Takım ve Bireysel Spor Yapan Sporcuların Temporomandibular Eklem Disfonksiyonunun Karşılaştırılması

Abstract

Temporomandibular bozukluklar (TMB), çiğneme kasları ve temporomandibular eklemlerde ağrı ve işlev bozukluğu ile karakterize edilen bir grup bozukluktur. Bu konuda sınırlı sayıda çalışma olmasına rağmen, eldeki veriler takım sporcularında TMB şikayetlerinin yaygın olduğunu göstermektedir. Bu çalışmada, takım ve bireysel spor yapan sporcuların TMD varlığının karşılaştırılması amaçlanmıştır. Bu çalışmada, kesitsel bir anket çalışması yapılmıştır. Araştırmaya farklı spor branşlarından 18-25 yaş arası 97 kadın, 241 erkek olmak üzere toplam 338 kişi katılmıştır. Katılımcılarda TMB varlığı, on soru içeren Fonseca Anamnestik İndeksi (FAI) kullanılarak değerlendirildi. Anketten alınan puana göre bireyler TMB'si olmayan, hafif, orta ve ağır TMB'si olan kişiler olarak sınıflandırıldı. Veriler istatistiksel olarak analiz edildi. Çalışma grubunun %28,69'u kadın, %71,31'i erkekti. Bireysel sporlarda ciddi TMB vakası görülmedi. Orta ve ağır vakalar kadınlarda %13,4 iken erkeklerde %7,8 idi. Takım sporları ile bireysel sporlar arasında TMB skorları açısından farklılık yoktu (p>0,05). Kadınlar ve erkekler arasında TMB puanları açısından anlamlı bir farklılık vardı. Kadınlarda TMB puanları erkeklere göre daha yüksekti (p=0,023). Stresli ve diş sıkma ya da çene ağrısı olanların TMB puanları daha yüksek bulundu (p=0,001). Gelir durumu ve diş fırçalama sıklığı ile TMB arasında farklılık yoktu. Bildiğimiz kadarıyla bu çalışma, spor branşları ile TMD ilişkisini değerlendiren ilk çalışmadır. Sonuçlarımız, bireysel ve takım sporcuları arasında TMD puanlarında fark olmadığını gösterdi. Bu sonuçlar, diğer risk faktörlerini belirlemek için ek araştırma ihtiyacını vurgulamaktadır.

Keywords

• Temporomandibular bozukluklar
• sporcu
• branş
• Fonseca Anamnestik İndeksi

Comparison of Temporomandibular Joint Dysfunction of Team and Individual Athletes

Abstract

Temporomandibular disorders (TMDs) are a group of disorders characterized by pain and dysfunction in the masticatory muscles and temporomandibular joints (TMJs). Although there are limited studies on this subject, available data show that TMD complaints are common in competitive athletes. In this study, it was aimed to compare the presence of TMD in team and individual sportsmen. In this study, a cross-sectional study was conducted. A total of 338 people, 97 women, and 241 men from different sports branches, who are between the ages of 18 and 25, participated in the study. The presence of TMD in participants was assessed using the Fonseca Anamnestic Index (FAI), which contains ten questions. According to the score obtained from the questionnaire, individuals were classified as having no TMD, mild, moderate, or severe TMD. The data was analyzed statistically. 28.69% of the study group was female and 71.31% was male. There were no severe TMD cases in individual sports. While moderate and severe cases were 13.4% in females, they were 7.8% in males. There was no difference in TMD scores between team sports and individual sports (p>0.05). There was a significant difference between females and males in terms of TMD scores. The TMD scores in females were higher than in males (p=0.023). TMD scores were found to be higher in those who were stressed and had clenching or jaw pain (p=0.001, p=0.001 respectively). There was no difference between income status, tooth brushing frequency, and TMD. As far as we know, this is the first study to evaluate the relationship between sports branches and TMD. Our results showed that there was no difference in TMD scores between individual and team athletes. These results highlight the need for additional research to identify other risk factors.

Keywords

• Temporomandibular disorders
• athlete
• branch
• Fonseca Anamnestic Index

References

1. Ahuja, V., Ranjan, V., Passi, D., & Jaiswal, R. (2018). Study of stress-induced temporomandibular disorders among dental students: An institutional study. Natl J Maxillofac Surg. 9(2), 147-154. DOI: 10.4103/njms.NJMS_20_18
2. Bahrani, F., Ghadiri, P., & Vojdani, M. (2012). Comparison of temporomandibular disorders in Iranian dental and nondental students. J Contemp Dent Pract. 13(2), 173-7. DOI: 10.5005/jp-journals-10024-1116
3. Basafa, M., & Shahabee, M. (2006). Prevalence of TMJ disorders among students and it relation to malocclusion. Iran J Otorhinolaryngol. 18, 53-59. Doi: 10.22034/ijo.2006.251261.
4. Berger, M., Szalewski, L., Bakalczuk, M., Bakalczuk, G., Bakalczuk, S., & Szkutnik, J. (2015). Association between estrogen levels and temporomandibular disorders: a systematic literature review. Prz Menopauzalny. 14(4), 260-270. DOI: 10.5114/pm.2015.56538
5. Berni, K.C., Dibai-Filho, A.V., & Rodrigues-Bigaton, D. (2015). Accuracy of the Fonseca anamnestic index in the identification of myogenous temporomandibular disorder in female community cases. J Bodyw Mov Ther. 19, 404-409. DOI: 10.1016/j.jbmt.2014.08.001
6. Bicaj, T., Shala, K., Krasniqi, T.P., Ahmedi, E., Dula, L., & Lila-Krasniqi, Z. (2017). Frequency of symptoms of temporomandibular disorders among prishtina dental students. Open Access Maced J Med Sci. 5(6), 781- 784. doi: 10.3889/oamjms.2017.165.
7. Chapman, P.J. (1989) Mouthguards and the role of sporting team dentists. Aust Dent J. 34(1), 36-43.
8. Cormie, P., Zopf, E.M., Zhang, X., & Schmitz, K.H. (2017). The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiol Vern. 39, 71-92. DOI: 10.1093/epirev/mxx007

9. Dervis, N.E. (2019). Prevalence of temporomandibular disorder in Turkish university students: A questionnaire study. Balkan J Dent Med. 23(2), 80-87. DOI: 10.2478/bjdm-2019-0015
10. Duplat, Y.S., & Achilles, M.N. (2018). Prevalência de sinais e sintomas para disfunção temporomandibular em lutadores de boxe. Rev Pesqui Fisioter. 8(2), 191-198. DOI:10.17267/2238-2704rpf.v8i2.1882
11. Emodi-Perlman, A., Eli, I., Smardz, J., Uziel, N., Wieckiewicz, G., Gilon, E., Grychowska, N., & Wieckiewicz, M. (2020). Temporomandibular disorders and bruxism outbreak as a possible factor of orofacial pain worsening during the covid-19 pandemic-concomitant research in two countries. J Clin Med. 2020; 9(10): 3250. DOI: 10.3390/jcm9103250
12. Freiwald H.C., Schwarzbach, N.P., & Wolowski, A. (2021). Effects of competitive sports on temporomandibular dysfunction: a literature review. Clin Oral Investig. 25(1), 55-65. DOI: 10.1007/s00784-020-03742-2
13. Gallagher, J., Ashley, P., Petrie, A., & Needleman, I. (2018). Oral health and performance impacts in elite and professional athletes. Community Dent Oral Epidemiol. 46(6), 563-568. DOI: 10.1111/cdoe.12392
14. Gas, S., Ekşi-Özsoy. H., & Cesur-Aydın, K. (2021). The association between sleep quality, depression, anxiety and stress levels, and temporomandibular joint disorders among Turkish dental students during the COVID- 19 pandemic. Cranio. 1-6. DOI: 10.1080/08869634.2021.1883364
15. Gauer, R.L., & Semidey, M.J. (2015). Diagnosis and treatment of temporomandibular disorders. Am. Fam. Physician. 91, 378-386.
16. Geneen, L.J., Moore, R.A., Clarke, C., Martin, D., Colvin, L.A., & Smith B.H. (2017). Physical activity and exercise for chronic pain in adults: an overview of cochrane reviews. Cochrane Database Syst Rev. 1, CD011279. DOI: 10.1002/14651858.CD011279.pub3
17. Gustafsson, H., Sagar, S.S., & Stenling, A. (2017). Fear of failure, psychological stress, and burnout among adolescent athletes competing in high level sport. Scand J Med Sci Sports. 27(12), 2091-2102. DOI: 10.1111/sms.12797
18. Karthik, R., Hafila, M.I.F., Saravanan, C., Vivek, N., Priyadarsini, P., Ashwath, B. (2017). Assessing prevalence of temporomandibular disorders among university students: A Questionnaire Study. J Int Soc Prev Community Dent. 7(1), 24-29. DOI: 10.4103/jispcd.JISPCD_146_17
19. Kaynak, B.A., Taş, S., & Salkın, Y. (2023). The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders. Cranio. 41(1), 78-83. DOI: 10.1080/08869634.2020.1812808
20. Kaynak, B.A., Tas, S., Unluer. N.O., Yasar, U., Erdoganoglu, Y. (2019). Üniversite öğrencilerinde temporomandibular eklem disfonksiyonu prevalansının araştırılması. H.Ü. Sağlık Bilimleri Fakültesi Dergisi. 6(3), 287-98. doi: 10.21020/husbfd.594937.
21. Lange, M., Ahlers, M.O., Ottl, P., Deutsche Gesellschaft für Funktionsdiagnostik und-therapie. https://www.dgfdt. de/de_DE/was-kann-ich-selbst-tun-1 (Accessed 01 April 2020).
22. LeResche, L. (1997). Epidemiology of temporomandibular disorders: Implications for the investigation of etiologic factors. Crit. Rev. Oral Biol. Med. 8, 291-305. doi: 10.1177/10454411970080030401.
23. Liu, F., & Steinkeler, A. (2013). Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent. Clin. N. Am. 57, 465-479. doi: 10.1016/j.cden.2013.04.006.
24. Lobbezoo, F., Ahlberg, J., Glaros, A.G., Kato, T., Koyano, K., Lavigne, G.J., de Leeuw, R., Manfredini, D., Svensson, P., & Winocur, E. (2013). Bruxism defined and graded: An international consensus. J. Oral Rehabil. 40, 2-4. doi: 10.1111/joor.12011.
25. Moon, H.J., Lee, Y.K., (2011). The relationship between dental occlusion/temporomandibular joint status and general body health: part 1. Dental occlusion and TMJ status exert an influence on general body health. J Altern Complement Med. 17(11), 995-1000. doi: 10.1089/acm.2010.0739.
26. Motta, L.J., Guedes, C.C., De Santis, T.O., Fernandes, K.P., Mesquita-Ferrari, R.A., & Bussadori, S.K. (2013). Association between parafunctional habits and signs and symptoms of temporomandibular dysfunction among adolescents. Oral Health Prev Dent. 11(1), 3-7. doi: 10.3290/j.ohpd.a29369.
27. Namvar, M.A., Afkari, B.F., Moslemkhani, C., Mansoori, K., & Dadashi, M. (2021). The Relationship between Depression and Anxiety with Temporomandibular Disorder Symptoms in Dental Students. Maedica (Bucur). 16(4), 590-594. DOI: 10.26574/maedica.2021.16.4.590
28. Ohlmann, B., Waldecker, M., Leckel, M., Bomicke, W., Behnisch, R., Rammelsberg, P., & Schmitter, M. (2020). Correlations between Sleep Bruxism and Temporomandibular Disorders. J Clin. Med. 9, 611. DOI: 10.3390/jcm9020611.
29. Ohrbach, R., Fillingim, R.B., Mulkey, F., Gonzalez, Y., Gordon, S., Gremillion, H., Lim, P.F., Ribeiro-Dasilva, M., Greenspan, J.D., Knott, C., Maixner, W., & Slade, G. (2011). Clinical findings and pain symptoms as potential risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain. 12(11), 27-45. doi: 10.1016/j.jpain.2011.09.001
30. Özdinç, S., Ata, H., Selçuk, H., Can, H.B., Sermenli, N., & Turan, F.N. (2020). Temporomandibular joint disorder determined by Fonseca anamnestic index and associated factors in 18 to 27 year old university students. Cranio. 38(5), 327-332. DOI: 10.1080/08869634.2018.1513442
31. Pastore, G.P., Goulart, D.R., Pastore, P.R., Prati, A.J., & de Moraes, M. (2018). Comparison of instruments used to select and classify patients with temporomandibular disorder. Acta Odontol Latinoam. 31, 16-22. PMID: 30056462
32. Paulino, M.R., Moreira, V.G., Lemos, G.A., da Silva, P.L., Bonon, P.R.F., & Batista, A.U.D. (2015). Prevalence of signs and symptoms of temporomandibular disorders in college preparatory students: associations with emotional factors, parafunctional habits, and impact on quality of life. Ciênc. saúde colet. 23(1), 173-186. doi: 10.1590/1413-81232018231
33. Reinhel, A.F., Scherma, A.P., Peralta, F.S., & Palma, I.C.R. (2015). Saúde bucal e performance física de atletas. ClipeOdonto. 7(1), 45-56.
34. Resende, C.M., Alves, A.C., Coelho, L.T., Alchieri, J.C., Roncalli, A.G., & Barbosa, G.A. (2013). Quality of life and general health in patients with temporomandibular disorders. Braz Oral Res. 27, 116-21. doi: 10.1590/s1806-83242013005000006.
35. Riffel, C.T.D., Flores, M.E., Scorsatto, J.T., Ceccon, L.V., De Conto, F., & Rovani, G. (2015). Association of temporomandibular dysfunction and stress in university students. Int. J. Odontostomat 9(2), 191-197. DOI:10.4067/S0718-381X2015000200003.
36. Rodrigues-Bigaton, D., de Castro, E.M., & Pires, P.F. (2017). Factor and Rasch analysis of the Fonseca anamnestic index for the diagnosis of myogenous temporomandibular disorder. Braz J Phys Ther. 21(2), 120-126. doi: 10.1016/j.bjpt.2017.03.007.
37. Sailors, M.E. (1996). Evaluation of sports-related temporomandibular dysfunctions. J Athl Train. 1996; 31(4): 346-50. PMID: 16558422. PMCID: PMC1318920
38. Santos, R.C.O., Padovan, Neto, J.B., Pinto, S.S., & Cyrillo, F.N. (2009). Comparison of the electromyographic activity of the right and left masseter muscles in softball athletes during sports hitting gesture. Revista Brasileira de Ciência e Movimento, 17(2).
39. Schmid-Schwap, M., Bristela, M., Kundi, M., Piehslinger, E. (2013). Sex-specific differences in patients with temporomandibular disorders. J Orofac Pain. 27(1), 42-50. doi: 10.11607/jop.970.
40. Spinas, E., Aresu. M., & Giannetti, L. (2014). Use of mouth guard in basketball: observational study of a group of teenagers with and without motivational reinforcement. Eur J Paediatr Dent. 15(4), 392-396. PMID: 25517587.
41. Trize, D.M., Calabria, M.P., Franzolin, S., Cunha, C.O., & Marta, S.N. (2018). Is quality of life affected by temporomandibular disorders? Einstein 16, eAO4339. doi: 10.31744/einstein_journal/2018AO4339
42. Wahid, A., Mian, F.I., Razzaq, A., et al. (2014). Prevalence and severity of temporomandibular disorders (Tmd) in undergraduate medical students using Fonseca’s Questionnaire. Pakistan Oral & Dental Journal, 34(1), 38-41.
43. Weiler, R.M., Vitalle, M.S., Mori, M., Kulik, M.A., Ide, L., Pardini, S.R., & Santos, F.M. (2010). Prevalence of signs and symptoms of temporomandibular dysfunction in male adolescent athletes and non-athletes. nt J Pediatr Otorhinolaryngol. 74(8), 896-900. doi: 10.1016/j.ijporl.2010.05.007
44. Winocur, E., Littner, D., Adams, I., & Gavish, A. (2006). Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescents: A gender comparison. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 ;102(4):482-87. doi: 10.1016/j.tripleo.2005.11.007
45. Yakşi, E., Demirel, A., Yaşar, M.F., Kılınç, S., & Balcı, M. (2023). The prevalence of temporomandibular disorders among medical students. Northwestern Med J. 3(1), 38-44. doi: 10.54307/NWMJ.2023.66376
46. Zamora-Olave, C., Willaert, E., Montero-Blesa, A., Riera-Punet, N., Martinez-Gomis, J. (2018). Risk of orofacial injuries and mouthguard use in water polo players. Dent Traumatol. 34(6), 406-412. doi: 10.1111/edt.12434.