Work

Predictive Value of Diagnostic Methods for TMJ Hypermobility in the Associated Clinical and Functional Features of Temporomandibular Disorders: A Regression Study

Year: 2025

Type: article

Abstract: BACKGROUND: Joint hypermobility (JH), particularly at the temporomandibular joint (TMJ), has been proposed as a potential risk factor for temporomandibular disorders (TMD). However, its heterogeneous diagnostic approaches (clinical, anamnestic and imaging) limit the identification of reliable predictors of masticatory dysfunction and TMD outcomes. OBJECTIVES: To determine which diagnostic methods for TMJ hypermobility best predict masticatory dysfunction and the clinical and functional repercussions of TMD. METHODS: This cross-sectional study included 126 adults recruited at the Bauru School of Dentistry. Participants were classified by Diagnostic Criteria for TMD (DC/TMD) into painful, dysfunction or combined groups, balanced by history of open-locking. Assessments comprised DC/TMD and ICOP examinations, symptom intensity on the visual analog scale (VAS), Beighton score, pressure pain thresholds, bite-force and fatigue tests, ultrasound of the TMJ capsule and masseter, CBCT-based condylar angle and validated measures of mandibular function and psychosocial factors. RESULTS: Bivariate analyses yielded associations, but multivariate models identified specific predictors. Open-locking independently predicted TMJ subluxation and higher joint instability. Increased condylar angle was associated with greater assisted opening and midline deviation. Unassisted opening predicted a larger condylar angle, greater pain-free opening and lateral condylar jump; assisted opening similarly predicted pain-free opening and lateral condylar jump. Lateral condylar jump independently predicted functional limitation in wide-opening tasks. CONCLUSION: Clinical, functional and imaging indicators of TMJ hypermobility capture distinct aspects of the condition. While open-locking, condylar angle and mouth-opening measures predict specific features, no single marker explains the full spectrum and TMJ hypermobility shows limited impact on overall TMD outcomes.

Source: Journal of Oral Rehabilitation

DOI: 10.1111/joor.70120

Authors: Samilla Pontes Braga, Dyanne Medina Flores, Maria Emilia Servin Berden, Ana Claudia de Castro Ferreira Conti, Ambrosina Michelotti, Paulo César Rodrigues Conti

Institutions: Universidade de São Paulo, University of Naples Federico II

Language: English

Topic: Temporomandibular Joint Disorders

Subfield: Complementary and Manual Therapy

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,990