[Dissertations 25 years after date 45. Prevalence and etiology of craniomandibular dysfunction in the Netherlands]. / Proefschriften 25 jaar na dato 45. Prevalentie en etiologie van craniomandibulaire disfunctie in Nederland.

The disorders temporomandibular dysfunction and craniomandibular dysfunction are still being discussed intensely in the literature 25 year after the publication of the dissertation 'Prevalence and etiology of craniomandibular dysfunction. An epidemiological study of the Dutch adult population'. Attention is especially being devoted to occlusion and its relationship with this disorder; the conclusions reached are often contradictory. In addition to the definitions of temporomandibular and craniomandibular dysfunction and of occlusion, a possible explanation for this controversy can be found in the methodological shortcomings of the studies. On the basis of the most important results in the dissertation of 25 years ago and the scientific discussion since, 7 guidelines are formulated that are illustrated with clinical examples for an evidence-based treatment of patients with this disorder in a general dental practice.

Associations between craniomandibular disorders, sociodemographic factors and self-perceived general and oral health in an adult population.

OBJECTIVE: The aim of this study was to analyze the relationships between pain in the craniomandibular region and jaw dysfunction, respectively, to sociodemographic factors and self-perceived general and oral health in a middle-aged and elderly population in Västerbotten County, Sweden. MATERIALS AND METHODS: Six hundred individuals, 35-, 50-, 65- and 75 years old, from inland and 600 individuals from coastal areas were randomly selected in 2002. Of these, 987 individuals completed a questionnaire and 779 participated in a clinical examination. Thirty-five- and 50-year-olds together constituted a middle-aged group and the rest an elderly group. RESULTS: Among the middle-aged, craniomandibular pain was associated with impaired general health status, signs of temporomandibular disorder (TMD) pain were associated with female gender and living alone, jaw dysfunction symptoms were associated with university degree and chewing with caution; and signs of TMD dysfunction were associated with female gender and living in the more densely populated coastal region. Among the elderly, craniomandibular pain was more common among those living in the inland region, craniomandibular pain and signs of TMD pain were associated with impaired general health status, jaw dysfunction symptoms were associated with higher education level and self-perceived impaired general health and oral health; and signs of TMD dysfunction were associated with female gender and living in the coastal region. Dental status was not associated with craniomandibular pain. CONCLUSIONS: Socioeconomic factors and impaired general state of health were related to signs and symptoms indicative of CMD. These factors may influence demand for treatment among the affected.

Hábitos parafuncionais na dentição decídua: associação com disfunção dos movimentos mandibulares e desordem craniomandibular / Parafunctional habits in deciduos dentition: association with mandibular movements dysfunction and craniomandibular disorder

O propósito deste estudo foi avaliar a possível correlação entre a presença de hábitos parafuncionais e a amplitude bucal e movimentos mandibulares excursivos, bem como com a presença de desordem craniomandibular (DCM) em crianças com dentição decídua. A amostra foi constituída por 63 crianças na faixa etária de 4 e 5 anos, estudantes de escolas públicas da cidade de Juiz de Fora (MG), divididas em: Grupo A (n=30), caracterizado pela presença de hábitos parafuncionais após os 3 anos de idade; e Grupo B (n=33), considerado controle, em que as crianças não realizavam atividades parafuncionais e/ou pararam antes dos 3 anos de idade. A abertura bucal máxima voluntária e assistida e os movimentos mandibulares excursivos foram mensurados com o auxílio de um paquímetro digital e uma régua milimetrada, respectivamente. O índice anamnético de Fonseca et al. foi utilizado para a avaliação quanto à presença ou não de DCM; houve diferença estatisticamente significativa entre as médias mensuradas nos grupos (p&0,005), de acordo com o teste t de Student. Todos os movimentos mandibulares se mostraram diminuídos no grupo considerado de risco, quando comparado com o grupo controle. Os resultados mostraram uma nítida associação entre a presença de hábitos parafuncionais, movimentos mandibulares excursivos alterados e presença de DCM.

Factores de riesgo en pacientes con disfunción temporomandibular / Risk facts in patients with temporomandibular dysfunction

La controversia existente en cuanto al carácter multifactorial que rodea la disfunción temporomandibular dificulta el conocimiento pleno de esta entidad, por lo que se ha estudiado el comportamiento de diferentes factores de riesgo que pueden manifestarse de forma individual o no, pero que contribuyen en muchos casos al desencadenamiento de este problema clínico. El propósito de este trabajo fue realizar un estudio descriptivo y transversal sobre la identificación de algunos factores de riesgo presentes en pacientes con disfunción temporomandibular con edades comprendidas ente 7 y 44 años, pertenecientes a diferentes centros de enseñanza del municipio de Matanzas. La muestra se obtuvo mediante la aplicación de un esquema probabilístico y multietápico, en el que fueron seleccionados 1,866 sujetos agrupados por edades y sexo. El diagnóstico de disfunción fue realizado mediante la aplicación del Test de Krogh Paulsen. Fueron identificados los factores de riesgo Hábitos parafuncionales, Pérdida dentaria, Interferencias oclusales, Bruxismo y Estrés, determinándose que los Hábitos parafuncionales estuvieron presentes en un 47.5 por ciento, la Pérdida dentaria: 41.9 por ciento, las Interferencias Oclusales: 39.7 por ciento, el estrés: 33.4 por ciento y, por último, el bruxismo con 30.3 por ciento. Fue apreciado un incremento de estos factores conjuntamente con las edades, aunque no de manera uniforme. Se comprueba relación significativa entre estos factores y la disfunción temporomandibular. Una actuación preventiva e interceptiva mediante actividades de promoción, prevención e intervención clínicas oportunas sobre estos factores puede contribuir a disminuir las cifras de afectados(AU)

The existing controversy about the multifactorial character of the temporomandibular dysfunction makes it difficult the complete knowledge of this entity. Thus there has being studied the behavior of several risk facts that can show themselves in an individual way or not, but contributing in many cases to unleashing this clinical problem. The purpose of this work was carrying out a descriptive and transversal study identifying several risk facts in 7-to-44 years-old patients with temporomandibular dysfunction, who are studying in several schools of the province of Matanzas. The sample was selected applying a probabilistic and multistage scheme and 1 866 persons were selected, grouped by age and sex. The dysfunctional diagnostic was achieved applying the Krogh Paulsens Test. As risk facts were identified: Parafunctional Habits, Dental Loss, Occlusal Interferences, Bruxism and Stress, determining that Parafunctional Habits were present in 47. 5 percent, Dental Loss: 41.9 percent. Occlusal Interferences: 39.7 percent, Stress:33.4 percent, and Bruxism: 30.3 percent. It was appreciated an increase of these facts parallel to aging, though not evenly. There was stated a significant relationship between these facts and temporomandibular dysfunction. An interceptive, preventing action through opportune promotional, preventive and clinical interventional activities on these facts can contribute to diminishing the number of affected patients(AU)

Factores de riesgo en pacientes con disfunción temporomandibular / Risk facts in patients with temporomandibular dysfunction

La controversia existente en cuanto al carácter multifactorial que rodea la disfunción temporomandibular dificulta el conocimiento pleno de esta entidad, por lo que se ha estudiado el comportamiento de diferentes factores de riesgo que pueden manifestarse de forma individual o no, pero que contribuyen en muchos casos al desencadenamiento de este problema clínico. El propósito de este trabajo fue realizar un estudio descriptivo y transversal sobre la identificación de algunos factores de riesgo presentes en pacientes con disfunción temporomandibular con edades comprendidas ente 7 y 44 años, pertenecientes a diferentes centros de enseñanza del municipio de Matanzas. La muestra se obtuvo mediante la aplicación de un esquema probabilístico y multietápico, en el que fueron seleccionados 1,866 sujetos agrupados por edades y sexo. El diagnóstico de disfunción fue realizado mediante la aplicación del Test de Krogh Paulsen. Fueron identificados los factores de riesgo Hábitos parafuncionales, Pérdida dentaria, Interferencias oclusales, Bruxismo y Estrés, determinándose que los Hábitos parafuncionales estuvieron presentes en un 47.5 por ciento, la Pérdida dentaria: 41.9 por ciento, las Interferencias Oclusales: 39.7 por ciento, el estrés: 33.4 por ciento y, por último, el bruxismo con 30.3 por ciento. Fue apreciado un incremento de estos factores conjuntamente con las edades, aunque no de manera uniforme. Se comprueba relación significativa entre estos factores y la disfunción temporomandibular. Una actuación preventiva e interceptiva mediante actividades de promoción, prevención e intervención clínicas oportunas sobre estos factores puede contribuir a disminuir las cifras de afectados.

The existing controversy about the multifactorial character of the temporomandibular dysfunction makes it difficult the complete knowledge of this entity. Thus there has being studied the behavior of several risk facts that can show themselves in an individual way or not, but contributing in many cases to unleashing this clinical problem. The purpose of this work was carrying out a descriptive and transversal study identifying several risk facts in 7-to-44 years-old patients with temporomandibular dysfunction, who are studying in several schools of the province of Matanzas. The sample was selected applying a probabilistic and multistage scheme and 1 866 persons were selected, grouped by age and sex. The dysfunctional diagnostic was achieved applying the Krogh Paulsens Test. As risk facts were identified: Parafunctional Habits, Dental Loss, Occlusal Interferences, Bruxism and Stress, determining that Parafunctional Habits were present in 47. 5 percent, Dental Loss: 41.9 percent. Occlusal Interferences: 39.7 percent, Stress:33.4 percent, and Bruxism: 30.3 percent. It was appreciated an increase of these facts parallel to aging, though not evenly. There was stated a significant relationship between these facts and temporomandibular dysfunction. An interceptive, preventing action through opportune promotional, preventive and clinical interventional activities on these facts can contribute to diminishing the number of affected patients.

Factores asociados a disfunción craneomandibular en una población de un centro de salud / Factors associated with temporomandibular disorder in a health centre’s population

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[Association among postural and skull-cervico-mandibular disorders in childhood and adolescence. Analysis of 428 subjects]. / Associazione tra disordini posturali e cranio-cervico-mandibolari in età evolutiva. Analisi di un campione di 428 soggetti.

The aim of the study is to appraise the prevalence of the mild defects of the spine or paramorphysm in a normal paediatric population, without orthopaedic pathology, and to verify the possible association with the dysfunctions of the dental apparatus. The recovery of a real association among these pathologies could furnish a sprout for a correct therapeutic approach. In the study 428 subjects (211 females and 217 males), aged 9 to 14 years, have been analyzed. The data have been recorded on special schedules, orthopaedic and orthodontic, containing the number of progressive order and the initials of name and last name, in the respect of the privacy of the subjects. From the study a 2.8% scoliosis incidence has emerged, an incidence of scoliotic attitudes 9.5% and an incidence of 83% normality deviations. As deviations by the normality have been classified the isolated skeletal asymmetries, agreements as varying functional not yet pathological, for instance scapular or flank asymmetry, mild genu varum or valgum, femoral anteversion. A statistically significant relationship among that disorders of posture and malocclusion (P < 0.005) and ogival palate (P < 0.002) has been found. Despite these correlations, it is very difficult to explain this association from the point of view of etiopathogenesis. For this we hold to have to continue the study, to give a meaning to such correlations and to find an appropriate therapy.

Disfunción craneomandibular: frecuencia y formas de presentación en una población de trescientos adultos jóvenes y su demanda de atención / Carniomandibular dysfunction: frequency and forms of presentation in a three-hundred adult population and its care demand

Objetivo: el objetivo de este estudio fue determinar la frecuencia de signos y síntomas de disfunción craneomandibular (DCM) y la demanda y necesidad de tratamiento en una muestra de 300 estudiantes adultos jóvenes con una edad promedio de 26.9, con una distribución por sexo del 68.5 por ciento de hombres y 79,7 por ciento de mujeres. Se utilizó el protocolo de Fricton para organizar la data, generándose 4 índices según áreas observadas: dolor a la palpación muscular articular, limitación y dolor en los movimientos mandibulares y ruidos articulares. Se observaron además algunas características oclusales y otros síntomas que comúnmente acompañan a la DCM, para establecer su posible asociación. Resultados: se observó una alta frecuencia de signos y síntomas que alcanzó el 75.7 por ciento de la muestra, pero en sólo el 3,3 por ciento presentó DCM severa. El dolor a la palpación muscular alcanzó el 41,3 por ciento de la muestra, en la ATM al 24.7 por ciento, el chasquido al 27 por ciento y la limitación en la movilidad mandibular el 24,3 por ciento. La necesidad y demanda de tratamiento fueron escasas, alcanzando el 7 y 6.7 por ciento, respectivamente. Los factores oclusales comparados no fueron estadísticamente significativos asociados a la DCM. Por el contrario, el bruxismo, las cefaleas, el tinnitus, el vértigo, la fatiga mandibular y la hipermovilidad articular sistémica (HAS) estuvieron asociados a la DCM significativamente (P=0,001 a 0,047), no así la hipoacusia. Conclusión: la frecuencia de signos y síntomas de DCM fue muy alta. Sin embargo, sólo el 3,3 por ciento de la muestra presentó sintomatología severa y por lo tanto, la necesidad y demanda de atención alcanzaron un bajo porcentaje de los encuestados. De los resultados obtenidos en este estudio se observa un alto factor de riesgo para el sexo femenino y la DCM. Como en la mayor parte de los trabajos publicados últimamente, la asociación de factores oclusales y la DC no es significativa.

Signos y síntomas de la disfunción temporomandibular en población de 7–25 y más años de edad. Municipio Matanzas / Temporomandibular dysfunction symptoms and signs in a 7-25 and more years-old population. Matanzas municipality

Fue realizado un estudio descriptivo, transversal, de los signos y síntomas que predominan en población con Disfunción temporomandibular. La muestra se obtuvo mediante la aplicación de un esquema probabilístico y multietápico, donde resultaron seleccionados 1,860 sujetos de 7 a 25 años y más que se agruparon por grupos de edades y sexo, pertenecientes a centros de diferentes niveles de enseñanza del municipio Matanzas. A todos les fue aplicado el Test de análisis de la función temporomandibular de K. Paulsen. Los signos y síntomas fueron estudiados en los diagnosticados con Disfunción, destacándose que más del 50 por ciento de éstos la presentaron con mayor frecuencia: Posición de primer contacto distinta de Posición de Máxima intercuspal (60.00 por ciento), irregularidad en los movimientos de apertura y cierre (53.05 por ciento), así como Ruidos (50.27 por ciento). Los signos y síntomas incrementaron sus valores conjuntamente con las edades, sobre todo en las pruebas de la Articulación Tempomandibular y las Pruebas dentarias. No se comprobaron diferencias significativas entre géneros. Se enfatiza en la necesidad de una adecuada preparación de los profesionales en el diagnóstico temprano de los trastornos craneomandibulares...(AU)

Disfunción temporomandibular en población de 7-25 y más años de edad. Municipio Matanzas / Temporomandibular dysfunction in a 7-25 and more years-old population. Matanzas municipality

Los trastornos de la Articulación Temporomandibular pueden aparecer independientes de la edad y el sexo, afectando considerablemente su funcionamiento. El propósito de este trabajo fue realizar un estudio descriptivo, transversal, de prevalencia de la disfunción temporomandibular en población de 7–25 años y más, pertenecientes a diferentes centros de enseñanza del municipio de Matanzas. La muestra se obtuvo mediante la aplicación de un esquema probabilístico y multietápico, en el que fueron seleccionados 1,860 sujetos agrupados por edades y sexo. El diagnóstico de disfunción, el riesgo de padecerla o la presencia de un signo de perturbación fue efectuado mediante la aplicación del Test de Krogh Paulsen. Se determinó que la prevalencia de disfunción fue de 38.71 por ciento, notándose su incremento conjuntamente con los años, siendo el grupo de 25 y más años el mayor afectado con 75.61 por ciento. Los que presentaron dos o más signos positivos (Riesgo) constituyeron el 25.65 por ciento, mientras que con un solo signo positivo (Perturbación) registraron un 19.30 por ciento. En ambas categorías los valores disminuyeron según avanzaron los años, lógicamente en situación inversa a la presentada en disfunción. No hubo diferencias de comportamiento en cuanto al género. El estudio y la preparación adecuada en un método de examen de las funciones temporomandibulares constituirá una valiosa ayuda diagnóstica en cualquier especialidad estomatológica...(AU)

Disfunción craneomandibular: frecuencia y formas de presentación en una población de trescientos adultos jóvenes y su demanda de atención / Carniomandibular dysfunction: frequency and forms of presentation in a three-hundred adult population and its care demand

Objetivo: el objetivo de este estudio fue determinar la frecuencia de signos y síntomas de disfunción craneomandibular (DCM) y la demanda y necesidad de tratamiento en una muestra de 300 estudiantes adultos jóvenes con una edad promedio de 26.9, con una distribución por sexo del 68.5 por ciento de hombres y 79,7 por ciento de mujeres. Se utilizó el protocolo de Fricton para organizar la data, generándose 4 índices según áreas observadas: dolor a la palpación muscular articular, limitación y dolor en los movimientos mandibulares y ruidos articulares. Se observaron además algunas características oclusales y otros síntomas que comúnmente acompañan a la DCM, para establecer su posible asociación. Resultados: se observó una alta frecuencia de signos y síntomas que alcanzó el 75.7 por ciento de la muestra, pero en sólo el 3,3 por ciento presentó DCM severa. El dolor a la palpación muscular alcanzó el 41,3 por ciento de la muestra, en la ATM al 24.7 por ciento, el chasquido al 27 por ciento y la limitación en la movilidad mandibular el 24,3 por ciento. La necesidad y demanda de tratamiento fueron escasas, alcanzando el 7 y 6.7 por ciento, respectivamente. Los factores oclusales comparados no fueron estadísticamente significativos asociados a la DCM. Por el contrario, el bruxismo, las cefaleas, el tinnitus, el vértigo, la fatiga mandibular y la hipermovilidad articular sistémica (HAS) estuvieron asociados a la DCM significativamente (P=0,001 a 0,047), no así la hipoacusia. Conclusión: la frecuencia de signos y síntomas de DCM fue muy alta. Sin embargo, sólo el 3,3 por ciento de la muestra presentó sintomatología severa y por lo tanto, la necesidad y demanda de atención alcanzaron un bajo porcentaje de los encuestados. De los resultados obtenidos en este estudio se observa un alto factor de riesgo para el sexo femenino y la DCM. Como en la mayor parte de los trabajos publicados últimamente, la asociación de factores oclusales y la DC no es significativa.(AU)

[The prevalence of craniomandibular disorders in the military population of the Republic of Serbia].

INTRODUCTION: The aim of this study was to determine the prevalence of craniomandibular dysfunction (CMD) in the military personnel of the Republic of Serbia, as well as the distribution of sings and symptoms of CMD in this population group. MATERIAL AND METHODS: The epidemiological investigation included 284 male persons between 18 - 25 years of age. The sample consisted of Military Academy students, and soldiers from different regions of the Republic of Serbia. A questionnaire was designed using Helkimo's clinical dysfunction index and sings and symptoms of CMD were evaluated, namely the anamnestic index (Ai) and the dysfunction index (Di). RESULTS: According to the anamnestic dysfunction index (Ai), 85% of persons among the examined group presented without any symptoms of CMD (Ai = 0), 14% had mild symptoms (Ai =1) and 1% had severe symptoms of CMD (Ai = 5). Functional analysis of the orofacial system in the examined group (evaluation of dysfunction index - Di) revealed, however, that 70% of solders had at least one sign of CMD, precisely a dysfunction index Di > 0. The analysis of signs and symptoms of CMD revealed that disturbances in mandibular kinematics were the most prevalent sign of CMD in this population group, which was confirmed in 56% of examined persons. Disturbed functions of temporomandibular (TM) joints (click, and reciprocal click, deviation and deflection during mandibular opening) were established in 31% of examined persons, and sensitivity of TM joints and masticatory muscles during palpation in 4% of examined persons. Pain during mandibular movements was established only in 1% of examined persons. CONCLUSION: The results of this investigation point to significant prevalence of craniomandibular disorders in the examined population group. The incidence of TMJ and masticatory muscle pain in 4% of examined persons and of pain during mandibular movements only in 1% of examined persons, points to presence of mild or initial types of CMD in this population group.

Orthodontic treatment in children to prevent sleep-disordered breathing in adulthood.

The purpose of this article is to review human craniofacial growth and development, especially the growth of the mandible, to clarify the relationship between obstructive sleep apnea (OSA) syndrome and craniofacial abnormality, and finally, to propose the hypothesis that negative pressure produced in the chest of the OSA child inhibits the growth of the mandible. Recently, the development of diagnosis and treatment of OSA syndrome has progressed rapidly; however, the prevention of OSA syndrome was merely seen. Craniofacial abnormality is reported as one of the causes of OSA syndrome. If craniofacial abnormality is determined only by genetics, it is difficult to manage the craniofacial skeleton to prevent OSA syndrome. The role of epigenetic factors on craniofacial growth and development is still controversial. However, if we stand on the functional matrix hypothesis, we can manage not only growth of the mandible but also the craniofacial skeleton as a whole. The author proposes the hypothesis that the negative pressure produced in the chest prohibits the growth of the mandible even if the patients have a capacity for growth and development; therefore, if this negative pressure disappears because of the removal of the tonsil and/or adenoids or by an orthodontic treatment to make a patency of the airway, the mandible may grow normally, and we can prevent or reduce a number of OSA syndromes in the future.

Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section.

The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4,310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.

[Epidemiologic study of patients with craniomandibular disorders. Report of data and clinical findings]. / Studio epidemiologico su un gruppo di pazienti con disordini craniomandibolari. Analisi dei dati e delle caratteristiche cliniche.

BACKGROUND: The purpose of this retrospective study was to identify the subjective and objective characteristics of a population referred to a clinic for diagnosis and treatment of orofacial pain and/or temporomandibular disorders. METHODS: Beginning in 1993, 825 patients, consecutively referred to the University of Naples Federico II , were examined and their records entered into a database. These data were collected by trained clinicians. Diagnostic subgroups were identified following the Research Diagnostic Criteria for temporomandibular disorders (RDC). RESULTS: Seventy-nine percent of patients were female, the mean age of the sample was 31.3+/-13 years (range: 5 to 74 years), most of patients were between 15 and 39 years of age. Based on diagnostic subgroups, patients were divided into: patients affected with myogenous pain (59%), arthrogenous pain (13%), arthrogenous and myogenous pain (16%) and fibromyalgia (4%). Sixty-three percent of the sample reported recent headaches, 53% reported parafunction, and 28% reported a previous trauma. Eighty-one percent reported spontaneous pain, which was chronic in 83% of them. The majority of patients (78%) presented a relatively high cultural BACKGROUND. CONCLUSIONS: These data appear to agree with other epidemiologic studies and depict the TMD treatment-seeking population as a predominantly female population during child-bearing years with multiple chronic pain complaints.

Is use of exogenous estrogen associated with temporomandibular signs and symptoms?

BACKGROUND: Studies of historical data suggest a link between exogenous estrogen use and referral for treatment for temporomandibular disorders, or TMDs. The purpose of the authors' study was to determine the association between exogenous estrogen use and signs and symptoms of TMD assessed by direct physical examination in a randomly selected community sample of primarily postmenopausal women. METHODS: A calibrated clinical examiner examined a stratified random sample of 510 women aged 37 to 82 years using the Craniomandibular Index, or CMI. All medications that subjects were taking at the time of the examination were identified by interview and examination of subjects' medication containers on two occasions. One hundred seventy-four subjects were taking medications containing estrogen, and 336 were taking no such medications. RESULTS: The muscle and joint signs and symptoms of women taking and not taking estrogen were not significantly different after the authors controlled for sociocultural, demographic and health care utilization variables. Estrogen use also failed to distinguish women receiving relatively high and low scores on the CMI. CONCLUSION: Estrogen replacement therapy does not place women at increased risk of developing TMDs. CLINICAL IMPLICATIONS: Clinicians need not be concerned that patients taking oral contraceptives or replacement estrogens are at increased risk of developing TMDs.

Prevalência de disfunção craniomandibular entre os pacientes portadores de prótese total / Craniomandibular disorder among patients wearing complete dentures

Foi investigada a prevalência de disfunção craniomandibular (DCM) apenas entre os pacientes desdentados totais que procuram a Clínica de Prótese Total da Faculdade de Odontologia de Araras, para realização de uma nova prótese. A partir de então foram entrevistados e os dados coletados foram analisados. Os resultados mostraram que 38.89% não apresentaram sintomas de CDM; 44.44% apresentaram sintomas leves; 9.72% apresentaram DCM moderada e 6.94% apresentaram sintomas severos. Conclui-se que os profissionais deveriam estar mais atentos à presença de sinais e sintomas de DCM nos pacientes desdentados totais, para que possam estabelecer um plano de tratamento correto para uma prótese total confortável

Prevalencia de signos y síntomas en pacientes que consultan al odontólogo en los consultorios de Talca / Sign and symptom prevalence in patients of the public dental care centers from Talca

Determinar la prevalencia de signos y síntomas de desórdenes craneomandibulares (DCM), y las diferencias existentes entre sexos y edades. Método: Se realizó un estudio no experimental descriptivo. Se evaluaron 414 pacientes, entre 5 y 73 años, que consultaron al odontólogo del servicio público. Para evaluar signos y síntomas del DCM se realizó una evaluación clínica a cada paciente. Los datos descriptivos fueron analizados con el sofware Stata. Resultados: 87 por ciento del grupo estudiado presentó al menos un signo o síntoma del Dcm. Para ambos sexos, el porcentaje aumentó con la edad. Las mujeres presentaron una mayor prevalencia de la sintomatología. 50 por ciento de los paciente mostró desviación mandibular. 57 por ciento presentó dolor en la musculatura masticatoria. Conclusiones: Se encontró una prevalencia de 87 por ciento de signos y síntomas en el grupo estudiado, siendo la desviación mandibular y el dolor de la musculatura masticatoria el signo y el síntoma con mayor prevalencia respectivamente

[Influence of body posture in the prevalence of craniomandibular dysfunction]. / Influencia de la postura corporal en la prevalencia de las disfunciones craneomandibulares.

BACKGROUND: Postural alterations of the shoulders, dorsal spine and hips could have an influence on the development of craniomandibular dysfunctions. AIM: To study the influence of body posture on the prevalence of craniomandibular dysfunction. SUBJECTS AND METHODS: One hundred thirty six dental students and 41 patients assisting to the temporomandibular joints (TMJ) clinic at the Freie Universität at Berlin, were studied. Masticator, cervical muscles, temporomandibular joints and occlusions were clinically examined. The position of shoulders and hips was measured with the use of an acromiopelvimeter. RESULTS: No relationship was found between postural alterations of the hips and shoulders, articular noises and sensibility or pain while palpating the temporomandibular joints. Among students, a relationship between postural alterations of the shoulders and the sensibility or pain while palpating the TMJ, was observed. When all muscles were considered, a significant relationship between asymmetric shoulders or hips and muscular pain while palpating was observed among students. CONCLUSIONS: Some symptoms, especially muscular sensibility is more pronounced in people with hip and shoulder asymmetries. This relation is more pronounced in dental students than in patients.