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International Journal of Dentistry and Oral Science (IJDOS)

ISSN: 2377-8075

Prevalence of Temporomandibular Disorders and Assessment of Factors Associated with it - A Retro-

spective Study
Research Article

Sanjana Devi1, Revathi Duraisamy2*

1
Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University,
Chennai 600077, Tamil Nadu, India.
2
Senior Lecturer, Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha
University, Chennai 600077, Tamil Nadu, India.

Abstract

E The temporomandibular joint has many anatomic and functional features that make it one of the most complex joints of
the body. Temporomandibular disorders are a complex group of conditions involving the temporomandibular joint, disc or
masticatory muscles. This condition causes a physical and psychological debility in the population, as the pain is widespread
and causes disability. Patients can also have clicking or grating sounds, limited or asymmetrical jaw movement. Even though
it is not a life threatening disease, the quality of life is reduced. The aim of this study was to evaluate the prevalence of tem-
poromandibular disorders and assessment of factors associated with it. A retrospective study was conducted in the Saveetha
Dental College. Ethical clearance was obtained from SRB committee, Saveetha Dental College. Data was collected from a total
of 86000 patients who visited Saveetha dental college between Jun,2019 to March,2020. Out of this, the data of 69 patients
who had pain in the TMJ in this time frame were retrieved. The data obtained was tabulated in SPSS for windows, version 20.
Frequencies were analysed. Chi square test was done to analyse association. There is no significant association between type
of TMD with age (P=0.342), gender (P=0.950) and dental status (P=0.404) in the present study. Within the limitations of this
study, TMD was more predominant in males, disc displacement was more predominant and the most affected age group was
between 30-39 years of age.

Keywords: Temporomandibular Disorders; Tmd; Condylar Disc Disorder; Mpds; Degenerative Disorders.

Introduction cal debility in the population, as the pain is widespread and causes
disability. Patients can also have clicking or grating sounds, limited
The temporomandibular joint has many anatomic and functional or asymmetrical jaw movement. Even though it is not a life threat-
features that make it one of the most complex joints of the body ening disease, the quality of life is reduced [5, 62, 7].
[11]. The part of the mandible in the TMJ is the condyle. Con-
dylar remodeling is continuous even after cessation of growth. It TMD can be caused by trauma, grinding and clenching of teeth,
is associated with ageing. Condylar remodeling is a physiological, disc slip, stress, osteoarthritis and rheumatoid arthritis [16]. Also,
adaptive process. It is the adaptation of the structure of the con- a hereditary problem named joint hypermobility where there is
dyle to meet the functional demands [3]. While evaluating pano- increased range of motion in all joints. This is called TMJ hy-
ramic radiographs, this adaptive mechanism must be kept in mind. permobility. Winocur et al, after conducting a study about the
Temporomandibular disorders are a complex group of condi- prevalence of general joint laxity and TMJ hypermobility among
tions involving the temporomandibular joint, disc or masticatory adolescent girls, stated that there was a 43% prevalence of gen-
muscles. It is characterized by chronic facial pain. Sometimes, it eralized joint laxity and out of which 27.3% was recognised as
is also associated with other comorbidities, like chronic joint and TMJH [68]. Adair et al, conducted a survey where they discovered
muscle pain [1]. This condition causes a physical and psychologi- that patients with generalized joint hypermobility were more likely

*Corresponding Author:
Revathi Duraisamy,
Senior Lecturer, Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077,
Tamil Nadu, India.
Tel: +91-7598267022
E-mail: [email protected]

Received: July 30, 2021

Accepted: August 10, 2021
Published: August 17, 2021

Citation: Sanjana Devi, Revathi Duraisamy. Prevalence of Temporomandibular Disorders and Assessment of Factors Associated with it - A Retrospective Study. Int J Dentistry Oral
Sci. 2021;8(8):3871-3876.

Copyright: Revathi Duraisamy©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution and reproduction in any medium, provided the original author and source are credited.

Sanjana Devi, Revathi Duraisamy. Prevalence of Temporomandibular Disorders and Assessment of Factors Associated with it - A Retrospective Study. Int J Dentistry Oral Sci. 2021;8(8):3871-
3876.
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to show signs and symptoms of TMD than ones with normal Priyadharsini and Raghunandhakumar, 2020 [45]), (Palati et al.,
joint mobility [68]. Types of TMD include disc condyle disorder, 2020 [43]), (Samuel, Acharya and Rao, 2020 [50]) Now the grow-
MPDS and degenerative disorder [9]. ing trend in this area motivated us to pursue this project.

Certain genetic factors, like polymorphisms in COMT - catechol The purpose of this study was to evaluate the prevalence of tem-
- O - methyltransferase - and ADRB2 – beta - 2 adrenoceptor poromandibular disorders.
genes, are likely to be responsible for hypersensitivity to experi-
mental pain in at least 50% of the cases studied. These same fac- Materials And Methods
tors may make individuals more susceptible to developing chronic
pain throughout life [25]. Joint pains can also be associated with A retrospective study was conducted in the Saveetha Dental Col-
systemic factors like, hormonal changes, autoimmune diseases, lege, Chennai, India. Ethical clearance was obtained from SRB
bacterial and viral infiltration, tissue metabolism, etc [59, 63, 32, committee, Saveetha Dental College, Chennai, India. The clinical
8]. portion of this retrospective study was conducted over a 9 month
period,i.e, between June, 2019 to March,2020 and included pa-
Several studies state that females have more predilections for tients who came with pain in the TMJ.
TMD due to stress and hormonal changes [36, 48, 57]. Dental sta-
tus like occlusal interference, loss of teeth, loss of vertical dimen- Inclusion criteria: Patients who came with pre-existing pain in
sion, excess vertical dimension in removable or fixed prosthesis, TMJ, both males and females.
orthodontic treatment, parafunctional habits like clenching and
bruxism, and talking with phone over shoulder [24, 52, 25, 27]. Exclusion criteria: Patients in whom only clicking was present
Dental treatments like implant placements, extraction of teeth, without any pain.
etc exacerbate the pain [2, 25, 17]. Different studies state different
relationships between age and TMD. According to Österberg T et Data was collected from a total of 86000 patients who visited
al, neither the variation in TMD symptoms between various age Saveetha dental college between Jun, 2019 to March,2020. Out of
groups and with time is fully understood, nor is the etiology of this, the data of 69 patients who had pain in this time frame were
TMD clarified [41]. However Ferreira et al stated a higher occur- retrieved. The data obtained was tabulated in SPSS for windows,
rence in young adults [21]. version 20. Frequencies were analysed. Chi square test was done
to analyse correlation.
Previously our team has a rich experience in working on various
research projects across multiple disciplines. (Jain, 2017 [31]), Results
(Varghese, Ramesh and Veeraiyan, 2019 [61]), (Ashok and Ga-
napathy, 2019 [6]), (Padavala and Sukumaran, 2018 [42]), (Ke et In the present study 55.1% were males and 44.9% were females
al., 2019 [34]), (Krishnan et al., 2018 [6]), (Ezhilarasan, Sokal and [Figure 1].13% of the patients were <20 years, 21.7% of the pa-
Najimi, 2018 [20]), (Pandian, Krishnan and Kumar, 2018 [44]), tients were between 20-29 years of age, 40.6% of the patients
(Ramamurthy and Mg, 2018 [50]), (Gupta, Ariga and Deogade, were between 30-39 years of age, 14.5% of the patients were be-
2018 [27]), (Vikram et al., 2017 [66]), (Paramasivam, Vijayashree tween 40-49 years of age, 8.7% of the patients were 50-59 years

Figure 1 - Bar graph represents the association between gender and type of TMD. X-axis represents the gender and Y-axis represents the
percentage of patients with TMD. Chi-square test was done.(Pearson Chi-square P value:0.950(>0.05), hence not statistically significant).
There is no statistically significant association between gender and type of TMD.

Figure 2 - Bar graph represents the association between age and type of TMD(. X-axis represents the age and Y-axis represents the percent-
age of patients with TMD. Chi-square test was done. (Pearson Chi-square P value: 0.342(>0.05), hence not statistically significant). There
is no significant association between age and type of TMD.

Sanjana Devi, Revathi Duraisamy. Prevalence of Temporomandibular Disorders and Assessment of Factors Associated with it - A Retrospective Study. Int J Dentistry Oral Sci. 2021;8(8):3871-
3876.
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Figure 3 - Bar graph represents the association between dental status and type of TMD. X-axis represents the dental status and Y-axis
represents the percentage of patients with TMD. Chi-square test was done and association was not found to be statistically significant.
(Pearson Chi-square P value:0.404(>0.05), hence not statistically significant). There is no significant association between dental status
and type of TMD.

Table 1 - Represents the frequencies of age, gender, type of TMD, dental status of participants.

S.No Variable Options Frequency [%]

1 Gender Male 38 [55.1%]

Female 31 [44.9%]
2 Age <20 years 9 [13%]
20-29 years 15 [21.7%]
30-39 years 28 [40.6%]
40-49 years 10 [14.5%]
50-59 years 6 [8.7%]
60-69 years 1 [1.4%]
3 Type of TMD Disc condylar disorder 41 [59.4%]
MPDS 23 [33.3%]
Degenerative disorder 5 [7.2%]
4 Dental status Caries 19 [27.5%]
Restorations 10 [14.5%]
Crowns 2 [2.9%]
Partially edentulous 11 [15.9%]
Completely edentulous 2 [2.9%]
Non-carious lesions 25 [36.2%]

of age, 1.4% of the patients were between 60-69 years of age restorations, 2.9% had crowns, 15.9% were partially edentulous,
[Figure 2]. 59.4% had Disc condylar disorder, 33.3% had MPDS, 2.9% were completely edentulous, and 36.2% had non carious
and 7.2% had degenerative disorder. 27.5% had caries, 14.5% had lesions [Figure 3].
restorations, 2.9% had crowns, 15.9% were partially edentulous,
2.9% were completely edentulous, 36.2% had non carious lesions In the present study, males with TMD were more predominant
[Figure 3][Table 1]. than females. But there was no significant correlation between
type of TMD with gender (P=.950). Haissam Dahan et al state
There was no significant correlation between Type of TMD with that gender is a major confounder in TMD [15]. Korszun et al,
gender (P=.950), age (P=.342), Dental status (P=.404) and sys- Contreras et al, Gonçalves DA, Österberg et al, Plesh et al, also
temic diseases (P=.205). Significance level was set at P<0.05. stated that TMD is more predominant in women due to an in-
creased predominance of stress related disorders (Website, no
Discussion date; [35, 41, 48, 13] Bonato et al stated that 82.5% of their sam-
ple population with TMD was women [10]. A study done by Fill-
In the present study 55.1% were males and 44.9% were females ingim et al on chronic TMD patients stated that women reported
[Figure 1].13% of the patients were <20 years, 21.7% of the pa- with higher levels of psychological distress across several SCL-
tients were between 20-29 years of age, 40.6% of the patients 90R scales, along with greater neuroticism, perceived stress, nega-
were between 30-39 years of age, 14.5% of the patients were be- tive affect, and somatic awareness. Women also reported greater
tween 40-49 years of age, 8.7% of the patients were 50-59 years use of catastrophizing, distraction, and praying & hoping, while
of age, 1.4% of the patients were between 60-69 years of age men reported higher scores on coping self-statements, and ignor-
[Figure 2]. 59.4% had Disc condylar disorder, 33.3% had MPDS, ing and reinterpreting pain sensations [2]. Another study done by
and 7.2% had degenerative disorder. 27.5% had caries, 14.5% had Ferreira CL et al stated that the number of women who presented

Sanjana Devi, Revathi Duraisamy. Prevalence of Temporomandibular Disorders and Assessment of Factors Associated with it - A Retrospective Study. Int J Dentistry Oral Sci. 2021;8(8):3871-
3876.
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a higher prevalence of painful symptoms was greater, followed by of age. There is no significant association between type of TMD
otologic symptoms and complaints of dysphonia [21]. However, with age, gender and dental status in the present study.
Hiltunen et al stated that no differences based on gender were
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