Zemowski Michał, Yushchenko Yana, Wieczorek Aneta
Student Research Group, Department of Prosthodontics and Orthodontics, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland.
Department of Prosthodontics and Orthodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland.
J Clin Med. 2025 Jul 27;14(15):5301. doi: 10.3390/jcm14155301.
Temporomandibular disorders (TMD) are common musculoskeletal conditions affecting the temporomandibular joints, masticatory muscles, and associated structures. Their etiology is complex and multifactorial, involving anatomical, behavioral, and psychosocial contributors. Parafunctional habits such as clenching, grinding, and abnormal jaw positioning have been proposed as contributing factors, yet their individual and cumulative contributions remain unclear. This exploratory cross-sectional study aimed to evaluate the prevalence and severity of parafunctional habits and their association with TMD in medical students-a group exposed to elevated stress levels. Subjects were examined in Krakow, Poland, using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. : Participants completed a 21-item Oral Behavior Checklist (OBC) assessing the frequency of oral behaviors on a 0-4 scale. A self-reported total parafunction load was calculated by summing individual item scores (range: 0-84). Logistic regression was used to evaluate associations between individual and total parafunction severity scores and TMD presence. The study included 66 individuals aged 19-30. TMD was diagnosed in 55 participants (83.3%). The most commonly reported habits were resting the chin on the hand (90.9%) and sleeping in a jaw-compressing position (86.4%). Notably, jaw tension (OR = 14.5; = 0.002) and daytime clenching (OR = 4.7; = 0.027) showed significant associations with TMD in the tested population. Each additional point in the total parafunction score increased TMD odds by 13.6% ( = 0.004). : These findings suggest that parafunctional behaviors-especially those involving chronic muscle tension or abnormal mandibular positioning-may meaningfully contribute to the risk of TMD in high-stress student populations. Moreover, the cumulative burden of multiple low-intensity habits was also significantly associated with increased TMD risk. Early screening for these behaviors may support prevention strategies, particularly among young adults exposed to elevated levels of stress.
颞下颌关节紊乱病（TMD）是一种常见的肌肉骨骼疾病，会影响颞下颌关节、咀嚼肌及相关结构。其病因复杂且具有多因素性，涉及解剖学、行为学和心理社会学等多种因素。诸如紧咬牙、磨牙以及异常的颌位等副功能习惯被认为是致病因素，但它们各自以及累积的影响仍不明确。这项探索性横断面研究旨在评估医学生中副功能习惯的患病率和严重程度，以及它们与TMD的关联，医学生群体面临较高的压力水平。研究对象在波兰克拉科夫接受检查，采用颞下颌关节紊乱病诊断标准（DC/TMD）方案。参与者完成了一份包含21项内容的口腔行为检查表（OBC），该检查表按照0 - 4的等级评估口腔行为的频率。通过将各个项目得分相加计算出自报的总副功能负荷（范围：0 - 84）。采用逻辑回归分析来评估个体及总副功能严重程度得分与TMD存在情况之间的关联。该研究纳入了66名年龄在19 - 30岁之间的个体。55名参与者（83.3%）被诊断患有TMD。最常报告的习惯是手托下巴（90.9%）以及在颌部受压的姿势下睡觉（86.4%）。值得注意的是，颌部紧张（OR = 14.5；P = 0.002）和白天紧咬牙（OR = 4.7；P = 0.027）在受试人群中与TMD存在显著关联。总副功能得分每增加1分，患TMD的几率就增加13.6%（P = 0.004）。这些发现表明，副功能行为，尤其是那些涉及慢性肌肉紧张或下颌异常定位的行为，可能在高压力的学生群体中对TMD的发病风险有显著影响。此外，多种低强度习惯的累积负担也与TMD风险增加显著相关。对这些行为进行早期筛查可能有助于预防策略的实施，尤其是在面临较高压力水平的年轻人中。
