Assessment of Etiological Factors Reported in the Literature and Their Impact on TMD Incidence in Young Adults
DOI:
https://doi.org/10.12775/QS.2025.43.61496Keywords
temporomandibular disorder, young adults, temporomandibular joint, etiologyAbstract
Introduction:
Chronic temporomandibular disorders (TMDs) typically result from long-term exposure to factors such as occlusal dysfunction, stress, and parafunctions, and are often associated with older patients. In contrast, young adults, exposed for a shorter time, may recover fully if diagnosed early. However, there is limited data comparing TMD treatment in young adults versus older individuals.
Aim:
To assess whether the development of TMD in young adults differs from that in the general population and whether a different treatment approach may be needed.
Materials and Methods:
Eighty-nine students aged 18–26 from various universities in Poznań completed a questionnaire and underwent clinical examination.
Results:
Muscular TMD diagnoses correlated with depression, stress, and surgical extraction of wisdom teeth. TMD presence was associated with anxiety, insomnia (AIS), pain (PS), and overbite. Parafunctional behaviors (OBC scale) correlated with anxiety, depression, stress, insomnia, and pain. Latent trigger points (TrPs) were significantly more frequent in TMD patients.
Conclusions:
Psychological factors significantly contribute to TMD in young adults, despite lower pain intensity compared to older patients. Occlusal factors and orthodontic treatment showed no correlation, while a link between wisdom tooth extraction and TMD was confirmed.
References
Panek H., Spikowska-Szostak J.: The influence of stress and personality traits to dysfunction of temporomandibular dysfunction and bruxism based on the literature and own studies. Dental Medical Problems. 2009; 46 (1): 11–16.
Okeson, Jeffrey P. Management of Temporomandibular Disorders and Occlusion. Elsevier - Health Sciences Division, 2019. Chapter 2, p. 123
Guarda-Nardini, Luca et al. “Age-related differences in temporomandibular disorder diagnoses.” Cranio : the journal of craniomandibular practice vol. 30,2 (2012): 103-9. doi:10.1179/crn.2012.015
Yap, Adrian Ujin, and Carolina Marpaung. “Correlates between temporomandibular disorder severity, emotional distress, and eudaimonic well-being among young adults.” Oral diseases vol. 29,7 (2023): 2780-2788. doi:10.1111/odi.14343
Daley, S E et al. “Depression and Axis II symptomatology in an adolescent community sample: concurrent and longitudinal associations.” Journal of personality disorders vol. 13,1 (1999): 47-59. doi:10.1521/pedi.1999.13.1.47
Yap, Adrian U J et al. “Depression and somatization in patients with temporomandibular disorders.” The Journal of prosthetic dentistry vol. 88,5 (2002): 479-84. doi:10.1067/mpr.2002.129375
Hammen, Constance. “Stress sensitivity in psychopathology: mechanisms and consequences.” Journal of abnormal psychology vol. 124,1 (2015): 152-4. doi:10.1037/abn0000040
Auerbach, S M et al. “Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients.” Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons vol. 59,6 (2001): 628-33; discussion 634. doi:10.1053/joms.2001.23371
Rudy, Thomas E et al. “Differential treatment responses of TMD patients as a function of psychological characteristics.” Pain vol. 61,1 (1995): 103-112. doi:10.1016/0304-3959(94)00151-4
Minghelli, Beatriz et al. “Prevalence of temporomandibular disorder in children and adolescents from public schools in southern portugal.” North American journal of medical sciences vol. 6,3 (2014): 126-32. doi:10.4103/1947-2714.128474
Velly, Ana Miriam et al. “The effect of catastrophizing and depression on chronic pain--a prospective cohort study of temporomandibular muscle and joint pain disorders.” Pain vol. 152,10 (2011): 2377-2383. doi:10.1016/j.pain.2011.07.004
Gil-Martínez, Alfonso et al. “Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement.” The journal of headache and pain vol. 17,1 (2016): 103. doi:10.1186/s10194-016-0690-1
Antoun, J S et al. “Self-reported oral behaviour habits in hyperdivergent and normodivergent facial types.” Journal of oral rehabilitation vol. 44,1 (2017): 16-21. doi:10.1111/joor.12452
Wieckiewicz, Mieszko et al. “Reported concepts for the treatment modalities and pain management of temporomandibular disorders.” The journal of headache and pain vol. 16 (2015): 106. doi:10.1186/s10194-015-0586-5
Schiffman, Eric et al. “Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.” Journal of oral & facial pain and headache vol. 28,1 (2014): 6-27. doi:10.11607/jop.1151
Okeson, Jeffrey P, and Reny de Leeuw. “Differential diagnosis of temporomandibular disorders and other orofacial pain disorders.” Dental clinics of North America vol. 55,1 (2011): 105-20. doi:10.1016/j.cden.2010.08.007
Longitudinal epidemiological analysis of three decades of TMD populations / Serritella, E.; Di Giacomo, P.; Vompi, C.; Falisi, G.; Di Paolo, C.. - In: DENTAL CADMOS. - ISSN 0011-8524. - 88:8(2020), pp. 527-536. [10.19256/d.cadmos.08.2020.07]
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. https://doi.org/10.11607/jop.1151
Kotiranta, U., Forssell, H., & Kauppila, T. (2019). Painful temporomandibular disorders (TMD) and comorbidities in primary care: associations with pain-related disability. Acta Odontologica Scandinavica, 77(1), 22-27. https://doi.org/10.1080/00016357.2018.1493219
Osiewicz, M. A., Lobbezoo, F., Loster, B. W., Loster, J. E., & Manfredini, D. (2017). Frequency of temporomandibular disorders diagnoses based on RDC/TMD in a Polish patient population. CRANIO®, 1–7. doi:10.1080/08869634.2017.1361052
Simons DG, Travell JG, Simons LS, et al. Pain and dysfunction: a trigger point manual. 2nd edition. Baltimore (MD): Williams & Wilkins; 1999
Money, S. (2017). Pathophysiology of Trigger Points in Myofascial Pain Syndrome. Journal of Pain & Palliative Care Pharmacotherapy, 31(2), 158–159. doi:10.1080/15360288.2017.1298688
Stohler C. S. (1999). Muscle-related temporomandibular disorders. Journal of orofacial pain, 13(4), 273–284.
Fernández-de-Las-Peñas, C., Galán-Del-Río, F., Alonso-Blanco, C., Jiménez-García, R., Arendt-Nielsen, L., & Svensson, P. (2010). Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disoders. The journal of pain, 11(12), 1295–1304. https://doi.org/10.1016/j.jpain.2010.03.005
Najafi S, Faraji Z. Evaluating the role of stress and anxiety with clinical symptoms in TMD patients. J Craniomaxillofac Res. 2021;7(4):213-221.
Michelotti, Ambrosina et al. “Occlusion, orthodontics, and temporomandibular disorders: Cutting edge of the current evidence.” Journal of the World federation of orthodontists vol. 9,3S (2020): S15-S18. doi:10.1016/j.ejwf.2020.08.003
Bales, J M, and J B Epstein. “The role of malocclusion and orthodontics in temporomandibular disorders.” Journal (Canadian Dental Association) vol. 60,10 (1994): 899-905.
Olliver, S J et al. “Occlusal Features and TMJ Clicking: A 30-Year Evaluation from a Cohort Study.” Journal of dental research vol. 99,11 (2020): 1245-1251. doi:10.1177/0022034520936235
Mélou, Caroline et al. “Relationship between natural or iatrogenic malocclusions and temporomandibular disorders: A case control study.” Cranio : the journal of craniomandibular practice vol. 42,2 (2024): 206-214. doi:10.1080/08869634.2021.1933307
John, M T et al. “Overbite and overjet are not related to self-report of temporomandibular disorder symptoms.” Journal of dental research vol. 81,3 (2002): 164-9.
Hirsch, Christian et al. “Relationship between overbite/overjet and clicking or crepitus of the temporomandibular joint.” Journal of orofacial pain vol. 19,3 (2005): 218-25.
Seligman, D A, and A G Pullinger. “The role of intercuspal occlusal relationships in temporomandibular disorders: a review.” Journal of craniomandibular disorders : facial & oral pain vol. 5,2 (1991): 96-106.
Fushima, K et al. “Dental asymmetry in temporomandibular disorders.” Journal of oral rehabilitation vol. 26,9 (1999): 752-6. doi:10.1046/j.1365-2842.1999.00447.x
Celić, Robert et al. “A study of the influence of occlusal factors and parafunctional habits on the prevalence of signs and symptoms of TMD.” The International journal of prosthodontics vol. 15,1 (2002): 43-8.
Padala, Soumya et al. “Comparative evaluation of condylar position in symptomatic (TMJ dysfunction) and asymptomatic individuals.” Indian journal of dental research : official publication of Indian Society for Dental Research vol. 23,1 (2012): 122. doi:10.4103/0970-9290.99060
Jain, Sandhya et al. “Association of midline discrepancy with tempromandibular joint disorder. A systematic review.” Clujul medical (1957) vol. 91,2 (2018): 151-156. doi:10.15386/cjmed-832
Aboalnaga, Amira A et al. “Malocclusion and Temporomandibular Disorders: Verification of the Controversy.” Journal of oral & facial pain and headache vol. 33,4 (2019): 440–450. doi:10.11607/ofph.2260
Michelotti, A, and G Iodice. “The role of orthodontics in temporomandibular disorders.” Journal of oral rehabilitation vol. 37,6 (2010): 411-29. doi:10.1111/j.1365-2842.2010.02087.x
Duval, Florian et al. “Relations entre les extractions de dents de sagesse et les dysfonctionnements de l'appareil manducateur : étude cas / témoins” [Relations between extraction of wisdom teeth and temporomandibular disorders: a case/control study]. L' Orthodontie francaise vol. 86,3 (2015): 209-19. doi:10.1051/orthodfr/2015021
Juhl, G I et al. “Incidence of symptoms and signs of TMD following third molar surgery: a controlled, prospective study.” Journal of oral rehabilitation vol. 36,3 (2009): 199-209. doi:10.1111/j.1365-2842.2008.01925.x
Huang, Greg J, and Tessa C Rue. “Third-molar extraction as a risk factor for temporomandibular disorder.” Journal of the American Dental Association (1939) vol. 137,11 (2006): 1547-54. doi:10.14219/jada.archive.2006.0090
Bhardwaj, Aakansha et al. “Mischievous mandibular third molars camouflaging temporomandibular joint disorders.” Journal of the Korean Association of Oral and Maxillofacial Surgeons vol. 48,3 (2022): 155-158. doi:10.5125/jkaoms.2022.48.3.155
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