TTM PEDIATRIA

8/22/2019 TTM PEDIATRIA

1/7

REFERENCE MAN UA L' V 34 I NO 6 ' 12 / 13 ' '

Originating CommitteeClinical Affairs Committee - Temporomandibular joint Problems in Children SubcommitteeReview CouncilCouncil on Clinical AffairsAdopted1990

! Revised1999,2002,2006, 2010

PurposeThe Ametiean Aeademy of Pdiatrie Dentistry (AAPD) reeog-nizes that disorders of the. temp orom andib ular join t (TM J)oeeasionally oeeur in infants, ehildren, and adoleseents. Thisguideline is intended to assist the praetitioner in the reeogni-t ion and diagnosis of temporomandibular disorders (TMD)and to identify possible treatment options. It is beyond theseope of this doeurnent to teeommend the use of specifictreatment modalities.MethodsThis document is an update of the previous document, revisedin 2006. The update included an electtonic seatch using thefollowing parametets: Terms: "temporomandibulat disorder","TM J dysfunc tion" , " TM D AN D adolescents" , "T M D A NDgender dif ferences", " TM D AN D occlusion", T M D A N Dtreatment"; Fields: all fields; Limits: within the last 15 years,humans, English, clinical trials. The reviewers agreed uponthe inclusion of 69 references to support this guideline. Whendata did not appear suffieient or were ineonelusive, reeom-mendations were based upon expert and/or eonsensus opinionby experieneed researehers and elinieians.BackgroundDevelopm ent o f the TMJFunetion influenees form as development and growth of theTMJ proeeeds. The TMJ is eomprised of 3 major eomponents:the mandibulat eondyle, the mandibular fossa, and the asso-eiated eonneetive tissue (ineluding the artieular disk).' Thefirst evidenee of development of the TMJ in humans is seen8 weeks after conception.^ During the first decade of life,th mandibulat cohdyle becomes less vascularized and most ofthe major morphological changes are completed. Duting thesecond decade of life, there is continued but progressive slow-ing of growth. The shape of the mandibular eondyle mayehange signifieantly during growth with apptoximately 5% ofeondyles undergoing radiographie ehanges in shape between

12 and 16 yeats of age.' From adoleseenee to adulthood, theondyle ehanges to a form that is greater in width than lengthAlthough the TMJ experiences active growth in the first decades, it undetgoes adaptive remodeling changes throughout life.Definition of TMDTemporomandibular disorder is a term adopted by the American Dental Association in 1983 to facilitate coordination oreseatch and communication."* While T M D has been defineas "functional distutbanees of the mastieatory system"', otheinelude mastieatory musel disorders' ' , degenerative and inflammatory TMJ disorders^, and TMJ disk displaeementsunder the umbtella of T M D .

Certain medieal eonditions ate reported to oeeasionallmimic TM D . Amo ng them are trigeminal neuralgia , centrnervous system lesions, odontogenic pain, sinus pain, otolgica! pain, developmental abnotmalities, neoplasias, parotidiseases, vascular diseases, myofascial pain, cervical muscdysfunction, and Eagle's syndtome. Other common medicaconditions (eg, otitis media, allergies, airway congestion, rheumatoid ar thti tis) can cause symptoms similar to TM D .'Etiology of TM DTemporomandibular disorders have multiple etiological factors.'" Many studies show a poor correlation between ansingle etiological faetot and resulting signs (findings identifieby the dentist during the examination) and symptoms (findings reported by the child or parent). '" In fact, the TMJ anmasticatoty system is complex and, thus, requires a thorougunderstanding of the anatomy and physiology of the struetutal, vaseular, and neurologieal eomponents in order to manage T M D . Alterations in any one or com binatio n of teetpetiodontal ligament, the TMJ, or the muscles of masticatioeventually can lead to T M D . " Research is insufficient to prdict reliably which pa tient will or will not develop T M DEtiologic factors suggested as contributing to the develoment o f T M D a re :


2/7

AMERICAN ACAD EMY OF PEDIATRIC DENTISTRY

1. Trauma: This would inelude impaet injuries sueh as trau-ma to the ehin. A eommon oeeurrenee in ehildhood be-eause of falling, ehin trauma is reported to be a faetor inthe development ofTMD in pdiatrie patients.'^''' Uni-lateral and bilateral intraeapsular or subeondylar fraeturesare the most eommon mandibular fraetures in ehildren."Closed reduetion and prolonged immobilization ean re-sult in anky losis."''''2. Oeelusal faetors: There is a relatively low assoeiatjon ofoeelusal faetors and the development of temporomandi-bular disorders.'*'" However, several features eharaeterizemaloeelusions assoeiated with T M D : skeletal anterior open bite; " overjet greater than 6 to 7 mm;^"' ' retroeuspal position (eentrie relation) to intereuspal po-sition (eentrie oeelusion) slides greater than 4 unila teral lingual eross bite;^ 5 or more missing posterior Class III maloeelusion.^*

3. Parafunetional habits (eg, bruxism, clenching, hyperex-tension, other repetitive habitual behavior): Bruxism isthought to contribute to the development of TM D byjoint overloading that leads to cartilage breakdown, syno-vial Huid alterations, and other changes within the joint.These parafunetional habits may occur while the patientis asleep or awake. A study of 854 patients youngerthan 17 years old found the prevalence of bruxism to be38%.^ ' The literature on the association between para-function and TM D in pdiatrie patients is contradic-tory.'"'^ However, childhood parafunction was found tobe a predictor of the same parafunction 20 years late r."Other studies found correlations between reported bruxismand TMD''' with a 3.4 odds ratio." Children who grindtheir teeth were found to complain more often of pain andmuscle tenderness when eating.""

4. Posture: Craniocervical posture has been associated withocclusion and with dysfunetion of the TMJ, ineludingabnormalities of the mandibular fossa, eondyle, ramus,and dise." '"

5. Changes in "free-way" dimension of the rest position:Normally 2-4 mm, this may be impinged by oeelusalehanges, disease, musel spasms, nervous tension, and/orrestorative prostheties."6. Orthodontie treatment: Current literature does not sup-port that the development of TMD is eaused by ortho-

dontie treatment,^'''"''" regardless of whether premolarswere extraeted prior to treatment.''''Prevalence of TMD in children and adolescentsThe reported prevalenee of TMD in infants, ehildren, and ado-leseents varies widely in the literatu re.''''''" Prevalenee of signsand symptoms inereases with age. One study of the primarydentition reported 34% of patients with signs and/or symp-toms of TMD.''* An epidemiologieal study of 4724 ehildrenaged 5-17 years reported 25% with symptoms. Clieking was

seen in 2.7% of ehildren in the primary dentition and 10.1%in late mixed dentition and further inereased to 16.6% in pa-tients with permanent dentition.^" A similar study in pre-sehool ehildren found TMJ sounds and elieking in 16.6% ofpatients."' A study of 217 adoleseents found that over 20%had signs and/or symptoms of dysfunction, with TMJ soundsand tenderness in the lateral pterygoid muscle as the mostcommon findings.'" Clicking is seen more frequently thaneither locking or luxation and affeets girls more than boys. Ingeneral, the prevalenee of signs and symptoms of TM D is lowerin ehildren eompared to adults and is even less the youngerthe child but increases with increasing age.^' Recent surveyshave indicated a significantly higher prevalence of symptomsand greater need for treatment in girls than boys'" with thedevelopment of symptomatic TMD correlated with the onsetof puberry in girls."'^

Controversy surrounds the significance of signs and symp-toms in this age group, the value of certain diagnostic proce-dures, and what constitutes appropriate therapy. It is notclear whether these signs and symptoms constitute normalvariation, preclinical features, or manifestations of a diseasestate. Whether these signs and symptoms warrant treatmentas predictors of TMD in adulthood is questionable."Diagnosing TM DAll comprehensive dental examinations should include ascreening evaluation of the TMJ and surrounding area."'"Diagnosis of TMD is based upon a combination of historicalinformation, clinical examination, and/or craniocervical andTMJ imaging."^'" The findings are classified as symptomsand signs."

For a diagnosis of TMD, patients must have a history offacial pain combined with physical findings, supplemented byradiographie or imaging data when indieated.'* A sereeninghistory, as part of the health history, may inelude questionssueh as: " Do you have diffieulty opening your mouth? Do you hear noises within your jaw joint? Do you have pain in or around your ears or your eheeks? Do you have pain when ehewing? Do you have pain when opening your mouth wide orwhen yawning? Has your "bite" felt uneomfortable or unusual? Does your jaw ever "loek" or "go out"? Have you ever had an injury to your jaw, head, or neek?If so, when? How was it treated? Have you previously been treated for a temp orom andib -ular disorder? If so, when? How was it treated?Clinieal and physieal assessment of the TMJ may inelude:^' Manual palpation of the musels and TM J to evaluate fortenderness of intraoral and extraoral jaw musels, neek

musels, and TM J eapsule; Evaluation of jaw movem ents ineluding assessment ofmandibular range of motion using a millimeter ruler(ie, maximum unassisted opening, maximum assisted


3/7

R E F E R E N C E M A N U A L V 34 I N O 6 1 2 1 1 3

opening, maximum lateral excursion, maximum protru-sive excursion) and mandibular opening pattern (ie, is itsymmetrical?). Restricted mandibular opening with orwithout pain on mandibular movement may be inter-preted as signs of TM J internal derangement.' "

Determination of TM J sounds by palpation and ausculta-tion w ith a stethoscope;

Radiographs (panoram ic, full mo uth periapicals, lateralcephalometric), TMJ tomography, and magnetic resonanceimaging to examine for TMJ pathology and/or dentalpathology. TMJ arthography is not recommended as aroutine diagnostic procedure.'*'"

As some mental disorders can greatly influence a patient'spain experience, psyehosoeial faetors related to temporoman-dibular symptoms should be eonsidered; this would ineludemood disorders, anxiety disorders, museuloskeletal problems,migraine headaehes, tension headaehes, emotional faetors, ul-eers, eoliltis, oeeupational faetors, and developmental/aequirederaniofaeial anomalies."

There is a need for improved elassifieation of TMDs;however, they largely ean be grouped into 3 elasses:1 . Disorders of the musels of mastieation (ineluding pro-

tective muscle splinting, muscle spasm, and muscle in-flammation);2 . Disorders of the TMJ (including internal disk derange-ment, disk displacement with reduction accompanied by

clicking, and anterior disk displacement without reduc-tion seen as mechanical restriction or closed lock); and3 . Disorders in other related areas that may mimic TMD

(eg, chronic mandibular hypomobility, inflammatoryjoint disorders such as juvenile rheumatoid arthritis, de-generative join t disease, extrinsic trauma such as fracture).''Treatment of T MDFew studies doeument sueeess or failure of speeifie treatmentmodalities for TMD in infants, ehildren, and adoleseents ona long-term basis. These suggest that simple, eonservative, andreversible types of therapy are effeetive in redueing most T M Dsymptoms in ehildren." The foeus of treatment should be tofind a balanee between aetive and passive treatment modali-ties. Aetive modalities inelude partieipation of the patientwhereas passive modalities may inelude wearing a stabiliza-tion splint. The most eommon form of treatment of TMD inchildren was information combined with occlusal appliancetherapy.''^ It has been shown that combined approaehes aremore sueeessful in treating TMD than single treatment mo-dalities.*'^'^'Treatment of TMD ean be divided into reversibleand irreversible treatment.Reversible therapies may include:

Patient education (eg, relaxation training , developingbehavior coping strategies, modifying inadequate percep-tions about TMD, patient awareness of clenching andbruxing habits, if presen t)."

Physical therapy [eg, jaw exercises or transcutaneous electrical nerve stimulation (TENS), ultrasound, iontophoresis, massage, thermotherapy, coolant therapy)] .^'^'^^

Behavioral therapy (eg, avoiding excessive chew ing ohard foods or gum, voluntary avoidance of Stressors, habireversal, decreasing stress, anxiety, and/or depression) .^^

Prescr ip t ion medicat io n (eg , non-s tero idal ant iinflammatory drugs, anxiolytic agents, muscle relaxers)While antidepressants have proved to be beneficialthey should be prescribed by a physician.''^

Occlusal splints. The goal of an occlusal appliance to provide orthopedic stability to the TMJ. These altethe patient's occlusion temporarily and may be used tdecrease parafunctional activity.''^''^'^'

Irreversible therapies can include: Occlusal adjustment (ie, permanently altering the occlusion or mandibular position by selective grinding or fulmouth restorative dentistry);

Ma ndibular repositioning [designed to alter the growtor permanently reposition the mandible (eg, headgearfunctional appliances];

Orthodontics.Referral should be made to other health care providers, including those with expertise in TMD, oral surgery, or pain management, when the diagnostic and/or treatment needs arbeyond the treating dentist's scope of practice.RecommendationsEvery comprehensive dental history and examination shoulinclude a TMJ history and assessment. The history should include questions concerning the presence of head and necpain and mandibular dysfunction, previous orofaeial traumaand history of present illness with an aeeount of eurrensymptoms. In the presenee of a positive history and/or signand symptoms of TMD, additional information is suggesteand a referral may be eonsidered. A more eomprehensive examination should be performed and inelude palpation of mastieatory and assoeiated musels and the TMJ's, doeumentatioof joint sounds, oeelusal analysis, and assessment of range omandibular movements ineluding maximum opening, protrusion, and lateral exeursions.Joint imaging may be reeommended by other speeialistto investigate joint sounds in the absenee of other TMD signand symptoms. For example, the presenee of erepitus may indieate degenerative ehange that is not yet painful.Therapeutie modalities to prevent TMD in the pdiatripopulation are yet to be supported by eontroUed studies. Foehildren and adoleseents with signs and symptoms of TMDreversible therapies should be eonsidered. Beeause of inadequate data regarding their usefulness, irreversible therapieshould be avoided.''''*' Referral to a medieal speeialist may bindicated when otitis media, allergies, abnormal posture, airwacongestion, rheumatoid arthritis, or other medical conditionare suspe cted."


4/7

AMERICAN ACADEMY OF PEOIATRIC DENtlStRY

References1. Catlson DS. Gtowth ofthe tempotomandihulat joint.In: Zath GAC, Catlsson GE, Sessle BJ, Mohl ND, eds.Tempotomandihulat Joint and Mastieatoty Musel Dis-

orders. 2"'' ed. Copenhagen: Munksgaard; 1994:128-50.2. Dixon Ad. Fotmation of the cranial base. In: Dixon AD,

Howyte DAN, Rnning O, eds. Fundamentals of Ctanio-faeial Gtowth. Boea Raton, Fl: CRC press; 1997:100-29.3. Dihbets JM, Van der Weele LT. Prevalenee of sttuetutalbony ehange in the mandibular eondyle. J CraniomandDis Fac Otal Pain 1992;6(4):254-9.

4. Griffiths R. Repott of the President's conferenee on theexamination, diagnosis, and management of tempoto-mandibulat disotders and oeelusion. J Am Dent Assoe1983;106(l):75-7.

5. Okeson J. Etiology of functional distutbances in the mas-tieatoty system. In: Management of TempotomandibularDisorders and Oeelusion. 6* ed. St Louis, Mo: MosbyYear Book Publication, Ine; 2008:130-63.

6. Sthlet CS. Clinical petspeetives on mastieatoty and te-lated musel disotdets. In: Sessle BJ, Btyant PS, DionneRA, eds. Tempotomandibulat Disorders and Related PainCo ndition s. Vol 4. Seattle, Wash: lASP Ptess; 1995:3 -30.

7. Kopp S. Degenerative and inflammatoty temp oroman -dibular joint disotders. In: Sessle BJ, Bryant PS, DionneRA, eds. Tempotomandihular Disorders and RelatedPain Conditions. Vol 4. Seatde, Wash: lASP Ptess; 1995:119-32.

8. Dolwieh MF. Temp oromand ibular joint disk displaee-ment. In: Sessle BJ, Btyant PS, Dionne RA, eds. Tem-potomandibulat Disotdets and Related Pain Conditions.Volume 4. Seattle, Wash: L\SP Press; 1995:79-113.9. Loos PJ, Aaron GA. Standards for management of thepediattie patient with aeute pain in the tempotomandi-bulat joint ot musels of mastieation. Pediatr Dent 1989;

10. Gteene CS. The etiology of tempotomandibular disorders:Implications for tteatment. J Orofae Pain 2001;15(2):93-105.

11 . Hiatt JL, Gattnet LP. Tempotomandibular joint. In: Text-book of Head and Neek Anatomy. 2"'' ed. Baltimote,Md; W illiams and W ilkins; 198 7:223.12. Greeo CM, Rudy TE, Turk DC, Herlieh A, Zaki HH.Traumatie onset of temporomandihular disorders: Posi-tive effeets of a standatdized eonsetvative treatment pto-gtam. Clin J Pain 1997;13(4):337-47.13 . Fiseher DJ, Mueller BA, Critehlow CW, LeResehe L. Theassoeiation of temporomandihular disorder pain withhistory of head and neck injury in adoleseents. J OtofaePain2006;20(3):191-8.14. Imahata SD, Hoppet RA, Wang J, Rivara FP, Klein MB.Patterns and outeomes of pdiatrie facial fractures in theUnited States: A sutvey of the National Trauma DataBank. J Am Col of Surg 2008;207(5):710-6.

13 . Posnick JC, Wells M, Pron GE. Pediattie facial fractures:Evolving pattetns of tteatment. J Otal Maxillofae Sutg1993;51(5):836-44; diseussion 844-5.

16. Kahan L. Aequired abnotmalities of the tempotoman-dibular join t. In : Kaban LB, Troulis MJ, eds. PdiatrieOtal and Maxillofaeial Surgery. Philadelphia, Pa; WBSaunders; 2004:340 -76.

17. Gven O. A elinieal study on tempotomandibular jointankylosis in eh ildten . J Ctaniofae Sutg 20 08; 19 (5):1263-9.18. De Boevet JA, Catlsson GE, Klinehetg .IJ. Need fot oc-clusal therapy and prosthodontic treatment in the

management of temporomandihular disorders. Part I.Occlusal interferenee and occlusal adjustment. J OtalRehahil 20 00;27(5):367-79.19. Taskaya-Yilmaz N, Ogiiteen-Tollet M, Sara Y. Relation-ship herween the TMJ dise and eondyle position on MRI

and oeelusal eontaets on lateral excursions in TMD pa-tients. J O tal Rehab 2004;31 (8):754-8.20. Thilandet B, Rubio G, Pena L, De Mayotga C. Prevalenceof tempotomandibular dysfunetion and its association

with malocclusion in childten and adoleseents: An epide-miologie study related to specified stages of dental de-velopment. Angle Orthod 2002;72(2): 146-54.21 . Henrikson T, Nilner M. Temporomandihular disorders,occlusion and orthodontic tteatment. J Otthod 2003;30

(2):129-37; diseussion 27.22. Phillips JT. What skeletal and dental ehataeteristies do

TMD patients have in eommon? Funet Orthod 2007;24(l):24-6,28,30.23 . Pahkala R, Qvarnsttm M. Can tempotomandihulatdysfunction signs be predieted by early morphologieal orfiinedonal variables? Euro J Ortho d 2004;26(4):367 -73.24. PuUinget AG, Seligman DA. Quantification and valida-tion of ptedietive values of occlusal vatiahles in temporo-

ma ndih ulat d isotdets using a multifaetotial analysis. JPtosthet Dent 2000;83(l):66-75.25. Seligman DA, Pullinger AG. Analysis of oeelusal vari-ables, dental attrition, and age fot distinguishing healthy

eonttols from female patients with intraeapsular tem-potomandihulat disotdets. J Ptosthet Dent 2000;83(l):76-82.

26. Cianeaglini R, Gherlone EF, Radaelli G. Assoeiation be-tween loss of oeelusal suppott and symptoms of func-tional disturbances of the mastieatoty system. J OtalRehabil 199 9;26(3):248-53.

27. Tallents RH, Maehet DJ, Kytkanides S, Katzhetg RW,Moss ME. Prevalenee of missing postetiot teeth and in-traartieular temporo man dihu lar disorders. J PtosthetDent 2002 ;87(l):45-50.

28. Rey D, Obetti G, Baeeetti T. Evaluation of tempoto-mandibulat disotdets in Class III patients treated withmandihular cervical headgear and fixed applianees. AmJ Orthod Dentofae O rthop 2008;133(3 ):379-81.


5/7

R E F E R E N C E M A N U A L V 3 4 / N O 6 1 2 / 1 3

2 9 . Cheifetz AT, Osganian SK, Allred EN, Needleman HL.Prevalenee of bruxism and assoeiated eorrelates in ehil-dren as reported by parents. J Dent Child 2005;72(2):67-73.

3 0 . Barbosa Tde S, Miyakoda LS, Poeztaruk Rde L, RoehaC P , Gavio MBD. Temporomandibular disorders andbruxism in ehildhood and adoleseenee: Review of theliterature. Int J Pediatr Otorhinolaryngol 2008;72(3):299-314.

3 1 . Castelo PM, Gavio MB, Peteira LJ, Bonjardim LR,Gavio MBD. Relationship between oral parafunetional/nutritive sueking habits and temporomandibular jointdysfunetion in primary dentition. Int J Paediatr Dent2005;15(l):29-36.

3 2 . Winoeur E, Gavish A, Finkelshtein T, Halaehmi M, GazitE. Oral habits among adoleseent girls and their asso-eiation with symptoms of temporomandibular disorders.J Oral Rehabil 2001;28(7):624-9.

3 3 . Carlsson GE, Egermark I, Magnusson T. Predietors ofsigns and symptoms of temporomandibular disorders: A20-year follow-up study from ehildhood to adulthood.Aeta Odo ntol Seand 2002;60(3): 180-5.

3 4 . Magnusson T, Egermarki I, Carlsson GE, Magnusson T,Egermarki I, Carlsson GE. A prospeetive investigationover two deeades on signs and symptoms of temporo-mandibular disorders and assoeiated variables. A finalsummary Aeta Odontol Seand 2005;63(2):99-109.

3 5 . Geseh D , Bernhardt O, Maek F, John U, KoeherT, DietriehA. Assoeiation of maloeelusion and funetional oeelu-sion with subjeetive symptoms of TMD in adults:Results of the Study of Health in Pomerania (SHIP).Angle O rthod 2005;75(2): 183-90.

3 6 . Alamoudi N. Correlation between oral parafunctionand temporomandibular disorders and emotional statusamong Saudi children. J Clin Pediatr Dent 2001;26(l):71-80.

3 7 . Sonnesen L, Bakke B, Solow B. Temporomandibular dis-order in relation to craniofaeial dimensions, head postureand bite force in children seleeted for orthodontie treat-ment. Eur J Orthod 2001;20(2): 179-92.

3 8 . Kondo E, Nakahara R, Ono M, et al. Cervieal spineproblems in patients with temporomandibular disordersymptoms: An investigation of the orthodontie treatmenteffeets for growing and nongrowing patients. World JOrthod 2002;3(4):295-312.

3 9 . Motoyshi M, Shimazaki T, Namura S. Biomeehanieal in-fluenees of head posture on oeelusion: An experimentalstudy using finite element analysis. Eur J Orthod 2002;24(4):319-26.4 0 . Egermark I, Carlsson GE, Magnusson T A prospeetivelong-term study of signs and symptoms of temporoman-dibular disorders in patients who reeeived orthodontie

treatment in ehildhood. Angle Orthod 2005;75(4):645-50.

4 1 . Henrikson T, Nilner M, Kurol J. Symptoms and signs otemporomandibular disorders before, during and afteorthodontie treatment. Swed Dent J 1999;23(5-6)193-207.

4 2 . Henrikson T, Nilner M, Kurol J. Signs of temporomandibular disorders in girls reeeiving orthodontie treatment. A prospeetive and longitudinal eomparison withuntreated Class II maloeelusions and normal oeelusionsubjeets. Eur J O rthod 2000;22(3):271-81 .

4 3 . Kim MR, Graber TM, Viana MA. Orthodonties andtemporomandibular disorder: A meta-analysis. Am JOrthod Dentofae Orthop 2002;121(5):438-46.

4 4 . Alamoudi N, Farsi N, Salako N, Feteih R. Temporomandibular disorders among sehool ehildren. J Clin PediatrDent 1998;22(4):323-9.4 5 . List T, Wahlund K, Wenneberg B, Dworkin SR TMD

in children and adolescents: Prevalence of pain, gendedifferences, and perceived treatment need. J Orofac Pain1999;13(l):9-20.4 6 . Stockstill JW, Bowley JF , Dunning D, Spalding P, StaffordK, Eriekson L. Prevalenee of temporomandibular disorders in ehildren based on physieal signs. J Dent Child1998;65(6):459-67, 438 .4 7 . Paesani D, Salas E, Martinez A, Isberg A. Prevalenee otemporomandibular joint disk displaeement in infantand young ehildren. Oral Surg Oral Med Oral PathoOral Radiol Endod 1999;87 (l):15-9.4 8 . Bonjardim LR, Baviao MB, Carmagnani FG, Pereira LFCastelo PM. Signs and symptoms of temporomandibulajoint dysfunetion in ehildren with primary dentition

J Clin Pediatr Dent 2003;28(l):53-8.4 9 . Widmalm SE, Christiansen RL, Gunn SM. Oral parafunetions as temporomandibular disorder risk faetors inehildren. Cranio 1995;13(4):242-6.5 0 . Bonjardim LR, Gavio MB, Pereira LJ, Castelo PMGareia RC. Signs and symptoms of temporomandibuladisorders in adolescents. Braz Oral Res 200 5;19(2):93 -8.5 1 . LeResche L, Mancl LA, Drangsholt MT, Saunders K, VonKorff M. Relationship of pain and symptoms to pubertadevelopment in adolescents. Pain 2005;l 18(l-2):201-9.5 2 . LeResehe L, Manel LA, Drangsholt MT, Huang G, von

Korff M V . Predietors of onset of faeial pain and temporomandibular disorders in early adoleseenee. Pain 2007129(3):269-78.

5 3 . MeDonald RE, Avery DR, Dean JA. Examination of themouth and other relevant struetures. In: Dean JA, AveryDR, MeDonald RE, eds. MeDonald and Avery's Dentistry for the Child and Adoleseent. 9* ed. MarylandHeights M o: Mosby Elsevier; 201 1:1-18 .

5 4 . Casamassimo P S, Christensen JR, Fields HW Jr , GanzberS. Examination, diagnosis, and treatment planning fogeneral and orthodontie problems. In: Pinkham JRCasamassimo PS, MeTigue DJ, Fields HW Jr, Nowak AJe d s . Pdiatrie Dentistry: Infaney through Adolescence4*e d. St. Louis, Mo; Elsevier Saunders 2005 :661 -89.


6/7

AMERICA N ACADEM Y OF PEOIATRIC DENTISTRY

55. Ameriean Aeademy of Pdiatrie Dentistry. Guideline onreeordk eeping . Ped iatr Den t 20 09;3 1 (speeial issue):239-46.

56 . Ameriean Aeademy of Orofaeial Pain. General assessmentof the otofaeial pain patient. In: de Leeuw R, ed. OrofaeialPain: Guidelines for Assessment, Diagnosis, and Manage-ment. Carol Stteam, 111: Quintessenee Publishing Co Ine;2008:25-47.57 . Wahlund K, List T, Dworkin SF. Temporomandibulardisorders in ehildren and adoleseents: Reliability of aquestio nnaire, elinieal examination , and diagno sis. JOrofae Pain 1998;12(1):42-51.

58. De Boever JA, Nilner M, Orthlieb JD, Steenks MH,Edueational Committee of the European Aeademy ofCraniomandibular Disorders. Reeommendations by theEACD for examination, diagnosis, and management ofpatients with temporomandibiilar disorders and oro-faeial pain by the general dental praetitionet. J OrofaePain 2008;22(3):268-78.

59 . Brooks, SL, Brand JW, Gibbs SJ, et al. Imaging of thetempromandibular joint: A position paper of the Ame-riean Aeademy of Oral and Maxillofaeial Radiology.Oral Surg Oral Med Oral Pathol Oral Radiol Endod1997;83(5):609-18.

60 . Hu YS, Sehneiderman ED , Harper RP. The temporo-mandibular joint in juvenile rheumatoid arthritis: PartII . Relationship between eomputed tomographie andelinieal findin gs. Pediatr Dent 1996;18 (4):312-9.

61. Bodnet L, Millet VJ. Temporomandibular joint dysfune-tion in ehildren: Evaluation of treatment. Int J PediatrOtorhinolaryngol 1998;44(2):133-7.62 . Wahlund K, List T, Larsson B. Treatment of temporo-mandibular disorders among adoleseents: A eomparisonbetween oeelusal applianee, relaxation ttaining, and btiefinfotmation. Aeta Odontol Seand 20 03;6l(4 ):203-l 1.

63 . Kutita H, Kutashina K, Kotani A. Clinieal effeet of fulleoverage oeelusal splint therapy for speeifie temporoman-dibular disorder eonditions and symptoms. J ProsthetDent 1997;78(5):506-10.64 . Miehelotti A, Steenks MH, Farella M, Parisini F, CiminoR, Martina R. The additional value of a home physiealtherapy regimen versus patient edueation only for the

treatment of myofaseial pain of the jaw muscles: Short-term results of a randomized clinical trial. J Orofac Pain2004;18(2):l 14-25. [Erratum in J Orofac Pain 2006;20

68

65 . Medlicott, MS, Harris SR. A systematic review of the ef-fectiveness of exercise, manual therapy, electrotherapy,relaxation training, and biofeedback in the managementof temporomandibular disorder. Phys Ther 2006;86(7):955-73.

66 . Crider, AB, Glaros AG. A meta-analysis of EMG bio-feedback tteatment of temporomandibular disordets.JOrofac Pain 1999;13 (l):29-37.

67 . List X Axelsson S, Leijon G. Phatmacologic interventionsin the treatment of temporomandibular disorders, atyp-ical facial pain, and burning mouth syndrome. A quali-tative systematic review. J Orofac Pain 2003;17(4):301-10.Fujii T, Torisu T, Nakamura S. A change of oeelusaleonditions after splint therapy for bruxers with andwithout pain in the mastieatoty musels. Cranio 2005;23

69 . Koh H, Robinson PG. Oeelusal adjustment for treatingand pteventing tempotomandibulat joint disorders. TheCoeh rane Database of Systematie Reviews. 20 03 ;l:A rt.No. CD003812. DOP: 10.1002/146751858.CD003812.


7/7

Copyright of Pediatric Dentistry is the property of American Society of Dentistry for Children and its content

may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express

written permission. However, users may print, download, or email articles for individual use.

TTM PEDIATRIA

Documents

Transcript of TTM PEDIATRIA