Pain syndrome in adolescents and young adults with temporomandibular disorders

Abstract

Introduction: Temporomandibular disorders (TMD) are a global public health problem affecting between 5-12% of the population, determined that the age peak with the highest incidence is among young people (up to 35 years), and with the advancement in age it decreases. In recent decades, special attention has also been paid to investigating the manifestation of temporomandibular disorders among adolescents, attesting to an increasing trend in prevalence in this age group. In the specialized literature, the peculiarities of the clinical expression of these conditions and the association with the sex of patients are not fully elucidated, especially regarding the cardinal symptoms related to the pain syndrome associated with TMD. The purpose of the study: to determine the peculiarities of the manifestation of pain syndrome in young people (adolescents, young adults) with temporomandibular disorders. Material and methods: Between 2022-2023, 37 young patients with temporomandibular disorders (mixed clinical form – myogenous-arthrogenous TMD) – 19 adolescents (10 girls, 9 boys) and 18 young adults (14 women, 4 men), who were referred to the university clinical bases of the departments of therapeutic dentistry and pediatric OMF and pedodontics “Ion Lupan”. The diagnosis of temporomandibular disorder was predetermined by applying the diagnostic criteria from the DC/TMD protocol. The clinical instrumental investigations were based on the evaluation of the number of pain-positive stomatognathic sites during the clinical examination and the investigation of the pain sensitivity thresholds (PPT) at the level of the masseter muscles and TMJ by means of the Wagner FDIX algometer (USA). Results: In the analyzed sample, a different gender distribution was determined in the 2 age groups – in teenagers, the proportions being approximately equal between girls and boys, while in young adults (18-29 years) a predominance of the female sex, with statistical significance (Chi2 = 5.65, p = 0.0174). The average number of algic positive sites in adolescents was 13.72±3.1, and in young adults 10.34±1.21, in adolescents a tendency to more frequent painful masticatory muscles was observed, the number of affected sites decreasing with age. Also, the average sensitivity thresholds were lower in female adolescents and young adults compared to males, both at the level of masseter muscles (0.64±0.12 vs. 0.89±0.7) and TMJ (0.34±0.2 vs. 0.43± 0.4). Conclusion: In young people (adolescents, young adults), an expression of the pain syndrome associated with temporomandibular disorders is attested to be more extensive (especially larger number of affected muscle sites) as well as in intensity (lower sensitivity thresholds), in especially with tendencies of more pronounced manifestation in female persons.