Generalized joint hypermobility and temporomandibular disorders: inherited connective tissue disease as a model with maximum expression.
OBJECTIVE
To study the relationship between generalized joint hypermobility (GJH) and temporomandibular disorders (TMD) by assessing prevalence and patient characteristics of TMD in a population of patients with maximum expression of GJH as a symptom of inherited connective tissue disease. In addition, diagnostic reliability of a series of clinical signs indicative of temporomandibular joint (TMJ) hypermobility was tested.


METHODS
The study sample consisted of 42 subjects with GJH, 24 with Marfan syndrome and 18 with Ehlers-Danlos syndrome. A subgroup of 27 individuals was selected by age (> or = 18 yrs) and was compared to 40 controls with TMD and normal peripheral joint mobility. TMD diagnoses were assigned to each subject according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).


RESULTS
In the GJH sample (n = 42), 71.4% of the subjects were symptomatic for TMD. Of those, 13.3% had sought treatment. A myofascial pain diagnosis was made in 69%, disc dislocation with reduction was diagnosed in 85.7%, and TMJ arthralgia in 61.9%. Multiple TMD diagnoses were assigned in 69% of the subjects; of these, 57% had 3 or more subgroup diagnoses. Joint noises (P < .01) and recurrent TMJ dislocations (P < .01) were a frequent finding in adult GJH subjects (n = 27) compared to controls, with symptomatic GJH subjects presenting more and more prolonged dislocation events than asymptomatic subjects (P < .001). TMJ hypermobility signs were expressed significantly more often in GJH compared to controls with TMD and normal joint mobility.


CONCLUSIONS
This study indicates a positive relationship between GJH and TMD.
De Coster
Peter J
PJ
Department of Paediatric Dentistry and Special Care, PaeCaMed Research, Ghent University, Ghent, Belgium. peter.de.coster1@pandora.be
Van den Berghe
Linda I
LI
Martens
Luc C
LC
D000293:Adolescent; D000328:Adult; D018771:Arthralgia; D016022:Case-Control Studies; D002648:Child; D003240:Connective Tissue Diseases / Q000235:genetics* / Q000503:physiopathology*; D004535:Ehlers-Danlos Syndrome / Q000503:physiopathology*; D005260:Female; D006801:Humans; D004204:Joint Dislocations; D007593:Joint Instability; D016013:Likelihood Functions; D008297:Male; D008382:Marfan Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology*