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Research Article Prevalence and Correlation Between TMD Based on RDC/TMD Diagnoses, Oral Parafunctions and Psychoemotional Stress in Polish University Students

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Research Article Prevalence and Correlation Between TMD Based on RDC/TMD Diagnoses, Oral Parafunctions and Psychoemotional Stress in Polish University Students View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Crossref Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 472346, 7 pages http://dx.doi.org/10.1155/2014/472346 Research Article Prevalence and Correlation between TMD Based on RDC/TMD Diagnoses, Oral Parafunctions and Psychoemotional Stress in Polish University Students Mieszko Wieckiewicz,1 Natalia Grychowska,2 Kamil Wojciechowski,2 Anna Pelc,2 Michal Augustyniak,2 Aleksandra Sleboda,2 and Marek Zietek3 1 Division of Dental Materials, Faculty of Dentistry, Wroclaw Medical University, 26 Krakowska Street, 50425 Wroclaw, Poland 2 Faculty of Dentistry, Wroclaw Medical University, 26 Krakowska Street, 50425 Wroclaw, Poland 3 Department of Periodontology, Faculty of Dentistry, Wroclaw Medical University, 26 Krakowska Street, 50425 Wroclaw, Poland Correspondence should be addressed to Mieszko Wieckiewicz; [email protected] Received 2 June 2014; Accepted 22 June 2014; Published 9 July 2014 Academic Editor: Anna Paradowska-Stolarz Copyright © 2014 Mieszko Wieckiewicz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The aim of the study was to assess the prevalence of temporomandibular disorders (TMD) and oral parafunctions, as wellas their correlation with psychoemotional factors in Polish university students. The research was conducted in a group of 456 students ( = 456). The examination form comprised of two parts: survey and clinical examination. The research diagnostic criteria for temporomandibular disorders (RDC/TMD) was used in order to assess TMD. Symptoms of TMD were observed in 246 (54%) students after clinical examination. The largest group involved students with disc displacement (women: 132, 29%; men: 70, 15%). Women (164; 36%) suffered more frequently than men (82; 18%) from problems related to the stomatognathic system ( < 0.05), described themselves as easily excitable and emotionally burdened, and reported symptoms as tightness of the facial and neck muscles ( < 0.05). In 289 (64%) students intraoral symptoms concerning occlusal parafunctions were observed. In 404 (89%) examined students, nonocclusal parafunctions were recorded. A significant correlation between TMD and psychoemotional problems could be detected. TMD symptoms more often concern women. Emotional burden and excitability are factors predisposing muscular disorders. 1. Introduction that TMD coexists with other numerous disorders such as SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, The temporomandibular disorders (TMD) and oral para- and osteitis syndrome), fibromyalgia, back- or spine ache, functionsseemtobeafrequentprobleminmodernsocieties chronic fatigue syndrome, spastic colons, sleep disorders, [1–6]. The etiopathology of the temporomandibular joints congenital defects, headaches, and arthritis [11, 12, 15, 16]. is related to muscles, teeth arches, and periodontium. Their Many studies report that the symptoms of the masticatory main causes involve both pathophysiological and psychoso- system disorders are more frequent in women than in men cial factors [7, 8]. In the literature, a significant impact [2–5]. This may result from biological differences, includ- of the psychoemotional factor is reported, comparable to ing hormonal ones, and also psychosocial factors [17, 18]. the impact of other factors concerning physical health such Stallman reports that student population lives more under as systemic diseases, malocclusions, loss of teeth, traumas, stress than the general population and develops considerably and microtraumas [9–12]. Stress, fatigue, anxiety, depression, often TMD and oral parafunctions [19]. The possible stress sleep disorders, and a fast pace of life affect negatively the factors include poor learning achievements, financial prob- human psyche [13]. In those patients muscular related TMD lems, unergonomic body position while studying, exams, is observed more often [14]. Moreover different studies report submitting academic papers, and the necessity to become 2 BioMed Research International independent [19–21]. Another predisposing factor to the gingival recession, crenated tongue, and cracked enamel were occurrence of the masticatory system disorders in students is systematically documented in an assessment form specially the age of this population, since the peak of the development made for the study. of the symptoms is between 20 and 40 years of age [3]. Based on self-report, clinical criteria, and diagnosis, the The aim of this epidemiological study is to assess the patients were divided in the following groups. prevalence of temporomandibular disorders and oral para- Group I: Muscle Disorders functions among Polish university students and their corre- Ia Myofascial Pain lation with psychoemotional factors. Consider the following: (i)painoracheinthejaw,temples,face,preauricular 2. Materials and Methods area, or inside the ear at rest or during function; (ii) pain in response to palpation of three or more of the The study was conducted at the four different Polish uni- following muscle sides (right and left side count as versities (Wroclaw Medical University, Wroclaw University separate sides for each muscle): posterior temporalis, of Technology, Wroclaw University of Environmental and middle temporalis, anterior temporalis, origin of Life Sciences, and University of Wroclaw) on a group of masseter, insertion of masseter, posterior mandibular 456 students in the years 2012–2014 (N = 456). Inclusion region, submandibular region, lateral pterygoid area, criteria were that the participants should be aged between 19 and tendon of the temporalis; and 30 years, be Polish university student (both gender were acceptable), and express consent to participate voluntarily (iii) at least one of painful muscle must be homolateral to in the study. Two hundred sixty four (58%) women and 192 the reported pain. (42%) men were examined. The mean age of participants was ± Ib Myofascial Pain with Limited Opening 22.01 2.11 years. Consider the following: The analysis was conducted by the research diagnos- tic criteria for temporomandibular disorders (RDC/TMD) (i)myofascialpainasdefinedinIa; introduced by Dworkin and LeResche in 1992 [1]. This enables < the standardization of the procedures of epidemiological (ii) pain-free unassisted mandibular opening 40 mm studies, the unification of TMD diagnostic and exploratory interincisal distance; criteria, and the comparison of results of other similar studies. (iii) maximum assisted opening (passive stretch) of The results of the study were based on the RDC/TMD Axis I ≥50 mm/greater than pain-free unassisted opening. diagnostic criteria. Mental state of subjects was not assessed according to RDC/TMD Axis II diagnoses. Group II: Disc Displacements Before the commencement all researchers have been IIa Disc Displacement with Reduction trained and calibrated in accordance with the adopted Consider the following: norms presented on the official website of the International RDC/TMD Consortium [22]. A simplified version of the (i) clicking in temporomandibular joint (TMJ) (click examination form was used, which comprised of the survey on both vertical opening and closing/occuring at and the clinical examination, developed on the basis of the a point at least 5mm greater interincisal distance RDC/TMD clinical physical examination form and question- on opening than closing/eliminated on protrusive naire [23]. opening), reproducible on 2 of 3 consecutive trials; As first part the survey included questions concerning (ii) clicking in TMJ on both vertical range of motion basic demographic data such as gender and age, type of (either opening or closing), reproducible on 2 of 3 reaction to stress, emotional burden, and occurrence of sub- consecutive trials and clicking during lateral excur- jective symptoms of TMD such as fatigue and tightness of the sion or protrusion, reproducible on 2 of 3 consecutive facial muscles, cervical muscle pain, chronic headache, and trials. otologic symptoms. It also included questions concerning the occurrence of nonocclusal parafunctions (habitual gum IIb Disc Displacement without Reduction with Limited Open- chewing, lip biting, nail biting and/or skin biting around ing nails, objects biting, and cheek biting). Consider the following: During the second part of the clinical examination, patients were given one or more diagnoses according to (i) history of locking or catching that interfered with RDC/TMD Axis I: group I/muscle disorders, group II/disc eating; displacements, and group III/other common joint disorders. (ii) unassisted opening (even painful) ≤35 mm interin- The study did not take into account individual unilateral cisal distance; diagnosis of TMD. Over the clinical examination no reliable < diagnosis was possible in order to unambiguously group (iii) contralateral excursion 7 mm and/or uncorrected a patient to subgroups IIc, IIIb, or IIIc. Thus, the authors deviation to ipsilateral side on opening; used only groups IIa, IIb, and IIIa. Intraoral symptoms of (iv) absence of joint sound or presence of joint sounds not occlusal parafunctions as teeth attrition, buccal linea alba, meeting criteria for disc displacement with reduction. BioMed Research International 3 Group III: Other Common Joint Disorders In 289 (64%) students intraoral symptoms concerning IIIa
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