Covid-19 Pandemisi Sürecinde Maske Kullanımının Temporomandibular Eklem Disfonksiyonu Üzerine Etkisinin Değerlendirilmesi: Kesitsel Bir Çalışma

Öz

Amaç: Bu çalışmanın amacı Covid-19 pandemisi sürecinde maske kullanımının temporomandibular eklem disfonksiyonu üzerine etkisinin değerlendirilmesidir. Gereç ve Yöntemler: Çalışma 2020-2022 yılları arasında radyoloji ve ortodonti kliniğine başvuran diğer tedavileri için panoramik filmi çekilen 500 yetişkin hasta üzerinde yapıldı. Hastaların kullandıkları maskenin türü ve kullanım süresi ile maske kullanırken nefes almakta zorlanma, farkında olmadan ağzı açık tutma, diş sıkma, alt çeneyi öne getirme, eklem ve kulak ağrısı gibi durumlarının varlığı hazırlanan anketler yardımıyla sorgulandı. Klinik ve radyografik temporomandibular eklem muayenesi yapıldı. Bulgular: N95 vb. maskeleri kullanan katılımcılarda maske takılıyken dişlerini sıkanların, çene ekleminde ve kulaklarında ağrı hissedenlerinin oranları; bu maskeyi takmayanlara göre anlamlı düzeyde daha yüksek bulundu (p<0.05). Günlük ortalama maske kullanım süresi 5-8 saat olan katılımcılarda maske takarken nefes zorluğu çekenlerin oranı diğerlerine göre anlamlı düzeyde daha yüksekti (p<0.05). Maske takarken nadiren de olsa dişlerini sıkan ve farkında olmadan alt çenesini öne getirenlerin eklem muayenesinde veya radyografik muayenesinde patolojik bir bulguya rastlananların oranı, ilgili sorunları hiç yaşamayanlara göre anlamlı düzeyde daha yüksek bulundu (p<0.05). Sonuç: Maske takarken dişlerini sıkan, farkında olamadan alt çenesini öne getiren, çene ekleminde ağrı hisseden katılımcılarda ve uzun süre maske kullananlarda eklem muayenesinde veya radyografik incelemede patolojik bir bulguya rastlanma oranı yüksek bulundu. Bu konuda daha ileri çalışmalara ihtiyaç olduğu görüldü.

Anahtar Kelimeler

• COVID-19
• maske
• temporomandibular eklem

Evaluation of the Effect of Mask Use on Temporomandibular Joint Dysfunction During the Covid-19 Pandemic: A Cross-Sectional Study

Öz

Objective: The aim of this study is to evaluate the effect of mask use on temporomandibular joint dysfunction during the Covid-19 pandemic. Material and Methods: The study was conducted on 500 adult patients who applied to the radiology and orthodontics clinic between 2020-2022 and had panoramic films taken for their other treatments.The type of mask used by the patients and the duration of use, as well as the presence of conditions such as difficulty breathing while using the mask, keeping the mouth open without realizing it, clenching the teeth, bringing the lower jaw forward, joint pain and earache, were questioned with the help of prepared questionnaires. Clinical and radiographic temporomandibular joint examination was performed. Results: Among the participants who wore N95 and similar masks, the rates of those who clenched their teeth while wearing the mask and felt pain in the jaw joint and ears were significantly higher than those who did not wear this mask (p<0.05). The rate of those who had difficulty breathing while wearing a mask was significantly higher in participants whose average daily mask use time was 5-8 hours compared to others (p<0.05). Conclusion: Participants who clenched their teeth while wearing a mask, unconsciously brought their lower jaw forward, felt pain in the jaw joint, and those who wore masks for a long time were more likely to have a pathological finding in joint examination or radiographic examination. Further studies are needed in this regard.

Anahtar Kelimeler

• COVID-19
• mask
• temporomandibular joint

Kaynakça

1. 1. Yaltırık M, Palancıoğlu A, Koray M, Turgut CT. Temporomandibular eklem bozuklukları ve teşhisi. Yeditepe J Dent. 2017;13(2):43-50.
2. 2. Kavuncu V. Temporomandibular eklem disfonksiyon sendromu. Göksoy T, editör. Romatizmal hastalıkların tanı ve tedavisi. İstanbul: Yüce Basımevi; 2002. p. 791-802.
3. 3. Yalçın S, Aktaş İ. Diş hekimliğinde temporomandibular eklem hastalarına yaklaşım. 1. Baskı. İstanbul: Vestiyer Yayın Grubu; 2010. p. 9-60.
4. 4. Odabaş B, Arslan SG. Temporomandibular eklem anatomisi ve rahatsızlıkları. Dicle Med J. 2008;35(1), 77-85.
5. 5. Dworkin SF, Burgess JA. Orofacial pain of psychogenic origin: current concepts and classification. J Am Dent Assoc. 1987; 115: 565-71.
6. 6. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Eng J Med. 2008;359(25):2693-2705.
7. 7. Pereira FJ, Lundh H, Westesson PL. Morphologic changes in the temporomandibular joint in different age groups. An autopsy investigation. Oral Surg Oral Med Oral Pathol. 1994; 78: 279-287.
8. 8. Hashemipour MA, Moslemi F, Mirzadeh A, Mirzadeh A. Parafunctional habits and their relationship with temporomandibular joint disorders in Iranian school students. Meandros Med Dent J. 2018;19(3):247.

9. 9. Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: a cross-sectional survey. BMC Oral Health. 2015; 15: 8.
10. 10. Song YL, Yap AUJ. Orthognathic treatment of dentofacial disharmonies: its impact on temporomandibular disorders, quality of life, and psychosocial wellness. CRANIO®. 2017;35(1):52-57.
11. 11. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017; 39(5):529-39.
12. 12. Yalciner G, Babademez MA, Gul F, Serifler S, Bulut KS, Ozturk L. Consequences of FFP3 mask usage on venous blood gases. Ir J Med Sci. 2021; 18:1-5.
13. 13. Martyny J, Glazer CS, Newman LS. Respiratory protection. N Eng J Med. 2002; 347: 824-30.
14. 14. Using MRI and Jaw-Tracking Technologies–Mechanics, Cells Tissues Organs 2005; 180 (1): 54–68.
15. 15. Petrikowski CG. Diagnostic imaging of the temporomandibular joint. White SC, Pharoah MJ, 5th ed. Oral Radiology, Principles and İnterpretation. St Louis Missouri: Mosby; 2004: 538-576.
16. 16. Brooks SL, Brand JW, Gibbs SJ, Hollender L, Lurie AG, Omnell KA, et al. Imaging of the temporomandibular joint. A position paper of American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83 (5): 609-618.
17. 17. Helenius LM, Hallikainen D, Helenius I, Meurman JH, Könönen M, Leirisalo-Repo M, et al. Clinical and radiographic findings of the temporomandibular joint in patients with various rheumatic diseases: A case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99 (4): 455-63.
18. 18. Tvrdy P. Methods of imaging in the diagnosis of temporomandibular joint disorders. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007; 151 (1): 133-136.
19. 19. Dahlstrm L, Carlsson GE. Temporomandibular disorders and oral health-related quality of life. A systematic review. Acta Odontol Scand. 2010;68(2):80-85.
20. 20. Zhang Q Bin, Yuan SS, Deng KT, Li XY, Li Y, Wu AT, et al. Correlation of patients’ demographics and clinical symptoms with temporomandibular disorders. CRANIO®. 2023; 41(5): 432-439.
21. 21. Ferrando M, Andreu Y, José Galdón M, Durá E, Poveda R, Vincente Bagán J. Psychological variables and temporomandibular disorders: Distress, coping, and personality. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2004;98(2):153-160.
22. 22. Cuccia AM, Caradonna C, Caradonna D. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders. J Am Osteopath Assoc. 2011;111(02):102–112.
23. 23. Cairns BE. Nociceptors in the orofacial region (temporo-mandibular joint and masseter muscle). Encyclopedic reference of pain. Heidelberg, Germany: Springer-Verlag; 2006. p.14.
24. 24. Zuhour M, Ismayilzade M, Dadacı M, Ince B. The Impact of eearing a face mask during the COVID-19 pandemic on temporomandibular joint: A radiological and questionnaire Assessment. Indian J Plast Surg. 2022;55(1):58-65.
25. 25. Maruyama T, Kotani M, Ozaki H, Sumida N, Akanishi M, Kuroda T. A study on the condylar position of temporomandibular joint in the dysfunction of the stomatognathic system using tomography. J Osaka Univ Dent Sch. 1984;24:89–96.
26. 26. Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, et al. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018;45(11):837-844.
27. 27. Weijenberg RAF, Lobbezoo F. Chew the pain away: Oral habits to cope with pain and stress and to stimulate cognition. Biomed Res Int. 2015;2015:149431.
28. 28. Kataoka K, Ekuni D, Mizutani S, Tomofuji T, Azuma T, Yamane M, et al. Association between self-reported bruxism and malocclusion in university students: A cross-sectional study. J Epidemiol. 2015;25(6):423-430.
29. 29. Ekici Ö. Psychological profile and sleep quality of patients with temporomandibular joint dysfunction with or without bruxism. J Turkish Sleep Med. 2021;8(1):35-42.
30. 30. Manfredini D, Lobbezoo F. Relationship between bruxism and temporomandibular disorders: A systematic review of literature from 1998 to 2008. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;109(6):26-50.
31. 31. Michelotti A, Cioffi I, Festa P, Scala G, Farella M. Oral parafunctions as risk factors for diagnostic TMD subgroups. J Oral Rehabil. 2010;37(3):157-162.
32. 32. Çarikci S, Ateş Sari Y, Özcan EN, Baş SS, Tuz K, Ünlüer NÖ. An Investigation of temporomandibular pain, headache, and fatigue in relation with long-term mask use during the COVID-19 pandemic period. Cranio. 2022; 26:1-10.