents RH, Wade DB, Beck FM. Lateral cephalometric analysis of asymptomatic volunteers and symptomatic patients with and without bilateral temporomandibular joint disk displacement. Am J Orthod Dentofacial Orthop 1998 Sep;114(3):248-255.
Miller JR, Burgess JA, Critchlow CW. Association between mandibular retrognathia and TMJ disorders in adult females. J Public Health Dent 2004 Summer;64(3):157-163.
Simmons HC, Oxford DE, Hill MD. The prevalence of skeletal Class II patients found in a consecutive population presenting for TMD treatment compared to the national average. J Tenn Dent Assoc 2008 Fall;88(4):16-18.
Farronato G, Rosso G, Giannini L, Galbiati G, Maspero C. Correlation between skeletal class II and temporomandibular joint disorders: a literature review. Minerva Stomatol 2016 Aug;65(4):239-247.
Chen CY, Palla S, Erni S, Sieber M, Gallo LM. Nonfunctional tooth contact in healthy controls and patients with myogenous facial pain. J Orofac Pain 2007 Summer;21(3):185-193.
Gonzalez HE, Manns A. Forward head posture: its structural and functional influence on the stomatognathic system, a conceptual study. Cranio 1996 Jan;14(1):71-80.
Gorucu-Coskuner H, Ciger S. Computed tomography assessment of temporomandibular joint position and dimensions in patients with class II division 1 and division 2 malocclusions. J Clin Exp Dent 2017 Mar;9(3):e417-e423.
Che B, Zhang H, Qian C, Zhang Y, Wang L, Ma J. Threedimensional positions and forms of temporomandibular joints in class II division 1 malocclusion patients associated with different vertical skeletal patterns. Zhonghua Kou Qiang Yi Xue Za Zhi 2014 Jul;49(7):399-402.
Merigue LF, Conti AC, Oltramari-Navarro PV, Navarro Rde L, Almeida MR. Tomographic evaluation of the temporomandibular joint in malocclusion subjects: condylar morphology and position. Braz Oral Res 2016;30(1).
Mehta NR, Forgione AG, Maloney G, Greene R. Different effects of nocturnal parafunction on the masticatory system: the Weak Link Theory. Cranio 2000 Oct;18(4):280-286.
Sari S, Sonmez H, Oray GO, Camdeviren H. Temporomandibular joint dysfunction and occlusion in the mixed and permanent dentition. J Clin Pediatr Dent 1999 Fall;24(1):59-62.
Barrera-Mora JM, Espinar Escalona E, Abalos Labruzzi C, Llamas Carrera JM, Ballesteros EJ, Solano Reina E, Rocabado M. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms. Cranio 2012 Apr;30(2):121-130.
Mladenovic I, Dodic S, Stosic S, Petrovic D, Cutovic T, Kozomara R. TMD in class III patients referred for orthognathic surgery: psychological and dentition-related aspects. J Craniomaxillofac Surg 2014 Dec;42(8):1604-1609.
Almasan OC, Baciut M, Almasan HA, Bran S, Lascu L, Iancu M, Bãciuþ G. Skeletal pattern in subjects with temporomandibular joint disorders. Arch Med Sci 2013 Feb;9(1): 118-126.
Haralur SB, Addas MK, Othman HI, Shah FK, El-Malki AI, Al-Qahtani MA. Prevalence of malocclusion, its association with occlusal interferences and temporomandibular disorders among the Saudi sub-population. Oral Health Dent Manag 2014 Jun;13(2):164-169.
Kahn J, Tallents RH, Katzberg RW, Moss ME, Murphy WC. Association between dental occlusal variables and intraarticular temporomandibular joint disorders: horizontal and vertical overlap. J Prosthet Dent 1998 Jun;79(6):658-662.
Celic R, Jerolimov V. Association of horizontal and vertical overlap with prevalence of temporomandibular disorders. J Oral Rehabil 2002 Jun;29(6):588-593.
Sonnesen L, Svensson P. Temporomandibular disorders and psychological status in adult patients with a deep bite. Eur J Orthod 2008 Dec;30(6):621-629.
Miyazaki H, Motegi E, Isoyama Y, Konishi H, Sebata M. An orthodontic study of temporomandibular joint disorders. Part 2: clinical research in orthodontic patients. Bull Tokyo Dent Coll 1994 May;35(2):85-90.
Bales JM, Epstein JB. The role of malocclusion and orthodontics in temporomandibular disorders. J Can Dent Assoc 1994 Oct;60(10):899-905.
Imai T, Okamoto T, Kaneko T, Umeda K, Yamamoto T, Nakamura S. Long-term follow-up of clinical symptoms in TMD patients who underwent occlusal reconstruction by orthodontic treatment. Eur J Orthod 2000 Feb;22(1):61-67.
Bernal M, Tsamtsouris A. Signs and symptoms of temporomandibular joint dysfunction in 3 to 5 year old children. J Pedod 1986 Winter;10(2):127-140.
Conti A, Freitas M, Conti P, Henriques J, Janson G. Relationship between signs and symptoms of temporomandibular disorders and orthodontic treatment: a cross-sectional study. Angle Orthod 2003 Aug;73(4):411-417.
Morrant DG, Taylor GS. The prevalence of temporomandibular disorder in patients referred for orthodontic assessment. Br J Orthod 1996 Aug;23(3):261-265.
Mohlin BO, Derweduwen K, Pilley R, Kingdon A, Shaw WC, Kenealy P. Malocclusion and temporomandibular disorder: a comparison of adolescents with moderate to severe dysfunction with those without signs and symptoms of temporomandibular disorder and their further development to 30 years of age. Angle Orthod 2004 Jun;74(3):319-327.
Jussila P, Krooks L, Napankangas R, Pakkila J, Lahdesmaki R, Pirttiniemi P, Raustia A. The role of occlusion in temporomandibular disorders (TMD) in the Northern Finland Birth Cohort (NFBC) 1966. Cranio 2018 Jan;1-7.
Gesch D, Bernhardt O, Kirbschus A. Association of malocclusion and functional occlusion with temporomandibular disorders (TMD) in adults: a systematic review of populationbased studies. Quintessence Int 2004 Mar;35(3):211-221.
Gesch D, Bernhardt O, Mack F, John U, Kocher T, Alte D. Association of malocclusion and functional occlusion with subjective symptoms of TMD in adults: results of the Study of Health in Pomerania (SHIP). Angle Orthod 2005 Mar;75(2):183-190.
Akeel R, Al-Jasser N. Temporomandibular disorders in Saudi females seeking orthodontic treatment. J Oral Rehabil 1999 Sep;26(9):757-762.
Henrikson T, Nilner M. Temporomandibular disorders, occlusion and orthodontic treatment. J Orthod 2003 Jun;30(2):129-137.
Wang M, Yao X, Yan C, Huang C, Zhang M, Zhang Y. A comparative study on the intercuspal occlusion among TMD patients, malocclusion patients and university students. Zhonghua Kou Qiang Yi Xue Za Zhi 2002 Jul;37(4):249-252.
Celic R, Jerolimov V, Panduric J. A study of the influence of occlusal factors and parafunctional habits on the prevalence of signs and symptoms of TMD. Int J Prosthodont 2002 Jan-Feb;15(1):43-48.
de Sousa ST, de Mello VV, Magalhaes BG, de Assis Morais MP, Vasconcelos MM, de Franca Caldas Junior A, Gomes SG. The role of occlusal factors on the occurrence of temporomandibular disorders. Cranio 2015 Jul;33(3):211-216.