Posturographic changes in university students with temporomandibular dysfunction

Abstract

Introduction: Temporomandibular dysfunction (TMD) is a problem which is increasing in general population. It is considered a multifactorial problem, which can become from biomechanical, neuromuscular, biopsychosocial or neurobiological factors. It is associated with risk of occlusion, parafunction, stress, trauma and hypermobility. The treatment of this pathology is based on teamwork, where Physiotherapy has a significant role (1). In recent years, the relationship between TMD and posturographic changes has been studied. Despite numerous studies have been published it is not clear yet if postural imbalances are etiological or perpetuating agents of TMD. Evidence from most of the studies shows that muscle and postural disorders are more frequent in patients with TMD and seem to be a correlation between the type of occlusion, the existence of signs and symptoms of dysfunction and postural imbalance (2). The general objective of this study was to observe if there is a relationship between the level of TMD and posturographic changes in college students aged between 18 and 30 years old.

Materials and Methods: Sixty students were assigned into two groups. Group 1 (n = 25) who presented moderate or severe TMD dysfunctions and group 2 (n = 25) who had no symptoms of TMD. All subjects completed a sample characterization questionnaire and the Fonseca Questionnaire to identify the prevalence of symptoms and severity of TMD. The selected subjects were submitted to four tests to measure the center of gravity position on several static and dynamic positions, on bilateral and unilateral podal stance with their eyes open and closed. This study followed all the principles of the Declaration of Helsinki.

Results: A total of 63 variables were studied. Of these, only 5 obtained significant differences between the group with TMD and the group without. The percentage of anteroposterior oscillation amplitude, the anteroposterior distance in the left unipodal with closed eyes, the anteroposterior oscillation amplitude in left unipedal with closed eyes, the left unipedal oscillation area with closed eyes and the percentage of oscillation velocity in the left unipedal with eyes, were the variables that obtained a p <0.05.

Discussion and Conclusion: The most common way to study postural control is to observe body behavior (especially the oscillation) during any task. The observation can be both qualitative and quantitative, with the aid of measuring instruments. Based on our results and according to the existing literature (3), we conclude that there is no relationship between the moderate and severe TMD variables and the changes in the center of pressure. The relationship between moderate and severe TMD with changes in the center of pressure is an approach that is poorly studied and developed.