TMJ derangements and osteoarthrosis subgroups differentiated according to active range of mandibular opening.
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Biomedical subjects
Publications and source records attributed to A G Pullinger.
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This article investigates the influence of occlusion on condylar position as seen on TMJ tomograms in a group of 44 young adults with no histories of orthodontic or occlusal therapy and no objective signs of masticatory dysfunction; the sample was screened from a population of 253 students. Nonconcentric condylar position at ICP was a feature of Class II malocclusion with significantly more anterior positions in Class II, Division 1 than in Class I. Condylar position was unrelated to the amount of sagittal RCP-ICP slide, although most slides were less than 0.5 mm. The frequency of lateral slides was low, but was mildly related to bilaterally asymmetric condylar positions. Position was unrelated to the degree of overbite, which ranged from 0 to 10 mm. Bilateral condylar position asymmetry was not related to the direction of dental midline discrepancy, which ranged from 0 to 2 mm. No open bites or mandibular overjets were seen in this asymptomatic normal sample.
According to linear interincisal measurements, women have a smaller maximum jaw opening than men. In this study the difference was 2.7%. In contrast, epidemiological surveys indicate that women have a greater mobility of joints and generally more joint laxity. Covariate analysis was used to test for the difference between sexes in mean maximum passive opening adjusted according to group mean differences in other parameters of body size. The net result was that the values became more equal between sexes. A second method, employing a geometric estimation for the angle of maximum jaw opening, showed that women had a 5.4% wider range of jaw opening than men (P less than 0.057). This method avoided the problem of considering relative body size and body factors which generally correlated poorly with maximum opening. It should be noted that an increased range of opening is a measure of hyperextensibility and does not necessarily imply laxity or instability.
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