title: Temporomandibular Joint Disorders in Patients With Different Facial Morphology. A Systematic Review of the Literature.
abstract: OBJECTIVE
  The present article aimed to review systematically the literature on the relation between facial skeletal structures and temporomandibular joint (TMJ) disorders.
  
  
  METHODS
  A systematic search in the dental and medical literature was performed to identify all studies of humans assessing the relation between TMJ disorders and facial morphology. Articles were included based on study design, irrespective of TMJ disorder (eg, disc displacement, osteoarthrosis, or unspecified), skeletal features, diagnostic strategies (e.g., imaging techniques or clinical assessment), and population (eg, demographic features of participants) under investigation. The selected articles were assessed according to a format based on patients, problem, and population, intervention, comparison, and outcome and quality was evaluated based on the Newcastle-Ottawa Scale.
  
  
  RESULTS
  Thirty-four articles were included in the review, 27 of which concerned adult samples and 7 concerned adolescent samples. Quality was generally moderate. The articles dealt with the relation between facial morphology and the following TMJ disorders, assessed clinically or by magnetic resonance (MR): disc displacement (n = 20), osteoarthritis or osteoarthrosis (n = 8), and temporomandibular disorder signs and symptoms (n = 6). The different approaches featuring the various investigations and the presence of some potential methodologic biases complicated a summary of the findings. Most studies reported that some features related to the vertical dimension of the face might help distinguish patients with potential TMJ disc displacement or MR-detected signs of osteoarthrosis from those without TMJ disorders.
  
  
  CONCLUSIONS
  The quality of the available literature is not adequate to provide an evidence base on the topic. Despite the heterogeneity of design and findings of the reviewed articles, it seems reasonable to suggest that skeletal Class II profiles and hyperdivergent growth patterns are likely associated with an increased frequency of TMJ disc displacement and degenerative disorders.
authors.affiliation: Assistant Professor, Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
authors.affiliation: Assistant Professor, Orofacial Pain Unit, Department of Clinical-surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Segù
authors.affiliation: Postgraduate Student, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
authors.forename: Niki
authors.initials: N
authors.lastname: Arveda
authors.affiliation: Assistant Professor, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Lombardo
authors.affiliation: Head, Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Siciliani
authors.affiliation: Research Fellow, Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy. Electronic address: alessandro.rossi@unipd.it.
authors.lastname: Alessandro Rossi
authors.affiliation: Head, Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guarda-Nardini
mesh_terms: D005146:Facial Asymmetry / Q000150:complications; D006801:Humans; D004204:Joint Dislocations / Q000150:complications; D019767:Maxillofacial Abnormalities / Q000150:complications*; D010003:Osteoarthritis / Q000150:complications; D019224:Temporomandibular Joint Disc / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000150:complications*