L. Sonnesen et al., Temporomandibular disorders in relation to craniofacial dimensions, head posture and bite force in children selected for orthodontic treatment, EUR J ORTHO, 23(2), 2001, pp. 179-192
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.