Generalized Joint Hypermobility and Temporomandibular Disorders: Inherited Connective Tissue Disease as a Model with Maximum Expression

Aims: To study the relationship between generalized joint hyper-mobility (GJH) and temporomandibular disorders (TMD) by assessing prevalence and patient characteristics of TMD in a popu-lation of patients with maximum expression of GJH as a symptom of inherited connective tissue disease. In addition, diagnostic relia-bility 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 (≥ 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 Diag-nostic 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 find-ing 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.

joint hypermobility; temporomandibular disorders; temporomandibular joint; temporomandibular joint dislocation

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