Joint Tenderness, Jaw Opening, Chewing Velocity, and Bite Force in Patients with Temporomandibular Joint Pain and Matched Healthy Control Subjects

Aims: To evaluate the effect of temporomandibular arthralgia on mandibular mobility, chewing, and bite force. Methods: Twenty female patients (ages 19 to 45 years) with unilateral temporo-mandibular joint (TMJ) pain during chewing (49 ± 27 mm on a 100-mm visual analog scale) and provocation, as well as TMJ ten-derness, were studied. The TMJ conditions were classified as disc derangement disorders (n = 9), osteoarthritis (n = 7), and inflam-matory disorders (n = 4). The patients were compared with matched healthy volunteers without orofacial pain or tenderness. Exclusion criteria were the presence of fewer than 24 teeth or mal-occlusion. The methods used were (1) algometric assessment of the pressure pain threshold (PPT) over the TMJ; (2) clinical recordings of maximum jaw opening; (3) computerized kinematic assessment of maximum vertical distance, velocity, and cycle duration during chewing of soft gum; and (4) measurement of unilateral molar bite force. Results: The mean (± SD) PPT in the patients’ painful side (69 ± 20 kPa; P = .000001) was significantly lower than in the control subjects (107 ± 22 kPa). Jaw opening was also significantly less (P = .00003) in the patients (42 ± 9 mm) than in the controls (52 ± 4 mm). Chewing cycle duration and maximum closing veloc-ity were significantly different (P ≤ .03) in the patients (948 ± 185 milliseconds and 142 ± 46 mm/s, respectively) versus the controls (765 ± 102 milliseconds and 173 ± 43 mm/s, respectively), and bite force was significantly lower (P = .000003) in the patients (238 ± 99 N) than in the controls (394 ± 80 N). Both bite force and jaw opening in patients were significantly correlated (P ≤ .02) with PPT (r = 0.53 and 0.63, respectively). Conclusion: These system-atic findings supplement results from acute pain experiments and confirm indications from unspecified patient groups that the clini-cal presence of long-standing TMJ pain is associated with marked functional impairment. This impairment might be a result of reflex adaptation and long-term hypoactivity of the jaw muscles.

bite force; jaw kinematics; mastication; orofacial pain; temporomandibular joint

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