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Informationen aus Orthodontie & Kieferorthopädie 2019; 51(01): 40-49
DOI: 10.1055/a-0830-1484
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© Georg Thieme Verlag KG Stuttgart · New York

Verbreitung und Ätiologie von kraniomandibulären Dysfunktionen (CMD) im Kindes- und Jugendalter

Prevalence and Etiology of Temporomandibular Disorders (TMD) In Childhood and Adolescence
Christian Hirsch
1   Poliklinik für Kinderzahnheilkunde und Primärprophylaxe, Universität Leipzig
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Publication History

Publication Date:
19 March 2019 (online)

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Zusammenfassung

Kinder und Jugendliche sind in der zahnärztlichen Sprechstunde als CMD‑Patienten kaum anzutreffen, obwohl die Symptome bereits in diesem Alter weitverbreitet sind. Das Erstauftreten von CMD besonders bei Mädchen während der Pubertät sowie die höhere Prävalenz bei Frauen während des Reproduktionsalters lassen die hormonellen Umstellungen während der Pubertät als ätiopathogenetisch bedeutsam erscheinen. Die Mechanismen sind noch nicht klar, es scheint aber ein Mangel an frei verfügbaren Sexualhormonen während der Pubertät ausschlaggebend zu sein. Hierbei könnte es sich um ein grundlegendes Muster für viele unklare Schmerzsymptome handeln, da damit klinische Beobachtungen erklärt werden können: der typische Alters- und Geschlechtsverlauf von CMD, die psychosoziale Charakteristik von CMD-Schmerzpatienten sowie die hohe Koinzidenz der verschiedenen Schmerzarten. Dagegen spielen morphologische Faktoren und deren Veränderungen, z. B. infolge kieferorthopädischer Behandlungen, in der Ätiologie von CMD während des Jugendalters kaum eine Rolle. Darüber hinaus gibt es Erkenntnisse über genetische Ursachen der CMD, ein Bereich, der ebenfalls Gegenstand aktueller Forschungen ist.

Abstract

Children and adolescents are rarely to be found as CMD patients in the dentist’s practice, even though the symptoms are already widespread at this age. The first appearance of CMD especially in girls during puberty as well as the higher prevalence in women during the reproductive age, indicate that the hormonal changes during puberty appear to be etiopathogenetically significant.

The mechanisms are not yet clear, but a lack of freely available sex hormones during puberty seems to be crucial. This may be a basic pattern for many unclear pain symptoms, as it can explain clinical observations: the typical age and sex history of CMD, the psychosocial characteristics of CMD pain patients, and the high coincidence of different types of pain. In contrast, morphological factors and their changes, e. g. as a result of orthodontic treatment, play hardly any role in the etiology of CMD during adolescence. In addition, there is evidence about the genetic causes of CMD, an area that is also the subject of current research.

Schlüsselwörter

kraniomandibuläre Dysfunktionen - Kiefergelenk

Key words

craniomandibular dysfunction - temporomandibular joint
 

  • Literatur

  • 1 Micheelis W, Reich E. Dritte Deutsche Mundgesundheitsstudie (DMS III). Köln: Deutscher Ärzte Verlag; 1999
    Google Scholar
  • 2 Al-Jundi MA, John MT, Setz JM. et al. Meta-analysis of treatment need for temporomandibular disorders in adult nonpatients. J Orofac Pain 2008; 22: 97-107
    PubMedGoogle Scholar
  • 3 Hirsch C, Sehrer G. TMD in Children and Adolescents. A Review of the current Literature. In: John M, Hirsch C, Reiber T. (eds.) Epidemiological Research on temporomandibular Disorders. Regensburg: Roderer; 2000
    Google Scholar
  • 4 Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29, 424 individuals aged 12–41 years. Spine 1998; 23: 228-234
    CrossrefPubMedGoogle Scholar
  • 5 List T, Wahlund K, Wenneberg B. et al. TMD in children and adolescents: prevalence of pain, gender differences, and perceived treatment need. J Orofac Pain 1999; 13: 9-20
    PubMedGoogle Scholar
  • 6 Hirsch C. Kraniomandibuläre Dysfunktionen bei Kindern und Jugendlichen [Habilitationsschrift]. Halle: Martin-Luther-Univ. Halle; 2003
    Google Scholar
  • 7 Huppertz HI. Gelenkschmerzen im Kindes- und Jugendalter. Monatsschr Kinderheilk 1998; 146: 5-11
    CrossrefPubMedGoogle Scholar
  • 8 Flato B, Aasland A, Vandvik IH. et al. Outcome and predictive factors in children with chronic idiopathic musculoskeletal pain. Clin Exp Rheumatol 1997; 15: 569-577
    PubMedGoogle Scholar
  • 9 Epping-Jordan JE, Wahlgren DR, Williams RA. et al. Transition to chronic pain in men with low back pain: predictive relationships among pain intensity, disability, and depressive symptoms. Health Psychol 1998; 17: 421-427
    CrossrefPubMedGoogle Scholar
  • 10 Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6: 301-355
    PubMedGoogle Scholar
  • 11 Epker J, Gatchel RJ. Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorder. Psychosom Med 2000; 62: 69-75
    CrossrefPubMedGoogle Scholar
  • 12 Nilsson IM, Drangsholt M, List T. Impact of temporomandibular disorder pain in adolescents: differences by age and gender. J Orofac Pain 2009; 23: 115-122
    PubMedGoogle Scholar
  • 13 Hanke BA, Motschall E, Turp JC. Association between orthopedic and dental findings: what level of evidence is available?. J Orofac Orthop 2007; 68: 91-107
    CrossrefPubMedGoogle Scholar
  • 14 Hirsch C, John MT, Stang A. Association between generalized joint hypermobility and signs and diagnoses of temporomandibular disorders. Eur J Oral Sci 2008; 116: 525-530
    CrossrefPubMedGoogle Scholar
  • 15 Dibbets JM, van der Weele LT. Signs and symptoms of temporomandibular disorder (TMD) and craniofacial form. Am J Orthod Dentofacial Orthop 1996; 110: 73-78
    CrossrefPubMedGoogle Scholar
  • 16 Onizawa K, Yoshida H. Longitudinal changes of symptoms of temporomandibular disorders in Japanese young adults. J Orofac Pain 1996; 10: 151-156
    PubMedGoogle Scholar
  • 17 LeResche L, Mancl LA, Drangsholt MT. et al. Predictors of onset of facial pain and temporomandibular disorders in early adolescence. Pain 2007; 129: 269-278
    CrossrefPubMedGoogle Scholar
  • 18 LeResche L, Mancl LA, Drangsholt MT. et al. Relationship of pain and symptoms to pubertal development in adolescents. Pain 2005; 118: 201-209
    CrossrefPubMedGoogle Scholar
  • 19 Greene CS, Laskin DM. Temporomandibular disorders: moving from a dentally based to a medically based model. J Dent Res 2000; 79: 1736-1739
    PubMedGoogle Scholar
  • 20 Hirsch C, John M. Prävalenz kraniomandibulärer Dysfunktionen (CMD) bei Kindern und Jugendlichen. Teil 1: Schmerzbefunde. Dtsch Zahnärztl Z 2003; 58: 589-592
    PubMedGoogle Scholar
  • 21 Von Korff M, Dworkin SF, Le Resche L. et al. An epidemiologic comparison of pain complaints. Pain 1988; 32: 173-183
    CrossrefPubMedGoogle Scholar
  • 22 LeResche L, Mancl L, Sherman JJ. et al. Changes in temporomandibular pain and other symptoms across the menstrual cycle. Pain 2003; 106: 253-261
    CrossrefPubMedGoogle Scholar
  • 23 LeResche L, Sherman JJ, Huggins K. et al. Musculoskeletal orofacial pain and other signs and symptoms of temporomandibular disorders during pregnancy: a prospective study. J Orofac Pain 2005; 19: 193-201
    PubMedGoogle Scholar
  • 24 LeResche L, Saunders K, Von Korff MR. et al. Use of exogenous hormones and risk of temporomandibular disorder pain. Pain 1997; 69: 153-160
    CrossrefPubMedGoogle Scholar
  • 25 Fillingim R, Ness T. The Influence of menstrual Cycle and Sex Hormones on Pain Response in Humans. In Fillingim R. (ed.) Sex, Gender, and Pain. Seattle: IASP; 2000: 191-207
    Google Scholar
  • 26 Cairns BE, Gazerani P. Sex-related differences in pain. Maturitas 2009; 63: 292-296
    CrossrefPubMedGoogle Scholar
  • 27 Wang J, Chao Y, Wan Q. et al. The possible role of estrogen in the incidence of temporomandibular disorders. Med Hypotheses 2008; 71: 564-567
    CrossrefPubMedGoogle Scholar
  • 28 Kröner-Herwig B, Vath N. Menarche in girls and headache – a longitudinal analysis. Headache 2009; 49: 860-867
    CrossrefPubMedGoogle Scholar
  • 29 Deng YM, Fu MK, Hagg U. Prevalence of temporomandibular joint dysfunction (TMJD) in Chinese children and adolescents. A crosssectional epidemiological study. Eur J Orthod 1995; 17: 305-309
    CrossrefPubMedGoogle Scholar
  • 30 Luther F, Layton S, McDonald F. Orthodontics for treating temporomandibular joint (TMJ) disorders. Cochrane Database Syst Rev 2010; 7: CD006541
    PubMedGoogle Scholar
  • 31 Godoy F, Rosenblatt A, Godoy-Bezerra J. Temporomandibular disorders and associated factors in Brazilian teenagers: a cross-sectional study. Int J Prosthodont 2007; 20: 599-604
    PubMedGoogle Scholar
  • 32 Mao Y, Duan XH. Attitude of Chinese orthodontists towards the relationship between orthodontic treatment and temporomandibular disorders. Int Dent J 2001; 51: 277-281
    CrossrefPubMedGoogle Scholar
  • 33 Hirsch C. No increased risk of temporomandibular disorders and bruxism in children and adolescents during orthodontic therapy. J Orofac Orthopedics 2009; 70: 39-50
    PubMedGoogle Scholar
  • 34 Glaros AG, Tabacchi KN, Glass EG. Effect of parafunctional clenching on TMD pain. J Orofac Pain 1998; 12: 145-152
    PubMedGoogle Scholar
  • 35 Hirsch C, John MT, Lobbezoo F. et al. Incisal tooth wear and selfreported TMD pain in children and adolescents. Int J Prosthodont 2004; 17: 205-210
    PubMedGoogle Scholar
  • 36 Pahkala R, Laine T, Narhi M. et al. Relationship between craniomandibular dysfunction and pattern of speech sound production in a series of first-graders. Eur J Orthod 1991; 13: 378-385
    CrossrefPubMedGoogle Scholar
  • 37 Pullinger AG, Seligman DA. Trauma history in diagnostic groups of temporomandibular disorders. Oral Surg Oral Med Oral Pathol 1991; 71: 529-534
    CrossrefPubMedGoogle Scholar
  • 38 Plesh O, Gansky SA, Curtis DA. et al. The relationship between chronic facial pain and a history of trauma and surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 16-21
    CrossrefPubMedGoogle Scholar
  • 39 Wu N, Hirsch C. Temporomandibular disorders in German and Chinese adolescents. J Orofac Orthop 2010; 71: 187-198
    CrossrefPubMedGoogle Scholar
  • 40 Slade GD, Fillingim RB, Sanders AE. et al. Summary of findings from the OPPERA prospective cohort study of incidence of firstonset temporomandibular disorder: implications and future directions. J Pain 2013; 14 (Suppl. 12) T116-T124
    CrossrefPubMedGoogle Scholar