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Are temporomandibular disorder symptoms and diagnoses associated with pubertal development in adolescents? An epidemiological study

Stehen CMD-Symptome und -Diagnosen in Zusammenhang mit der pubertären Entwicklung bei Jugendlichen? Eine epidemiologische Studie

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Abstract

Background

In addition to low back pain, temporomandibular disorders (TMDs) are the most prevalent pain- and disability-related musculoskeletal conditions. However, the influence of pubertal development on TMD diagnoses remains unknown.

Objective

To assess whether the prevalence of TMD diagnoses, in addition to self-reported symptoms (pain, restricted mandibular mobility, clicking), change according to pubertal stage.

Methods

A random sample of 1,011 children and adolescents was chosen from the general population of 24,129 children and adolescents aged 10–17 years living in the urban area of Halle, Germany. Study participants were examined for TMD symptoms and diagnoses according to the Research Diagnostic Criteria for TMDs (RDC/TMD). Status of pubertal development was assessed using the Pubertal Development Scale (PDS). The χ2 tests and multivariate logistic regression models were used, and odds ratios (ORs) and 95% confidence intervals calculated.

Results

The observed increase in TMD symptoms during adolescence was mainly due to the higher frequency of self-reports of these symptoms by girls than boys (ORs for girls vs. boys: 1.42–1.53; p ≤ 0.05), whereas clinical TMD diagnoses (any RDC/TMD diagnosis, or RDC/TMD group IIa diagnosis) in adolescence increased mainly due to pubertal development itself (ORs for subjects beyond vs. before puberty: 1.58–2.00; p < 0.05; no significant sex-related effect was found).

Conclusion

Pubertal development increases the probability of self-reported TMD symptoms among girls, while the probability thereof decreases among boys. Independent of sex, pubertal growth increases the prevalence of RDC/TMD-related diagnoses—mainly disk displacement—in both sexes.

Zusammenfassung

Hintergrund

Neben Schmerzen im unteren Rückenbereich sind kraniomandibuläre Dysfunktionen (CMD) die am häufigsten vorkommenden, mit Schmerzen und funktionellen Einschränkungen verbundenen Erkrankungen des Bewegungsapparats. Es ist jedoch immer noch nicht bekannt, welchen Einfluss die pubertäre Entwicklung auf CMD-Diagnosen hat.

Zielsetzung

Das Ziel der Studie war feststellen, ob sich die Prävalenz von CDM-Diagnosen, zusätzlich zu den selbst angegebenen Symptomen (Schmerzen, Einschränkungen der Unterkiefermobilität, Kiefergelenkknacken), während der Pubertät ändert.

Methoden

Eine Zufallsstichprobe von 1011 Kindern und Jugendlichen im Alter von 10 bis 17 Jahren wurde aus einer Gesamtheit von 24.129 Kindern und Jugendlichen der in Halle (Deutschland) lebenden Allgemeinbevölkerung ausgewählt. Die Studienteilnehmer wurden entsprechend den Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) auf CMD-Symptome und -Diagnosen untersucht. Der Stand der pubertären Entwicklung wurde mittels der pubertären Entwicklungsskala (Pubertal Development Scale, PDS) festgestellt. χ-Quadrat-Tests und multivariate logistische Regressionsmodelle wurden verwendet, Odds Ratios (ORs) und 95%-Konfidenzintervalle wurden berechnet.

Ergebnisse

Der beobachtete Anstieg von CMD-Symptomen während der Adoleszenz war hauptsächlich auf häufigere eigene Angaben dieser Symptome bei Mädchen im Vergleich zu Jungen zurückzuführen (ORs für Mädchen im Vergleich zu Jungen: 1,42–1,53; p ≤ 0,05), während sich die klinischen CMD-Diagnosen (alle RDC/TMD-Diagnosen; oder RDC/TMD-Gruppe-IIa-Diagnose) in der Adoleszenz hauptsächlich aufgrund der pubertären Entwicklung selbst erhöhten (ORs für Probanden nach im Vergleich zu vor der Pubertät: 1,58–2,00; p < 0,05; keine signifikanten geschlechtsbezogenen Auswirkungen).

Schlussfolgerungen

Die pubertäre Entwicklung erhöht die Wahrscheinlichkeit selbst angegebener CMD-Symptome bei Mädchen, während diese bei Jungen abnehmen. Unabhängig vom Geschlecht erhöht das pubertäre Wachstum die Prävalenz von RDC/TMD-Diagnosen, hauptsächlich von Diskusverlagerungen.

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Hirsch, C., Hoffmann, J. & Türp, J. Are temporomandibular disorder symptoms and diagnoses associated with pubertal development in adolescents? An epidemiological study. J Orofac Orthop 73, 6–18 (2012). https://doi.org/10.1007/s00056-011-0056-x

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  • DOI: https://doi.org/10.1007/s00056-011-0056-x

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