Signs and symptoms of temporomandibular disorder (TMD) and craniofacial form

Signs and symptoms attributed to temporomandibular disorder (TMD) were registered in 170 persons at an average age of 12.5 years. One hundred and ten were reexamined at an average age of 26.4 years. Craniofacial form was defined on standardized lateral cephalograms, taken at the time points mentioned, by 22 linear and 8 angular measurements. The symptoms, clicking and pain, never appeared to be associated with craniofacial form. The signs, clicking and crepitation, in children did not appear to be associated with craniofacial form either. However, adults with signs were characterized by horizontal facial deficiencies. Adults with clicking joints had a saggitally shorter maxilla and mandibular diagonal, whereas adults with crepitating joints had, in addition, a shorter anterior and posterior cranial base and pharynx. This sagittal "shortness" could already be demonstrated for many of the reported dimensions at the corresponding cephalograms taken about the age of 12.5 years, and did not appear to have changed much over time. It is concluded that the reported TMD signs in adults were associated with a sagittal shorter midface. Part of the typical structure associated with signs antedated the actual detection of these signs by 14 years. This implies that not all TMD signs in adults can be regarded as the exclusive result of some etiologic factor operating after the teenage period. This finding of an association cannot be interpreted as a causal relationship.