Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study
Abstract
:1. Introduction
1.1. The Current Knowledge on Occlusal Therapy
1.2. Assessment of Jaw Function
1.3. Study Objectives
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Jaw Movement Analyses
- An electrognathography test (J-T 3D; BioResearch Associates Inc., Brown Deer, WI, USA) to assess range of motion.
- Surface electromyography (BioEMG III, BioResearch Associates Inc., Brown Deer, WI, USA) to record masticatory muscle activity during mouth opening and closing.
2.3. Data Processing
2.4. Statistical Analyses
3. Results
4. Discussion
4.1. Awareness of Jaw Clicking
4.2. Mental Health and Jaw Clicking
4.3. Medical Conditions and Jaw Clicking
4.4. Influence of Tooth Extraction on Jaw Clicking
4.5. The Relation of Jaw Clicking to Occlusal Therapy
4.6. Sociodemographic Factors and Jaw Clicking
4.7. Study Limitations
- Data heterogeneity: Despite the good fit of the model, cross-validation and odds ratio analyses were considered inappropriate due to the small sample size and variations within the dataset, resulting in large confidence intervals. A cause-and-effect relationship model was not designed based on a time sequence because the exact time of clicking commencement could not be established from history alone. Furthermore, the precise reasons why participants underwent orthodontic treatment could not be verified as participant histories were reliant on self-report and details of the dental treatment practices were not recorded to preserve privacy and avoid biased claims. Therefore, the historical term “occlusal therapy” was used instead, as it encompasses various aspects of dentistry, primarily orthodontic treatment, but can also include prosthetic rehabilitation, paediatric prophylactic extractions, and surgical management [1].
- A lack of imaging data: The study did not involve computed tomography as input data to observe anatomical changes or magnetic resonance imaging for diagnosing disc displacement during opening or closing, and thus, confirmatory diagnoses was not made for any of the participants. The focus was instead directed towards evaluating the joint complex function. Points of maximum vibration during mouth opening were recorded. Data augmentation was not performed to stay true to the current demographic distribution and should be a topic of future deep learning applications [41].
- A lack of longitudinal data: The study did not facilitate a pre- and post-comparison of jaw movement and joint function following dental or specialist treatment, instead opting for a randomised cross-sectional approach. Future longitudinal studies, incorporating investigative imaging and assessments of orthodontic treatment needs, could be designed to evaluate the true impact of orthodontic correction across various clinical classifications of malocclusion. An additional investigation will be carried out to quantify occlusal parameters such as arch perimeters, overjet, and overbite, which were beyond the scope of the current investigation and warranted a separate study.
5. Conclusions
- Predictors such as the number of third molars extracted, history of vitamin D deficiency, and self-reported mental health disorders were associated with incidences of jaw clicking.
- A positive history of parafunctional clenching and the choice of dental prostheses showed noteworthy associations with the likelihood of experiencing jaw clicking, with removable appliances demonstrating lower associations and warrants further investigation.
- Wearing retainers for longer periods may reduce the likelihood of jaw clicking.
- The current study is limited in its capacity to determine whether occlusal therapy is ineffective in addressing jaw clicking or if it contributes to the condition. The small sample size would diminish confidence in the concluding statement. This aspect cannot be ascertained within the current study design and requires further investigation in future longitudinal research with larger population data to instil greater confidence.
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Australian and European Caucasian | East Asian | South Asian and Middle Eastern | South American | |
---|---|---|---|---|
Male | 11 | 6 | 5 | 1 |
Female | 25 | 15 | 7 | 0 |
Medication | Reporting Frequency |
---|---|
Vitamin D supplements | 15 participants |
Estrogen supplement | 4 participants |
Progesterone supplement | 4 participants |
Bronchodilators | 4 participants |
Selective serotonin reuptake inhibitors | 3 participants |
Thyroxine supplements | 2 participants |
Amphetamines | 2 participants |
Medical marijuana, Aromatase inhibitor, clonidine, doxycycline, sodium valproate, budesonide, empagliflozin, acetalopram, hexamethylenetetramine, fenofibrate, tamoxifen, carbamazepine, metformin, methyphenidate, candesartan, statin, caberlogine, sumatriptan, ondansetron | 1 participant |
Variables | Estimate | Standard Error | z-Value | p-Value |
---|---|---|---|---|
a Demographic origin | ||||
1. East Asian | −0.865 | 1.374 | −0.630 | 0.529 |
2. South Asian and Middle Eastern | 2.12 | 1.657 | 1.279 | 0.201 |
Age | −0.0336 | 0.0434 | −0.774 | 0.439 |
Gender | 0.996 | 1.224 | 0.814 | 0.416 |
Height (cm) | −0.0686 | 0.0720 | −0.953 | 0.341 |
Weight (kg) | 0.00155 | 0.0544 | 0.028 | 0.977 |
Medical history | ||||
1. History of mental health disorder | 3.720 | 1.800 | 2.066 | 0.039 * |
2. History of Vitamin D deficiency | −3.047 | 1.444 | −2.111 | 0.034 * |
3. History of endocrine system disorder | 0.107 | 1.220 | 0.088 | 0.930 |
4. History of Inflammatory joint or skin disorder | 0.275 | 2.491 | 0.110 | 0.912 |
5. Impact of long-term medication use | −1.463 | 1.273 | −1.149 | 0.251 |
6. History of asthma | −0.709 | 2.197 | −0.323 | 0.747 |
7. Average alcohol consumption (standard drinks per week) | −0.268 | 0.327 | −0.819 | 0.413 |
Dental history | ||||
History of jaw pain in last 2 years | −0.555 | 0.933 | −0.595 | 0.552 |
History of jaw injury | 1.222 | 1.458 | 0.839 | 0.402 |
History of jaw clenching | 0.851 | 1.334 | 0.638 | 0.524 |
History of bruxism | −0.116 | 0.984 | −0.118 | 0.906 |
History of snoring or sleep apnoea | 1.125 | 1.017 | 1.106 | 0.269 |
History of nail or object biting | 1.255 | 1.097 | 1.144 | 0.253 |
History of dental filling in the last 2 years | 1.593 | 1.099 | 1.450 | 0.147 |
History of endodontic treatment with or without prosthetic rehabilitation | 1.056 | 1.673 | 0.631 | 0.528 |
Number of 3rd molars extracted | 0.615 | 0.308 | 1.996 | 0.046 * |
History of orthodontic treatment | 2.220 | 1.158 | 1.917 | 0.055 |
History of surgery in the head and neck | 2.217 | 1.473 | 1.505 | 0.132 |
History of persistently blocked nasal airways | 1.976 | 1.276 | 1.549 | 0.121 |
R2 = 0.414, overall p-value = 0.048 * |
Variables | Estimate | Standard Error | Z Value | p Value |
---|---|---|---|---|
Body mass index (BMI) | −0.0333 | 0.4291 | −0.078 | 0.938 |
Maximum mouth opening | −0.4517 | 0.3615 | −1.250 | 0.211 |
TMJ vibration integral differences | 0.0502 | 0.0407 | 1.233 | 0.218 |
Normalised temporalis muscle activity | −102.74 | 76.635 | −1.341 | 0.180 |
Normalised masseter muscle activity | 327.59 | 306.65 | 1.068 | 0.285 |
Normalised digastric muscle activity | −239.55 | 296.39 | −0.808 | 0.419 |
Pre-treatment premolar extraction | −1.8563 | 11.6164 | −0.160 | 0.873 |
Removable retainers prescribed following treatment compared to fixed retainers | −9.2849 | 6.0161 | −1.543 | 0.123 |
Duration of time when retainers and prostheses were worn post-treatment | ||||
1. One to two years | 1.8841 | 2.4980 | 0.754 | 0.451 |
2. Two to four years | 6.5566 | 5.1486 | 1.273 | 0.203 |
3. More than four years | −0.7861 | 2.9978 | −0.262 | 0.793 |
Positive history of Jaw clenching | 9.4779 | 5.7984 | 1.635 | 0.102 |
Positive history of Bruxism | −0.1964 | 2.0019 | −0.098 | 0.922 |
R2 = 0.59, Overall p-value = 0.027 * |
Maximum mouth opening (mm) a | |||
Mean ± SD | t-stat | p-value | |
No treatment | 48.91 ± 6.66 | −0.439 | 0.662 |
Occlusal Therapy | 48.13 ± 7.59 | ||
Joint vibration integral difference b | |||
Median (IQR) | Z value | p-value | |
No treatment | −1.25 (7.18) | −1.033 | 0.302 |
Occlusal Therapy | 1.20 (11.65) | ||
Joint vibration frequency (Hz) difference b | |||
Median (IQR) | Z value | p-value | |
No treatment | −0.10 (0.65) | −0.495 | 0.621 |
Occlusal Therapy | −0.20 (1.27) | ||
Normalised Temporalis muscle activity b | |||
Median (IQR) | Z value | p-value | |
No treatment | 0.14 (0.07) | −1.884 | 0.06 |
Occlusal Therapy | 0.12 (0.05) | ||
Normalised Masseter muscle activity a | |||
Mean ± SD | t-stat | p-value | |
No treatment | 0.11 ±0.04 | −1.537 | 0.13 |
Occlusal Therapy | 0.13 ±0.05 | ||
Normalised Digastric muscle activity b | |||
Median (IQR) | Z value | p-value | |
No treatment | 0.11 (0.06) | −1.471 | 0.14 |
Occlusal Therapy | 0.10 (0.05) |
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Farook, T.H.; Ramees, L.; Dudley, J. Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study. Oral 2024, 4, 217-230. https://doi.org/10.3390/oral4020018
Farook TH, Ramees L, Dudley J. Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study. Oral. 2024; 4(2):217-230. https://doi.org/10.3390/oral4020018
Chicago/Turabian StyleFarook, Taseef Hasan, Lameesa Ramees, and James Dudley. 2024. "Variables Associated with Jaw Clicking in a South Australian Population: A Cross-Sectional Study" Oral 4, no. 2: 217-230. https://doi.org/10.3390/oral4020018