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Temporomandibular joint disorder and gross motor function in children with cerebral palsy
Özge Baykan Çopuroğlu1, Baki Umut Tuğay2, Muhammet Furkan Vatan3
1Physiotherapy Program, Department of Therapy and Rehabilitation, Incesu Ayşe and Saffet Arslan Vocational School of Health Services, Kayseri University, Kayseri, Türkiye.
Insights
Temporomandibular joint disorder (TMD) affects nearly 40% of children with cerebral palsy (CP), increasing with motor impairment severity. Spastic CP subtype and bruxism are associated with higher TMD prevalence.
Area of Science:
- Neurology
- Pediatrics
- Dentistry
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Temporomandibular joint (TMJ) disorders (TMD) can impact orofacial function and quality of life.
- The prevalence and associated factors of TMD in children with CP are not well understood.
Purpose of the Study:
- To determine the prevalence of clinical signs and symptoms of TMD in children with CP.
- To examine the association of TMD with the severity of gross motor impairment (GMFCS levels I-IV).
- To investigate associations between TMD, CP subtype, and caregiver-reported bruxism.
Main Methods:
- A cross-sectional study of 517 children with CP (mean age 10 years 10 months).
- TMJ function assessed using standardized clinical criteria, including maximum mouth opening, lateral jaw movement, joint sounds, palpation tenderness, and pain intensity.
- Caregiver-reported bruxism was also recorded.
Main Results:
- The overall prevalence of TMD was 38.7%, with caregiver-reported bruxism in 32.6%.
- TMD prevalence increased with GMFCS level, from 24.3% (Level I) to 62.5% (Level IV).
- Higher GMFCS level, spastic CP subtype, and bruxism were independent factors associated with TMD.
Conclusions:
- TMD is common in children with CP.
- TMD is significantly associated with greater motor impairment severity, spastic CP, and bruxism.
- Routine TMJ assessment is recommended in pediatric neurorehabilitation to support orofacial function.
Aim:
To determine the prevalence of the clinical signs and symptoms of temporomandibular joint (TMJ) disorder (TMD) in children with cerebral palsy (CP) and to examine their associations with severity of gross motor impairment, CP subtype, and caregiver-reported bruxism.
Method:
This cross-sectional study included 517 children with CP (mean age = 10 years 10 months [SD 3 years 7 months]; 57.2% male) classified according to Gross Motor Function Classification System (GMFCS) levels I to IV. TMJ function was evaluated using standardized clinical criteria, including maximum mouth opening, lateral jaw movement, joint sounds, palpation tenderness, pain intensity, and caregiver-reported bruxism.
Results:
The overall prevalence of TMD was 38.7% (95% confidence interval [CI] = 34.5-42.9), while caregiver-reported bruxism was observed in 32.6% (95% CI = 28.6-36.9) of participants. TMD increased progressively with severity of gross motor impairment, from 24.3% at GMFCS level I to 62.5% at GMFCS level IV (p < 0.001). Children with spastic CP showed a higher prevalence (44.3%) compared with those with the ataxic (26.1%), dyskinetic (36.6%), and mixed subtypes (33.3%) (p = 0.012). In a multivariable analysis, higher GMFCS level (odds ratio [OR] = 1.82, 95% CI = 1.45-2.29), spastic subtype (OR = 1.67, 95% CI = 1.12-2.50), and caregiver-reported bruxism (OR = 2.21, 95% CI = 1.55-3.15) emerged as independent factors associated with TMD.
Interpretation:
TMD is common in children with CP and is associated with greater severity of gross motor impairment, spastic subtype, and caregiver-reported bruxism. Systematic TMJ assessment should be incorporated into routine paediatric neurorehabilitation to support orofacial function and participation.
