Distribution of craniomandibular disorders, occlusal factors and oral parafunctions in a paediatric population

The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in a paediatric population.

The clinical study population comprised patients with TMJ disorders who were being treated in the orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid, suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal, overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant).

A substantial number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism, onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most representative symptoms.

The identification and recognition of factors, such as malocclusions and parafunctions, are considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the stomatognathic system.