Temporomandibular joint internal derangement: association with headache, joint effusion, bruxism, and joint pain

André L F Costa, Anelyssa D'Abreu, Fernando Cendes
Journal of Contemporary Dental Practice 2008 September 1, 9 (6): 9-16

AIM: The aim of the present study was to assess the correlation of temporomandibular joint internal derangement (TMJ ID) in patients with the presence of headache, bruxism, and joint pain using magnetic resonance imaging (MRI).

METHODS AND MATERIALS: This study evaluated 42 joints in 42 patients; 21 patients diagnosed with unilateral TMJ ID and a history of headaches and 21 patients diagnosed with unilateral TMD ID without a history of headaches. Signs of headache, bruxism, and joint pain were diagnosed clinically and were also obtained from the patient's history. Sixteen joints in 16 patients without signs or symptoms of TMD or headache were included as a control group. All patients underwent bilateral MRI of the TMJ to evaluate the disc position and the presence of joint effusion. Data were analyzed using Chi-square and Fischer's exact tests.

RESULTS: Bruxing behavior was most frequently reported by patients with headaches (p<0.0125). Eighty-five percent of subjects with headaches also reported joint pain. A significant association was found between headache and TMJ effusion (p<0.0125). Patients with more severe disc displacement also had a higher frequency of effusion (p=0.001).

CONCLUSION: The results suggest joint effusion may have a role in the pathogenesis of headache in TMJ ID.

CLINICAL SIGNIFICANCE: Temporomandibular joint effusion on MRI may serve as a biological marker of headache associated with TMD and could be helpful for diagnostic classification and treatment follow up.

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