Maryam Alsadat HASHEMIPOUR, Fatemeh MOSLEMİ, Azin MİRZADEH, Amir MİRZADEH

Parafunctional Habits and Their Relationship with Temporomandibular Joint Disorders in Iranian School Students

Objective: Unfavorable parafunctional habits affect the dentoalveolar structures and if they are diagnosed late and if the treatment is delayed, they will lead to severe problems that are either irreversible or are associated with high costs, difficult technical problems and severe patient suffering. The aim of this study was to determine the prevalence of parafunctional habits and their relationship with temporomandibular joint (TMJ) disorders in female high school students in Kerman, İran. Materials and Methods: In the present descriptive-analytical study, data were collected by completing a questionnaire and through clinical examination. The study population consisted of first- to fourth-grade high school students in Kerman, İran. Clinical examinations were carried out by one last-year dental student who was instructed in the faculty of dentistry in the relevant field by one professor and became proficient in clinical examination. Statistical analyses were carried out with SPSS 13.5, using t-test, chi-squared test and ANOVA. Results: A total of 368 questionnaires were completed in this study. Sixty-six students had no parafunctional habits and 78% of the subjects had at least one oral parafunctional habit; 1.2% of the subjects had all the eleven parafunctional habits and 22% of the subjects had only one parafunctional habit. The highest frequencies were related to chewing gums on one side, sleeping on one side and chewing pencils or pens. The prevalence of TMJ disorder symptoms and signs in the subjects was as follows: joint clicks (31%), pain in masticatory muscles (10%), pain during mastication of food (24%) and pain at mouth opening (14%). The results showed the greatest relationship between tooth clenching and tenderness to palpation in masticatory muscles. Of all the masticatory muscles, the most severe pain during palpation was detected in the masseter, followed by temporalis muscle. Conclusion: This study showed that the highest frequency of parafunctional habits was related to chewing gums and the most frequent sign of TMJ disorders was joint clicks in subjects. In addition, there were significant relationships between TMJ disorder symptoms and signs and parafunctional habits such as bruxism, unilateral mastication and tooth clenching.

İranlı Öğrencilerin Parafonksiyonel Alışkanlıkları ve Temporomandibuler Eklem Hastalıklarıyla Olan İlişkileri

Amaç: İstenmeyen parafonksiyonel alışkanlıklar dentoalveoler yapıları etkiler ve eğer geç tanı konurlarsa ve tedavi gecikirse, ya geri döndürülemez ya da yüksek masraf, zorlu teknik problemler ve ciddi hasta çekimi ile ilişkili ciddi problemlere neden olurlar. Bu çalışmanın amacı, İran’da Kerman’daki lise öğrencilerinin parafonksiyonel alışkanlık prevalansını ve temporomandibular eklem (TME) hastalıklarıyla olan ilişkilerini belirlemektir. Gereç ve Yöntemler: Mevcut betimsel-analitik çalışmada, anket doldurularak ve klinik muayene ile veriler toplandı. Çalışma grubu, İran’ın Kerman kentinde bulunan lise son sınıf öğrencilerinden dördüncü sınıf öğrencilerinden oluşmaktadır. Klinik muayene, bir profesör tarafından ilgili alanda diş hekimliği fakültesinde eğitim görmüş ve klinik muayeneye hakim bir önceki yıl diş hekimliği öğrencisi tarafından gerçekleştirilmiştir. İstatistiksel analizler SPSS 13.5 ile t-testi, ki-kare testi ve ANOVA kullanılarak gerçekleştirildi. Bulgular: Bu çalışmada toplam 368 anket dolduruldu. Altmış altı öğrencinin parafonksiyonel alışkanlığı yoktu ve %78’inde en az bir adet oral parafonksiyonel alışkanlık vardı; olguların %1,2’sinde on parafonksiyonel alışkanlıkların hepsi vardı ve %22’sinde sadece bir parafonksiyonel alışkanlık vardı. En yüksek sıklıklar bir tarafta sakız çiğneme, bir tarafa doğru uyuma ve kurşun kalem ya da tükenmez kalem çiğneme ile ilgilidir. Deneklerde TME bozukluğu semptom ve bulguları prevalansı şu şekildedir: Eklem çıtlaması (%31), çiğneme kaslarındaki ağrı (%10), gıdaların çiğnenmesi sırasında ağrı (%24) ve ağız açmada ağrı (%14). Sonuçlar, diş kenetlenmesi ve çiğneme kaslarına palpasyon ile hassasiyet arasındaki en büyük ilişkiyi gösterdi. Tüm çiğneme kaslarının palpasyon sırasında en şiddetli ağrı, masseterde temporal kas izledi. Sonuç: Bu çalışma, deneklerde parafonksiyonel alışkanlıkların en yüksek sıklığının çiğneme sakızıyla ilişkili olduğunu ve en sık görülen TME bozuklukluğu belirtisinin eklem çıtlamaları olduğunu göstermiştir. Buna ek olarak, TME bozukluğu semptomları ile brusizm, tek taraflı çiğneme ve diş kenetlenmesi gibi parafonksiyonel alışkanlıklar arasında anlamlı ilişkiler vardı.

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Okeson JP. Management of temporomandibular Disorder and occlusion. 6th ed. St. Louis: Mosby Co, 2008: 349.

Gavish A, Halachmi M, Winocur E, Gazit E. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. J Oral Rehabil. 2000; 27: 22-32

Sonmez H. Investigation of the relationship between oral parafunctions and temporomandibular joint dysfunction in Turkish children with mixed and permanent dentition. J Oral Rehabil. 2002; 29: 108-12.

Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita- Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC Oral Health 2015; 15: 8.

Poveda Roda R, Bagan JV, Diaz Fernadez JM, Hernadez Bazan S, Jimenez Soriano Y. Review of temporomandibular joint pathology. Part I: Classification, epidemiology and risk factors. Med Oral Patol Oral Cir Bucal 2007; 12: 292-8.

Winocur E, Littner D, Adams I, Gavish A. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: a gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: 482-7.

Alamoudi N. The correlation between occlusal characteristics and temporomandibular dysfunction in Saudi Arabian children. J Clin Pediatr Dent 2000; 24: 229-36.

Schiffman EL, Fricton JR, Haley D. The relationship of occlusion, parafunctional habits and recent life events to mandibular dysfunction in a non-patient population. J Oral Rehabil. 1992; 1: 201-23.

de Oliveira AS, Dias EM, Contato RG, Berzin F. Prevalence study of signs and symptoms of temporomandibular disorder in Brazilian college students. Braz Oral Res 2006; 20: 3-7.

Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil 2008; 35: 509-23.

Restrepo C, Gomez S, Manrique R. Treatment of bruxism in children: a systematic review. Quintessence Int 2009; 40: 84955.

Choi YS, Choung PH, Moon HS, Kim SG. Temporomandibular disorders in 19-year-old Korean men. J Oral Maxillofac Surg 2002; 60: 797-803.

Miyake R, Ohkubo R, Takehara J, Morita M. Oral parafunctions and association with symptoms of temporomandibular disorders in Japanese university students. J Oral Rehabil 2004; 31: 518-23.

Troeltzsch M, Cronin RJ, Brodine AH, Frankenberger R, Messlinger K. Prevalence and association of headaches, temporomandibular joint disorders, and occlusal interferences. J Prosthet Dent 2011; 105: 410-7.

Motghare V, Kumar J, Kamate S, Kushwaha S, Anand R, Gupta N, Gupta B. Singh Association Between Harmful Oral Habits and Sign and Symptoms of Temporomandibular Joint Disorders Among Adolescents. J Clin Diagn Res. 2015; 9: ZC45-8.

Ciancaglini R, Gherlone EF, Radaelli G.The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population. J Oral Rehabil 2001; 28: 842-8.

Pullinger AG, Seligman DA, Gornbein JA. A multiple logistic regression analysis of the risk and relative odds of temporomandibular disorders as a function of common occlusal features. J Dent Res 1993; 72: 968-79.

Morrant DG, Taylor GS. The prevalence of temporomandibular disorder in patients referred for orthodontic assessment. Br J Orthod 1996; 23: 261-5.

Agerberg G, Inkapool I. Craniomandibular disorders in an urban Swedish population. J Craniomandib Disord 1990; 4: 154-64.