Generalized joint hypermobility and temporomandibular disorders: inherited connective tissue disease as a model with maximum expression

J Orofac Pain. 2005 Winter;19(1):47-57.

Abstract

Aims: 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.

Conclusion: This study indicates a positive relationship between GJH and TMD.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Arthralgia
  • Case-Control Studies
  • Child
  • Connective Tissue Diseases / genetics*
  • Connective Tissue Diseases / physiopathology*
  • Ehlers-Danlos Syndrome / physiopathology*
  • Female
  • Humans
  • Joint Dislocations
  • Joint Instability*
  • Likelihood Functions
  • Male
  • Marfan Syndrome / physiopathology*
  • Middle Aged
  • Range of Motion, Articular
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Temporomandibular Joint Disorders / physiopathology*