Article Data

  • Views 269
  • Dowloads 56

Original Research

Open Access

Temporomandibular Joint Structural Derangement and General Joint Hypermobility

  • Huey-Yuan Wang1
  • Tiffany Ting-Fang Shih2
  • Juo-Song Wang2,3
  • Yuh-Yuan Shiau2
  • Yunn-Jy Chen2,*,

1Department of Dentistry, Mackay Memorial Hospital and Lecturer, Mackay Medicine, Nursing and Management College Taipei, Taiwan

2Department of Radiology and Medical Image National Taiwan University, Medical College and Hospital Taipei, Taiwan

3Taiwan and School of Dentistry, China Medical University, Taichung, Taiwan

DOI: 10.11607/jofph.2633 Vol.26,Issue 1,March 2012 pp.33-38

Published: 30 March 2012

*Corresponding Author(s): Yunn-Jy Chen E-mail: chenyj@ntu.edu.tw

Abstract

Aim: To explore the relationship between general joint hypermobility (GJH) and displacement of the temporomandibular joint (TMJ) disc as evident from magnetic resonance imaging (MRI). Methods: Fifth finger extension, thumb apposition, elbow extension, knee extension, trunk flexion, and ankle dorsiflexion were measured in 66 young female patients with MRI-evident TMJ internal derangement (ID) and in 30 age-matched female controls. The Beighton score of each subject was measured quantitatively. The possible association between TMJ ID and mobility of a single joint or index of GJH, ie, the Beighton score, were assessed with one-way ANOVA with post-hoc Bonferroni and chi-square test, respectively. Correlations of the mobility of every measured joint were also explored. Results: Very few of the TMJ ID patients and control subjects were diagnosed with GJH according to the Beighton score. The Beighton score did not differentiate between subjects with and without TMJ ID. Subjects with TMJ ID, especially patients with MRI-evident disc displacement without reduction, seemed to have a stiffer trunk than controls, but this may not be of clinical relevance. The mobilities of paired joints were significantly correlated; however, the mobilities of different anatomical joints seemed to be independent. Conclusion: Based on the Beighton score, GJH does not seem to be a reliable indicator of the presence of TMJ ID.


Keywords

Beighton score; general joint hypermobility; internal derangement; temporomandibular joint


Cite and Share

Huey-Yuan Wang,Tiffany Ting-Fang Shih,Juo-Song Wang,Yuh-Yuan Shiau,Yunn-Jy Chen. Temporomandibular Joint Structural Derangement and General Joint Hypermobility. Journal of Oral & Facial Pain and Headache. 2012. 26(1);33-38.

References

1. Glossary. In: Okeson JP (ed). Orofacial Pain Guidelines for Assessment, Diagnosis, and Management. Chicago: Quintessence, 1996:244.

2. Scapino RP, Mills DK. Disc displacement internal derangements. In: McNeill C (ed). Science and Practice of Occlusion. Chicago: Quintessence, 1997:220–234.

3. Bauss O, Sadat-Khonsari R, Fenske C, Engelke W, Schwest- ka-Polly R. Temporomandibular joint dysfunction in Marfan syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;97:592–598.

4. De Coster PJ, Van den Berghe LI, Martens LC. Generalized joint hypermobility and temporomandibular disorders: Inherited connective tissue disease as a model with maximum expression. J Orofac Pain 2005;19:47–57.

5. Dijkstra PU, Kropmans TJ, Stegenga B. The association between generalized joint hypermobility and temporomandibular joint disorders: A systematic review. J Dent Res 2002;81:158–163.

6. Huddleston Slater JJ, Lobbezoo F, Chen YJ, Naeije M. A comparative study between clinical and instrumental methods for the recognition of internal derangements with a clicking sound on condylar movement. J Orofac Pain 2004;18:138–147.

7. Wang HY, Shin TT, Wang JS, Shiau YY, Chen YJ. Low bone mineral density and temporomandibular joint derangement in young females. J Orofac Pain 2007;21:143–149.

8. Normal anatomy. In: Katzberg RW, Westesson PL (ed). Diagnosis of the Temporomandibular Joint. Philadelphia: WB Saunders, 1993:3–23.

9. Dijkstra PU, de Bont LG, van der Weele LT, Boering G. Joint mobility measurements: Reliability of a standardized method. Cranio 1994;12:52–57.

10. Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis 1973;32:413–418.

11. Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000;27:1777–1779.

12. Conti PC, Miranda JE, Araujo CR. Relationship between systemic joint laxity, TMJ hypertranslation, and intra-articular disorders. Cranio 2000;18:192–197.

13. Pinkert R. Anterior and lateral disk and capsule tissue of the temporomandibular joint and its relevance for temporomandibular joint diagnosis [in German]. Mund Kiefer Gesichtschir 1999;3:213–219.

14. Dijkstra PU, de Bont LG, van der Weele LT, Boering G. The relationship between temporomandibular joint mobility and peripheral joint mobility reconsidered. Cranio 1994;12:149–155.

15. Dijkstra PU, de Bont LG, Stegenga B, Boering G. Temporomandibular joint osteoarthrosis and generalized joint hypermobility. Cranio 1992;10:221–227.

16. Westling L. Craniomandibular disorders and general joint mobility. Acta Odontol Scand 1989;47:293–299.

17. Perrini F, Tallents RH, Katzberg RW, Ribeiro RF, Kyrka- nides S, Moss ME. Generalized joint laxity and temporomandibular disorders. J Orofac Pain 1997;11:215–221.

18. Katzberg RW, Tallents RH. Normal and abnormal temporomandibular joint disc and posterior attachment as depicted by magnetic resonance imaging in symptomatic and asymptomatic subjects. J Oral Maxillofac Surg 2005;63:1155–1161.

19. Ribeiro RF, Tallents RH, Katzberg RW, et al. The prevalence of disc displacement in symptomatic and asymptomatic volunteers aged 6 to 25 years. J Orofacial Pain 1997;11:37–47.

20. Tallents RH, Hatala M, Katzberg RW, Westesson PL. Temporomandibular joint sounds in asymptomatic volunteers. J Prosthet Dent 1993;69:298–304.

21. Westesson PL, Eriksson L, Kurita K. Reliability of a negative clinical temporomandibular joint examination: Prevalence of disk displacement in asymptomatic temporomandibualr joints. Oral Surg Oral Med Oral Pathol 1989;68:551–554.

22. Emshoff R, Innerhofer K, Rudisch A, Bertram S. Clinical versus magnetic resonance imaging findings with internal derangement of the temporomandibular joint: An evaluation of anterior disc displacement without reduction. J Oral Maxillofac Surg 2002;60:36–41.

23. Zhang J, Ma XC, Jin Z, Zhao YP, Meng JH, Zeng YW. Investigation on disc position of the temporomandibular joint in asymptomatic volunteers by magnetic resonance imaging [in Chinese]. Zhonghua Kou Qiang Yi Xue Za Zhi 2009;44:598–600.

24. Kircos LT, Ortendahl DA, Mark AS, Arakawa M. Magnetic resonance imaging of the TMJ disc in asymptomatic volunteers. J Oral Maxillofac Surg 1987;45:852–854.

25. Dijkstra PU, de Bont LG, de Leeuw R, Stegenga B, Boering

G. Temporomandibular joint osteoarthrosis and temporomandibular joint hypermobility. Cranio 1993;11:268–275.

26. Bates RE, Stewart CM, Atkinson WB. The relationship between internal derangements of the temporomandibular joint and systemic joint laxity. J Am Dent Assoc 1984;109:446–447.

27. Sáez-Yuguero MR, Linares-Tovar E, Calvo-Guirado JL, Bermejo-Fenoll A, Rodriguez-Lozano FJ. Joint hypermobility and disk displacement confirmed by magnetic resonance imaging: A study of women with temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e54–57.

28. Watkins MA, Riddle DL, Lamb RL, Personius WJ. Reliability of goniometric measurements and visual estimates of knee range of motion obtained in a clinical setting. Phys Ther 1991;71:90–96.

29. Artero EG, Espana-Romero V, Ortega FB, et al. Health- related fitness in adolescents: Underweight, and not only overweight, as an influencing factor. The AVENA study. Scand J Med Sci Sports 2010;20:418–427.


Abstracted / indexed in

Science Citation Index (SCI)

Science Citation Index Expanded (SCIE)

BIOSIS Previews

Scopus

Cumulative Index to Nursing and Allied Health Literature (CINAHL)

Submission Turnaround Time

Conferences

Top