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Temporomandibular disorders in adults with repaired cleft lip and palate: a comparison with controls
Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
Östergötlands Läns Landsting.
Linköping University, Department of Neuroscience and Locomotion, Dental Surgery. Linköping University, Faculty of Health Sciences.
Department of Oral Medicine and Psychiatry and Behavioural Sciences, School of Dentistry and Medicine, University of Washington, Seattle, USA .
2001 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 23, no 2, 193-204 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to investigate the prevalence of temporomandibular disorders (TMD), and assess psycho‐social distress in adult subjects with repaired complete cleft lip and palate (CLP). Sixty‐three adults (42 males and 21 females, mean age 24.2 years, range 19.5–29.2) with repaired CLP (CLP group) were compared with a group of 66 adults without cleft (non‐cleft group, 49 males and 17 females, mean age 25.5 years, range 20.2–29.9). All subjects underwent a clinical TMD examination, which followed the guidelines in the Research Diagnostic Criteria for TMD (RDC/TMD). Jaw function was assessed by evaluating answers to the mandibular function impairment questionnaire (MFIQ).

Tension‐type headache was diagnosed according to the International Headache Society (IHS) classification. Psychological status was assessed using the depression score and the non‐specific physical symptom score with subscales of the Revised Symptom Checklist‐90 (SCL‐90‐R).

The prevalence of reported pain in the face, jaws and/or TMJs was 14 and 9 per cent for the CLP and non‐cleft group, respectively, and did not differ significantly between the groups. The CLP group exhibited a significantly reduced jaw‐opening pattern (P < 0.001) and a higher frequency of crossbites (P < 0.05) compared with the non‐cleft group. Whilst jaw function was similar in both groups, a few items, e.g. speech and drinking, were significantly more impaired (P < 0.01) in the CLP group than in the non‐cleft group. There were no significant differences between the two groups concerning tension‐type headache or psycho‐social distress.

The study found that overall TMD pain or psycho‐social distress was not more common in this CLP group than in a non‐cleft group.

Place, publisher, year, edition, pages
2001. Vol. 23, no 2, 193-204 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27873DOI: 10.1093/ejo/23.2.193Local ID: 12633OAI: oai:DiVA.org:liu-27873DiVA: diva2:248425
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Adult patients with treated complete cleft lip and palate: Methodological and clinical stndies
Open this publication in new window or tab >>Adult patients with treated complete cleft lip and palate: Methodological and clinical stndies
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of the present thesis was to investigate the quality of life, satisfaction with treatment, prevalence of temporomandibular disorders, psychosocial distress, and occlusal stability in a treated group of adults with complete cleft lip and palate (CLP).

Sixty-eight adults ( 44 men and 24 women) with a mean age of 24.2 years (range 19.5-29.2) with treated CLP were compared with a gender- and agematched group with no clefts. The CLP subjects were born between 1968 and 1977 and had undergone standardised plastic surgery at the Department of Plastic Surgery, University Hospital, Linköping, Sweden. Logopaedic, phoniatric, otological, and orthodontic examinations and treatment had been provided locally, supervised by the Cleft Palate Team.

The subjects answered a multidimensional, self-report, standardised questionnaire regarding psychological and somatic conditions. The subjects underwent a clinical TMD examination and an evaluation of the occlusion. The reliability of the multidimensional questionnaire was analysed for the CLP group by a test-retest study within a 2-3 week interval and most questions showed an overall good reliability. A panel of professionals judged the outcome of the surgical treatment on colour slides of the CLP subjects. The dental plaster casts of 39 subjects born with complete unilateral cleft lip and palate (UCLP) were analysed (mean age 24.7 years, range 20.2-29.3) and compared with the dental plaster casts taken at mean age of 19.1 years (range 16.0-20.6).

The overall level of quality of life was rather high in both groups. The CLP group rated some detached aspects, such as life meaning, family life, and private economy, significantly lower than did the group without clefts. Overall aspects such as well-being and social life were affected by having a treated cleft but not the more practical and tangible aspects of their daily living.

There was an overall high level of satisfaction with all the different part of the body in both groups, but the CLP group reported significantly moredissatisfaction with their nose, lips, mouth, profile, and overall facial appearance than the group without clefts. The professionals and the subjects with CLP were generally not very satisfied with the results of surgical treatment. Thirty of the subjects with CLP (47%) wished to have more operations. The professional group recommended further operations in 38 of the subjects (59%) in particular, rhinoplasties.

The CLP group had significantly higher frequencies of cross-bite than the group without clefts, but no differences regarding TMD pain were found between the two groups. In the subjects with treated UCLP, there was a significant deterioration in the occlusal score and the maxillary arch dimensions between 19 and 25 years. This was irrespective of the type of retention. The persisting morphological mal occlusion with a low frequency of interferences has had no influence on TMD symptoms in the group of CLP patients studied.

The conclusion is that the CLP subjects in the present study seemed to be psycho-socially well adjusted to their disability. However, 47 per cent wished to have further surgical treatment. The persisting malocclusions did not provoke TMD symptoms.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2001. 57 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 666
Series
Swedish Dental Journal Supplement, ISSN 0348-6672 ; 145
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25690 (URN)10066 (Local ID)91-7219-959-8 (ISBN)10066 (Archive number)10066 (OAI)
Public defence
2001-04-20, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (Swedish)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-06Bibliographically approved

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Marcusson, AgnetaPaulin, Gunnar

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