title: Signs and symptoms of temporomandibular joint disorders related to the degree of mouth opening and hearing loss.
abstract: BACKGROUND
  The temporomandibular joint is a unique bi-condylar joint involved in mastication and speech. Temporomandibular joint disorders (TMD) have a range of symptoms, including aural symptoms, and are present in approximately 75% of normal populations. The present study examined the relationship between signs and symptoms of TMD and mouth opening, gender, joint and aural symptoms, and hearing loss.
  
  
  METHODS
  The study involved 464 healthy Greek university students (156 men and 308 women) with a mean age of 19.6 years. Age, gender and maximum mouth opening was recorded. Mouth opening was measured using Vernier calipers. An anamnestic questionnaire was used to stratify the subjects into four groups based on TMD severity. Aural symptoms and an audiogram were recorded for each subject too. Data were analyzed using multifactor ANOVA, chi-square, t-test, Mann-Whitney and Kruskal-Wallis tests.
  
  
  RESULTS
  The overall incidence of TMD signs and symptoms was 73.3%. The incidence and severity was greater in females than males (p-value 0.0001 < 0.05). The number of aural symptoms was associated to the TMD severity (p-value 0.0001 < 0.05) as well as maximum mouth opening (p-value 0.004 < 0.05). Audiometry showed that moderate and severe TMD was associated with hearing loss of median and low tones respectively (p-value 0.0001 < 0.05). TMJ pain (p-value 0.0001 < 0.05), TMJ ankylosis (p-value 0.0001 < 0.05), bruxism (p-value 0.0001 < 0.05) and ear itching (p-value 0.0001 < 0.05) were also found to be statistically different between TMD and non-TMD subjects.
  
  
  CONCLUSIONS
  TMD signs and symptoms were more common and severe in females than males. TMD severity is correlated with the degree of mouth opening and the number of aural symptoms. The absence or presence of mild TMD are associated with normal audiograms while moderate and severe TMD are related to hearing loss in median and low tones respectively. Bruxism, joint ankylosis, joint pain and ear itching were more common in TMD than non-TMD patients.
authors: Orthopaedic Surgeon, Professor of Anatomy-Histology-Embryology, Medical School, University of Ioannina, Greece. pkitsoulis@hotmail.com.
authors: Panagiotis
authors: P
authors: Kitsoulis
authors: Aikaterini
authors: A
authors: Marini
authors: Kalliopi
authors: K
authors: Iliou
authors: Vasiliki
authors: V
authors: Galani
authors: Aristides
authors: A
authors: Zimpis
authors: Panagiotis
authors: P
authors: Kanavaros
authors: Georgios
authors: G
authors: Paraskevas
references: J Laryngol Otol. 1983 Dec;97(12):1121-8
references: 6644170
references: Laryngoscope. 1999 Oct;109(10):1669-73
references: 10522940
references: Agri. 2009 Jul;21(3):89-94
references: 19779999
references: J Mich Dent Assoc. 1990 Nov-Dec;72(11-12):550-5
references: 2280405
references: Head Face Med. 2006 Aug 16;2:25
references: 16914032
references: J Oral Rehabil. 2002 Jun;29(6):534-9
references: 12071921
references: J Dent Res. 1993 May;72(5):871-5
references: 8501284
references: Kulak Burun Bogaz Ihtis Derg. 2006;16(5):205-8
references: 17124439
references: Int J Orthod. 1987 Spring;25(1-2):20-1
references: 3473051
references: Quintessence Int. 2007 Oct;38(9):e564-71
references: 17873977
references: Med Oral Patol Oral Cir Bucal. 2007 Mar 01;12(2):E96-100
references: 17322813
references: Am Fam Physician. 2007 Nov 15;76(10):1477-82
references: 18052012
references: Med Oral Patol Oral Cir Bucal. 2010 Jan 01;15(1):e14-9
references: 19767710
references: J Prosthet Dent. 2002 Feb;87(2):197-203
references: 11854677
references: J Dent Med. 1965 Jan;20:13-5
references: 14232340
references: Arch Otolaryngol Head Neck Surg. 2008 Apr;134(4):389-93
references: 18427004
references: Rev Stomatol Chir Maxillofac. 2005 Nov;106(5):267-71
references: 16292219
references: J Orofac Pain. 1994 Summer;8(3):293-7
references: 7812227
references: J Oral Rehabil. 2004 Feb;31(2):110-6
references: 15009593
references: Braz Oral Res. 2006 Jan-Mar;20(1):3-7
references: 16729167
references: Br J Oral Maxillofac Surg. 1997 Feb;35(1):40-2
references: 9043002
references: J Oral Rehabil. 1995 Apr;22(4):263-8
references: 7769524
references: Br J Oral Surg. 1964 Jul;2(1):28-32
references: 5212877
references: Minerva Stomatol. 2006 Nov-Dec;55(11-12):627-37
references: 17211368
references: Swed Dent J. 2009;33(3):115-23
references: 19994561
references: Acta Otolaryngol. 1960 Jan-Feb;51:184-8
references: 14409936
references: Arch Ohren Nasen Kehlkopfheilkd. 1959;175:396-401
references: 13802028
references: Braz Dent J. 2004;15(2):151-4
references: 15776199
references: Hear Res. 2002 Mar;165(1-2):48-52
references: 12031514
references: J Craniomandib Disord. 1990 Summer;4(3):186-92
references: 2098394
references: J Craniomaxillofac Surg. 1993 Jan;21(1):2-8
references: 8445049
references: Eur J Orthod. 2008 Dec;30(6):592-7
references: 18990679
references: Cranio. 1988 Jan;6(1):64-70
references: 3162840
references: J Craniomandib Disord. 1992 Fall;6(4):301-55
references: 1298767
references: J Oral Maxillofac Surg. 1989 Oct;47(10):1028-9
references: 2795295
references: Cranio. 1988 Jul;6(3):256-70
references: 3251659
references: Cranio. 1995 Apr;13(2):75-80
references: 8697503
references: Oral Oncol. 2008 May;44(5):430-8
references: 17826305
references: J Orthop Sports Phys Ther. 2000 Aug;30(8):484-92
references: 10949505
references: Cranio. 2006 Apr;24(2):104-11
references: 16711272
references: J Am Dent Assoc. 1990 Mar;120(3):273-81
references: 2312947
references: Sven Tandlak Tidskr. 1974 Mar;67(2):81-100
references: 4524736
references: Br J Oral Maxillofac Surg. 2002 Oct;40(5):418-23
references: 12379189