Craniofacial Morphology of Orthodontic Patients with and without Temporomandibular Disorders: A Cross-Sectional Study

Abstract

Purpose. We aimed to explore the relationship between temporomandibular disorders (TMDs) and craniofacial morphology in orthodontic patients. Methods. Altogether, 262 orthodontic patients were included and divided into two groups according to their Fonseca Anamnestic Index (FAI) scores: a no-TMD group (control group, FAI < 20) and a TMD group (FAI ≥ 20). Cephalometric parameters including cranial, maxillary, mandibular, and dental parameters were traced on cephalograms. Craniofacial morphology was compared between TMD and control groups, followed by subgroup analyses based on TMD severity, gender, age, and temporomandibular joint (TMJ) symptoms. Results. The prevalence of TMDs was 52.7% among included patients (138/262). The mean age of TMD patients was higher than that of the control group. No significant difference in gender distribution between the groups was observed. The most commonly reported FAI items were misaligned teeth, neck pain, and emotional tension. The Frankfort-mandibular plane angle (FMA) was larger in the TMD patients than in the control group, whereas no significant differences in other parameters were observed. Subgroup analysis based on TMD severity revealed that FMA and anterior facial height of moderate/severe TMD patients were significantly larger than those of mild or no-TMD patients. Among male patients, the anterior cranial base length was smaller, and the anterior facial height was larger in the TMD group. Among female patients, no significant differences in craniofacial morphology between the groups were observed. In juvenile patients, overjet and overbite were smaller in the TMD group. In adult patients, SNA, ANB, FMA, and gonial angle were larger in the TMD group. Within the TMD group, patients with TMJ pain or noises exhibited characteristic craniofacial features compared to patients without these symptoms. Conclusions. Orthodontic patients with TMDs have specific craniofacial morphology, suggesting a relationship between TMDs and particular craniofacial features in orthodontic patients.

Development of a new category system for the profile morphology of temporomandibular disorders patients based on cephalograms using cluster analysis

“…Recently, the craniofacial morphology of TMD and has been well-investigated ( 16 ) and it is reported that patients with TMD exhibit specific craniofacial features compared to patients without TMD ( 16 , 17 ). Our previous study ( 14 ) also validated the results and further observed a significant difference in Frankfort-mandibular plane angle (FMA) between patients with and without TMDs. Besides, we found there existed specific craniofacial features between TMD patients with and without TMJ pain as well ( 14 ).…”

“…Lateral cephalometric radiograph, an easily accessible and non-invasive examination, can supply abundant data concerning the cranial, facial bony and soft tissue structures. For its economy and convenience, lateral cephalometric radiograph has been not only widely used as facial analysis before and after orthodontic treatment, but also utilized to explore the association between TMD including its symptoms and the characteristics of craniofacial morphology ( 14 – 17 ). Already in 1995, lateral cephalometry was applied to investigate the association between morphologic features and internal derangements of the temporomandibular joint ( 15 ).…”

Effects of Radial Extracorporeal Shock Wave Therapy in Reducing Pain in Patients with Temporomandibular Disorders: A Pilot Randomized Controlled Trial

“…Several studies have examined the effects of conservative therapies, such as oral nonsteroidal anti-inflammatory drugs, orthodontics, electrotherapy, physical therapy, occlusal splints, oxygen-ozone therapy, and extracorporeal shockwave therapy (ESWT) in patients affected by TMD [13][14][15][16][17][18][19][20][21][22][23]. Among them, ESWT has been demonstrated to be effective in reducing pain and improving the function of the stomatognathic system; however, this treatment is relatively slow in relieving pain for patients and needs additional functional therapy to preserve the long-term therapeutic result [23].…”

Psychological Profiles and Their Relevance with Temporomandibular Disorder Symptoms in Preorthodontic Patients

“…In clinical practice, symptoms of TMDs have become recurring complaints among orthodontic patients [ 15 ], and a higher prevalence of TMDs has been observed in orthodontic patients than in the general population [ 16 , 17 ]. Malocclusion, as well as psychological distress following appearance unsatisfaction, may be potential risk factors for TMDs [ 18 ].…”