Altered MAstication Contribute to TMJ PAin (MAPA)

One Habitual Chewing Side May Contribute to Chronic Temporomandibular Joint Disorder Pain

The cause of temporomandibular joint disorders remains unknown. It is considered multifactorial and includes physical (peripheral) and psychosocial (central) factors. It has been showed an association: a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side. This finding argues the possibility of causation of some of these characteristics. This double blind longitudinal study aims to assess if the presence of one habitual chewing side could contribute to temporomandibular joint disorders over time.

Method. Young adults with no signs or symptoms of TMD will be assessed. Participants with one chewing side (observed and interview); with steeper condylar path and lower lateral guidance angles will be considered consistent one side chewers, and this side will be considered more susceptible to suffer TMD. Mouth opening, hemispheric dominance and hemimandibular retrognathia will be considered as secondary pre-specified outcomes. Four years later, both TMJs of each participant presenting signs and/or symptoms will be evaluated according to DC/TMD.

Study Overview

• Status: Completed
• Conditions: Temporomandibular Joint Disorders; Mastication Disorder
• Intervention / Treatment: Other: Diagnostic

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• Spain
  • A Coruña
    • Santiago de Compostela, A Coruña, Spain, 15702
      • University of Santiago de Compostela

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Medical or Dental School students. Healthy young adults with fully dentate normal occlusion

Description

Inclusion Criteria:

• healthies
• full dentates
• normal occlusion
• One habitual chewing side

Exclusion Criteria:

• Severe malocclusion, dental decay, severe periodontal disease.

Pains from other origins or Orthodontics are not criteria for exclusion

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Presence or not of symptoms of temporomandibular joint disorders according to DC/TMD	Pain-intensity (0-10 VAS scale, Von Korf)	At 3 years follow-up
Change of maximal unassited jaw opening	Maximum unassisted jaw opening or interincisal distance (from edge to edge) measured by a Boley gauge. Up 38 in females and up 40 mm in males are considered limited.	Baseline and 3 years follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of condylar paths angles inclination	Alteration of parasagittal plane Axiography of condyle motion in respect Frankfort horizontal plane	Baseline and 3-4-years follow-up (end of the study)
Alteration of lateral dental guidance angles	Angle between Frankfort plane and lateral dental anterior guidance	Baseline and 4-years follow-up (end of the study)
Change of maximal comfortable jaw opening	Maximum jaw opening or interincisal distance (from edge to edge) measured by a Boley gauge. Up 38 in females and up 40 mm in males are considered limited.	Baseline and 4-years follow-up (end of the study)
Change of the habitual chewing side	Determining the habitual chewing side by direct observation using chewing gum, First cicle, and subsequent cicles (7 or over of 10 cicles), interview (used one habitual chewing side?: 1, no, alternate; 2, yes, right; 3, yes, left; 4, I don't know) and kinesiography.	Baseline and 3-4-years follow-up (end of the study)
Change of lateral deviation during maximal unassisted jaw opening	Kiesiography K7	Baseline, 3 years follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hemimandibular retrognathia	Interincisal median midline and Angle Class on each side	Baseline
Hemispheric dominance, asuming oposite side to handedness preference	Edinburg inventory (Oldfield)	Baseline
Change of Life quality	SCL-90-R self-administered questionaire	Baseline, 3 years follow-up

Collaborators and Investigators

• Sponsor: University of Santiago de Compostela
• Investigators: Principal Investigator: Urbano Santana-Mora, PhD, University of Santiago de Compostela. Spain; Study Chair: Urbano Santana, Prof., University of Santiago de Compostela. Spain; Principal Investigator: Mª Jesús Mora, University of Santiago de Compostela. Spain

Publications and helpful links

General Publications

• Santana-Mora U, Lopez-Cedrun J, Mora MJ, Otero XL, Santana-Penin U. Temporomandibular disorders: the habitual chewing side syndrome. PLoS One. 2013 Apr 8;8(4):e59980. doi: 10.1371/journal.pone.0059980. Print 2013.

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2017
• Primary Completion (Actual): October 15, 2018
• Study Completion (Actual): October 30, 2018

Study Registration Dates

• First Submitted: May 10, 2016
• First Submitted That Met QC Criteria: May 1, 2017
• First Posted (Actual): May 4, 2017

Study Record Updates

• Last Update Posted (Actual): October 1, 2021
• Last Update Submitted That Met QC Criteria: September 30, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: pain; occlusion
• Additional Relevant MeSH Terms: Pathologic Processes; Musculoskeletal Diseases; Muscular Diseases; Stomatognathic Diseases; Jaw Diseases; Craniomandibular Disorders; Mandibular Diseases; Myofascial Pain Syndromes; Disease; Joint Diseases; Temporomandibular Joint Disorders; Temporomandibular Joint Dysfunction Syndrome
• Other Study ID Numbers: 20130123

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be shared in a on-line appendix linked from the article in a JCR Journal.