Evaluation of craniomandibular dysfunction in children 6 to 10 years of age with unilateral cleft lip or cleft lip and palate: a clinical diagnostic adjunct.

It is becoming increasingly apparent that a clinical evaluation for craniomandibular dysfunction in children is important for predicting future problems in adults. Because of the dysmorphology inherent in children with clefts, there is potential for craniomandibular dysfunction in many cases. The prevalence of craniomandibular dysfunction in white children with unilateral cleft lip or cleft lip and palate from 6 to 10 years of age was investigated. Thirty children (22 males and eight females) were examined. Craniomandibular dysfunction was detected clinically by the following criteria: mandibular movements; deflection of the mandible on opening; temporomandibular joint (TMJ) sounds; and muscle and temporomandibular joint tenderness to palpation. Information related to subjective symptoms (headaches, difficulties in opening wide, pain in the temple region, pain in opening wide, pain in chewing, and reported clicking) was collected by interview. The results showed that the prevalence of objective and subjective symptoms was 76.6 and 53.3 percent, respectively. The most frequent symptom was muscle tenderness (60 percent), followed by temporomandibular joint tenderness (26.6 percent), temporomandibular joint sounds (20 percent), and headaches (16.6 percent). Statistically significant differences by cleft type were not found in the prevalence of any objective or subjective symptom. Significant correlation was found only between temporomandibular joint tenderness and muscle tenderness. Because the overall prevalence of symptoms is shown to be high in the sample studied, routine dental examinations of patients with clefts should include an evaluation of the masticating system.