Šimunović Luka, Lapter Varga Marina, Negovetić Vranić Dubravka, Čuković-Bagić Ivana, Bergman Lana, Meštrović Senka
Department of Orthodontics, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Dent J (Basel). 2024 Jul 10;12(7):213. doi: 10.3390/dj12070213.
The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years.
TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth.
At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom.
Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.
本研究的目的是在克罗地亚一个由338名9至15岁处于混合牙列期的学童组成的样本中，检验错颌畸形和副功能习惯在多大程度上导致与颞下颌关节紊乱病（TMD）相关的体征和症状的出现。
临床医生评估的TMD体征和症状包括关节功能和疼痛、咀嚼肌压痛、下颌运动范围以及关节弹响。为了评估主观症状和副功能，询问了儿童及其家长是否存在头痛、关节绞锁、颞下颌关节（TMJ）弹响、张口时疼痛或磨牙症，以及咬铅笔或指甲、嚼硬糖或冰块、每天嚼口香糖、用牙齿开瓶子、玩颌关节、吮拇指和紧咬牙/磨牙等副功能情况。
142名参与者（42.0%）出现了至少一种TMD症状。最常报告的副功能是咬铅笔或指甲，25.1%的参与者存在该情况。II类错颌畸形使出现至少一种TMD症状的可能性增加2.6倍，咬铅笔或指甲增加2.34倍，紧咬牙/磨牙增加8.9倍。
每个处于混合牙列期的儿童都应接受颞下颌关节的简要检查，尤其是在存在II类错颌畸形、咬铅笔或指甲以及紧咬牙或磨牙的情况下，因为这些都已被确定为增加出现TMD症状可能性的重要风险因素。这凸显了医疗保健提供者进行主动筛查和评估以降低受影响儿童中TMD的风险和患病率并确保及时诊断和治疗的必要性。
