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Aims: To evaluate the effect of temporomandibular arthralgia on
mandibular mobility, chewing, and bite force. Methods: Twenty
female patients (ages 19 to 45 years) with unilateral temporomandibular
joint (TMJ) pain during chewing (49 ¡À 27 mm on a
100-mm visual analog scale) and provocation, as well as TMJ tenderness,
were studied. The TMJ conditions were classified as disc
derangement disorders (n = 9), osteoarthritis (n = 7), and inflammatory
disorders (n = 4). The patients were compared with
matched healthy volunteers without orofacial pain or tenderness.
Exclusion criteria were the presence of fewer than 24 teeth or malocclusion.
The methods used were (1) algometric assessment of the
pressure pain threshold (PPT) over the TMJ; (2) clinical recordings
of maximum jaw opening; (3) computerized kinematic assessment
of maximum vertical distance, velocity, and cycle duration during
chewing of soft gum; and (4) measurement of unilateral molar bite
force. Results: The mean (¡À SD) PPT in the patients¡¯ painful side
(69 ¡À 20 kPa; P = .000001) was significantly lower than in the
control subjects (107 ¡À 22 kPa). Jaw opening was also significantly
less (P = .00003) in the patients (42 ¡À 9 mm) than in the controls
(52 ¡À 4 mm). Chewing cycle duration and maximum closing velocity
were significantly different (P ¡Ü .03) in the patients (948 ¡À 185
milliseconds and 142 ¡À 46 mm/s, respectively) versus the controls
(765 ¡À 102 milliseconds and 173 ¡À 43 mm/s, respectively), and bite
force was significantly lower (P = .000003) in the patients (238 ¡À
99 N) than in the controls (394 ¡À 80 N). Both bite force and jaw
opening in patients were significantly correlated (P ¡Ü .02) with
PPT (r = 0.53 and 0.63, respectively). Conclusion: These systematic
findings supplement results from acute pain experiments and
confirm indications from unspecified patient groups that the clinical
presence of long-standing TMJ pain is associated with marked
functional impairment. This impairment might be a result of reflex
adaptation and long-term hypoactivity of the jaw muscles. J OROFAC
PAIN 2004;18:108¨C113.
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