Carl E. Rieder

The prevalence of mandibular dysfunction. Part I : Sex and age distribution of related signs and symptoms

This study concludes the following: 1. Mandibular dysfunction is extensive. 2. Age and sex differences are apparent with various signs and symptoms. 3. Women and younger patients tend to respond positively more often than men and older patients to questions relating to subjective TMJ and muscle symptoms. 4. Objective TMJ and occlusal signs show little age or sex differentiation. 5. Positive responses to questions regarding bruxism were more common in men. 6. Age and sex differences in the prevalence of mandibular dysfunction may be influenced by the method of investigation (anamnestic versus clinical examination) and by the signs and symptoms selected to be representative of this disorder. When compared with the findings of earlier investigations, the conclusions suggest that social, cultural, psychologic, sex, and age differences contribute to the responses to questions pertaining to mandibular dysfunction. However, this may not be an accurate reflection of the prevalence of mandibular dysfunction since the objective signs do not show the age and sex differences that the subjective symptoms indicate. Therefore, additional studies are needed to correlate all data to establish a more reliable profile of both signs and symptoms of mandibular dysfunction.

Comparison of the efficacy of a questionnaire, oral history, and clinical examination in detecting signs and symptoms of occlusal and temporomandibular joint dysfunction

A comparison of three methods of obtaining information relating to some TMJ signs and symptoms has been made. The taking of an oral history by this examiner was shown to be the least reliable. The acquisition of data by this verbal process is a clinically sophisticated and difficult medical procedure and a major source of error is the bias or preconception that a clinician brings to his observations. Far more effective was a written, self-administered patient questionnaire, which proved quite reliable in detecting the presence of some occlusal habits. This study indicates that the initial use of a self-administered patient questionnaire, even in the hands of an inexperienced dentist, will ensure that certain essential data are obtained and recorded and will result in the discovery that a substantial number of patients have signs and symptoms of occlusal and TMJ dysfunction. The most objective method is of course the direct clinical examination. A combination of these three methods of obtaining information is recommended as an important part of routine occlusal and TMJ examinations.

The prevalence of mandibular dysfunction. Part II: A multiphasic dysfunction profile

The frequency of occurrence of 20 signs and symptoms commonly associated with mandibular dysfunction was used to numerically rate the clinical severity of mandibular dysfunction. Some signs and symptoms had a clearly direct relationship whereas other signs demonstrated a diminished direct relationship, no relationship, or an inverse relationship in advanced dysfunction stages. Further study is needed to determine if there exists an exact relationship of some clinical signs to mandibular dysfunction.

Maximum mandibular opening in patients with and without a history of TMJ dysfunction

It was shown that there was no direct connection between maximum jaw opening and a history of TMJ symptoms (Fig. 7). An accurate diagnosis requires the evaluation of a wide range of signs and symptoms through both a history and a clinical examination.

The incidence of some occlusal habits and headaches/neckaches in an initial survey population

Abstract Some initial data obtained from a routine occlusal and temporomandibular joint examination in a limited study population have been evaluated to determine the incidence of headaches and neckaches, various habits of occlusal dysfunction, and their interrelationships. A further in-depth study of these and other parameters is indicated and anticipated.

Comparison of the multiphasic dysfunction profile with lateral transcranial radiographs

Lateral transcranial radiographs of 926 patients were analyzed for condylar position, TMJ space, and obvious condylar morphologic changes. Differences in condylar position and joint space variations were noted between men and women. An increase in nonconcentric condylar position, joint space variations, and condylar morphologic changes were found with advancing age. There was a significant correlation of condylar position, joint space variations, and condylar morphology with mandibular dysfunction profile scores. Mandibular dysfunction is manifested by a wide range of signs and symptoms, none of which is always present with the disorder. Although TRs are limited in their total diagnostic value, their use in discerning major TMJ changes serves as an important adjunct in the examination and diagnosis of mandibular dysfunction.

The prevalence and magnitude of mandibular displacement in a survey population

The prevalence and magnitude of mandibular displacement from RCP to IP in a principally adult sample was evaluated. The findings and their possible clinical significance were discussed.

Possible premature degenerative temporomandibular joint disease in violinists.

On occasion, there is danger of TMJ injury from holding the violin in a playing position for long periods of time. A study of a patient with premature degenerative TMJ disease emphasizes the value of a routine occlusal and TMJ examination.

Development of a simplified system for clinical evaluation of occlusal interrelationships. Part I. Acquisition of information.

The development of a standardized method of collecting data from a questionnaire and a simplified, yet relatively complete, occlusal and temporomandibular examination form has been described. The questionnaire and clinical examination form have evolved from earlier forms developed by the author1 which have been used in numerous private offices and institutions for a period of five years. These earlier forms have now been augmented and modified as a result of personal consultation with users of earlier forms and numerous clinical and academic authorites.2-27 The selection of information to be obtained through the use of the questionnaire and clinical examination forms was further influenced by the work of numerous authors.28-63 Part II of this report deals with (1) the development of a companion Data Processing Form and a method of transcribing to this form the data from the Patient Questionnaire and clinical examination forms, as well as (2) key-punch instructions consistent with data processing requirements.

Development of a simplified system for clinical evaluation of occlusal interrelationships. Part II. Storage of the information

The development of a simplified system for evaluation of occlusal interrelationships has been discussed in two parts. Part I concerned itself with data obtained from a Patient Questionnaire and through clinical examination. Part II has dealt primarily with the method of transcription of collected information and with data processing keypunch instructions. It is anticipated that this method of data collection will provide the vehicle for an ongoing, broad-base study of occlusal and temporomandibular joint/muscle interrelationships.