ASSESSMENT OF TEMPOROMANDIBULAR DISORDER PREVALENCE AND SEVERITY IN RELATION TO OCCLUSAL CHARACTERISTICS AMONG DENTAL STUDENTS AT HAWLER MEDICAL UNIVERSITY

Maryam Fouad Bilal; Shaho Al-talabani; Shaheen Ali Ahmed

doi:10.46903/gjms/23.3.1875

ASSESSMENT OF TEMPOROMANDIBULAR DISORDER PREVALENCE AND SEVERITY IN RELATION TO OCCLUSAL CHARACTERISTICS AMONG DENTAL STUDENTS AT HAWLER MEDICAL UNIVERSITY

Maryam Fouad Bilal, Shaho Al-talabani, Shaheen Ali Ahmed

Abstract

Background: Temporomandibular joint disorder (TMD) encompasses various clinical conditions affecting the temporomandibular joint (TMJ), masticatory muscles, and teeth. This study aimed to evaluate the prevalence and severity of TMD among dentistry students and to examine the relationship between TMD and occlusal classification.

Material & Methods: A cross-sectional study was conducted at Hawler Medical University in 2024, (HMU) using Fonseca’s questionnaire, involving 215 students aged 17–25 years. Data collection included three parts: demographic information, a 10-item Fonseca Anamnestic Index (FAI) assessing TMD severity (no dysfunction, mild, moderate, or severe dysfunction), and clinical examinations evaluating occlusal classifications, anterior/posterior crossbite, scissor bite, and measurements of overjet and overbite.

Results: Over half of the participants were affected by TMD, with 43.3% experiencing mild dysfunction. Students aged 23–25 years demonstrated significantly higher rates of moderate and severe TMD (p < 0.032), with only 26.1% exhibiting no dysfunction. No significant associations were found between TMD severity and variables such as deep bite, open bite, crossbite, posterior crossbite, or scissor bite, irrespective of orthodontic treatment history.

Conclusion: TMD is prevalent among HMU dentistry students. While malocclusion is not a definitive cause of TMD, its role in the etiology cannot be dismissed entirely.

Keywords

Bite; Dentistry; Disorder; Dysfunction; Malocclusion; Occlusion; Pain; Teeth; Temporomandibular joint.

Full Text:

PDF

References

Maini K, Dua A. Temporomandibular Syndrome. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Anterpreet Dua declares no relevant financial relationships with ineligible companies.2025.

Gokdeniz ST, Kolsuz ME, Buyuksungur A, Ozturk Barut ZI. Temporomandibular Disorders: Current Diagnosis and Treatment Methods. In: Zorzi AR, editor. Osteotomy Essentials - From Basic Techniques to Advanced Practices. Rijeka: IntechOpen; 2024.

Machoň V, Beňo M. Orthognatic Surgery With Reconstruction of the Temporomandibular Joint. In: Kummoona RK, editor. Temporomandibular Joint - Surgical Reconstruction and Managements. Rijeka: IntechOpen; 2022.

Monika K, Reche A, Tagore S, MONIKA K. Exploring Temporomandibular Disorders (TMDs) and Occlusion Debate in Dentistry: Biting Into Controversy. Cureus. 2024;16(5): 1-9. https://doi.org/10.7759/cureus.61108.

Pascu L, Haiduc R-S, Almășan O, Leucuța D-C. Occlusion and Temporomandibular Disorders: A Scoping Review. Medicina. 2025;61(5): 791. https://doi.org/10.3390/medicina61050791.

Al-Ani Z. Occlusion and Temporomandibular Disorders: A Long-Standing Controversy in Dentistry. Primary Dental Journal. 2020;9(1): 43-8. https://doi.org/10.1177/2050168420911029.

Alrizqi AH, Aleissa BM. Prevalence of temporomandibular disorders between 2015-2021: a literature review. Cureus. 2023;15(4): 1-8. https://doi.org/10.7759/cureus.37028.

Mitro V, Caso AR, Sacchi F, Gilli M, Lombardo G, Monarchi G, et al. Fonseca’s Questionnaire Is a Useful Tool for Carrying Out the Initial Evaluation of Temporomandibular Disorders in Dental Students. Clinics and Practice. 2024;14(5): 1650-68. http://dx.doi.org/10.3390/clinpract14050132.

Yakşi E, Demirel A, Yaşar MF, Kılınç S, Balcı M. The prevalence of temporomandibular disorders among medical students. Northwestern Medical Journal. 2023;3(1): 38-44. https://doi.org/10.54307/NWMJ.2023.66376.

Rehman A, Raja I, Ahmed S, Azeem S, Iqbal S, Khan MI. Prevalence of Temporomandibular Disorders among Undergraduate Dental Students Using Fonseca Questionnaire. Liaquat National Journal of Primary Care. 2023;5(2): 87-91.

Emel DN. Prevalence of temporomandibular disorder in Turkish university students: A questionnaire study. Balkan Journal of Dental Medicine. 2019;23(2): 80-7.

Zieliński G, Pająk-Zielińska B, Ginszt M. A Meta-Analysis of the Global Prevalence of Temporomandibular Disorders. Journal of Clinical Medicine. 2024;13(5): 1365. https://doi.org/10.3390/jcm13051365.

Ângelo DF, Mota B, João RS, Sanz D, Cardoso HJ. Prevalence of clinical signs and symptoms of temporomandibular joint disorders registered in the EUROTMJ Database: A prospective study in a Portuguese Center. Journal of Clinical Medicine. 2023;12(10): 3553. https://doi.org/10.3390/jcm12103553.

Ashfaq-Ur-Rahim MN, Ali S, Ihsan S, Qayyum T, Kirmani U. Prevalence of Sign and Symptoms of Temporomandibular Joint Disorders in Pakistani Population at Sheikhupura, Lahore: A Gender comparison. Headache. 2021;7(20): 0.59. https://doi.org/10.53350/pjmhs211582166.

Lövgren A, Vallin S, Häggman-Henrikson B, Kapos FP, Peck CC, Visscher CM, et al. Women are worse off in developing and recovering from temporomandibular disorder symptoms. Scientific Reports. 2025;15(1): 4732. https://doi.org/10.1038/s41598-025-86502-0.

Paço M, Duarte JA, Pinho T. Orthodontic Treatment and Craniocervical Posture in Patients with Temporomandibular Disorders: An Observational Study. International Journal of Environmental Research and Public Health. 2021;18(6): 3295. https://doi.org/10.3390/ijerph18063295.

Jussila P, Laura K, Ritva N, Jari P, Raija L, Pertti P, et al. The role of occlusion in temporomandibular disorders (TMD) in the Northern Finland Birth Cohort (NFBC) 1966. CRANIO®. 2019;37(4): 231-7. https://doi.org/10.1080/08869634.2017.1414347.

Khayat N, Winocur E, Kedem R, Orit W-A, Zaghal A, Shpack N. The Prevalence of Temporomandibular Disorders and Dental Attrition Levels in Patients with Posterior Crossbite and/or Deep Bite: A Preliminary Prospective Study. Pain Research and Management. 2021;2021(1): 1-8. http://dx.doi.org/10.1155/2021/8827895.

Nguyen MS, Saag M, Jagomägi T, Nguyen QH, Voog-Oras Ü. The impact of occlusal support on temporomandibular disorders: a literature review. Proceedings of Singapore Healthcare. 2022;31: 20101058211023779. 10.1177/20101058211023779.

Macrì M, Murmura G, Scarano A, Festa F. Prevalence of temporomandibular disorders and its association with malocclusion in children: A transversal study. Frontiers in Public Health. 2022;10(1): 1. http://dx.doi.org/10.3389/fpubh.2022.860833.

Jain S, Chourse S, Jain D. Prevalence and Severity of Temporomandibular Disorders among the Orthodontic Patients Using Fonseca’s Questionnaire. Contemporary Clinical Dentistry. 2018;9(1): 31-4. http://dx.doi.org/10.4103/ccd.ccd_689_17.

Yap AU, Chen C, Wong HC, Yow M, Tan E. Temporomandibular disorders in prospective orthodontic patients:Their association with malocclusion severity and impact on oral health–related quality of life. The Angle Orthodontist. 2021;91(3): 377-83. http://dx.doi.org/10.2319/010720-863.1.

DOI: https://doi.org/10.46903/gjms/23.3.1875