Comparison of signs and symptoms of temporomandibular disorders in orthodontic and non-orthodontic patients presenting at a tertiary care hospital in Karachi, Pakistan
Introduction: Temporomandibular disorder (TMD) is a collective term involving the pathology of the temporomandibular joint and masticatory muscles. It has been speculated whether orthodontics can exacerbate or relieve symptoms of TMD. So far, orthodontics is not accepted as a remedy of this condition. The objective of this study was to evaluate the signs and symptoms of TMD seen in orthodontic patients compared to signs and symptoms existing in nonorthodontically treated patients by utilizing the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).
Material and Methods: A sample of 200 patients was used. This study was a cross-sectional study.
The sample was divided into a control group of (100 patients) and a study group of (100 patients).The RDC/TMD was used to record signs and symptoms of joint dysfunction i.e. clicking, crepitus, tenderness to palpation, mouth opening, and lateral excursions. Subjects’ psychological status was also evaluated to determine links between depression and somatization.
Results: 85% of control and 84 % of the study group had no TMD symptoms in the past six months. 18% of control and 12% of the study presented with joint clicking. Mean mouth opening (control) was noted as 42.4mm and 44 mm (study). 22% of control had restricted mouth opening <40 mm as compared to 28% of study sample. No statistical significance was noted between different variables except depression and tenderness (p = .033), headaches ( p = .005), chronic pain, ( p = .000) and self-reported clenching (p=.000).Conclusions: A significant relationship exists between TMD and depression and somatization. Clenching, muscle and joint tenderness, headaches, and chronic pain were more frequently noted with patients suffering from depression.