Temporomandibular disorders in relation to craniofacial dimensions, head posture and bite force in children selected for orthodontic treatment

The present study examined the associations between craniofacial dimensions , head posture, bite force, and symptoms and signs of temporomandibular dis orders (TMD). The sample comprised 96 children (51F, 45M) aged 7-13 years, sequentially admitted for orthodontic treatment of malocclusions entailing health risks. Symptoms and signs of TMD were assessed by 37 variables descr ibing the occurrence of headache and facial pain, clicking, jaw mobility, t enderness of muscles and joints, and the Helkimo Anamnestic and Dysfunction indices, Craniofacial dimensions (33 variables), and head and cervical pos ture (nine variables) were recorded from lateral cephalometric radiographs taken with the subject standing with the head in a standardized posture (mi rror position). Dental arch widths were measured on plaster casts and bite force was measured at the first molars on each side by means of a pressure transducer. Associations were assessed by Spearman correlations and multipl e stepwise logistic regression analyses. The magnitudes of the significant associations were generally low to modera te. On average, temporomandibular joint (TMJ) dysfunction was seen in conne ction with a marked forward inclination of the upper cervical spine and an increased craniocervical angulation, but no firm conclusion could be made r egarding any particular craniofacial morphology in children with symptoms a nd signs of TMJ dysfunction. Muscle tenderness was associated with a 'long face' type of craniofacial morphology and a lower bite force. Headache was associated with a larger maxillary length and increased maxillary prognathi sm. A high score on Helkimo's Clinical Dysfunction Index was associated wit h smaller values of a number of vertical, horizontal, and transversal linea r craniofacial dimensions and a lower bite force.