Temporomandibular joint dysfunction in children: evaluation of treatment

Thirty-eight pediatric patients with temporomandibular joint (TMJ) dysfunction were diagnosed and treated. The etiology for the TMJ dysfunction was trauma in 30 (79%) patients, degenerative joint disease in two (5%) patients, growth disturbances in two (5%) patients and tumor in one (3%) patient. In three (8%) patients the etiology was unclear. The treatment modalities were: non-invasive therapy in 19 (50%) patients, occlusal therapy in 10 (26%) patients and surgical treatment in nine (24%) patients. The reported symptoms of temporomandibular joint dysfunction using the Helkino anamnestic index revealed that, at the initial examination, eight (21%) reported mild symptoms and 30 (79%) severe symptoms. One year later, 33 (87%) reported no symptoms, four (10%) mild symptoms and one (3%) severe symptoms. These differences were significant (P < 0.05-0.01). Maximum mouth opening 1 year after treatment as compared to the initial examination increased (P < 0.05) in all three treatment modalities. Deviation of the mandible on opening, 1 year after treatment as compared to the initial examination, decreased (P < 0.05) in all three treatment modalities. No differences were found between the modalities in both the maximum mouth opening or deviation of the mandible. TMJ dysfunction in children can be effectively treated by non-surgical treatment modalities. Surgery should be considered only when the non-surgical therapies were ineffective.