Share This Article:

The associations of TMJ pain and bone characteristics on the activities of daily living

Abstract Full-Text HTML Download Download as PDF (Size:350KB) PP. 237-243
DOI: 10.4236/ojst.2012.24042    3,324 Downloads   5,403 Views   Citations


The aim of this investigation was to analyze the associations of TMJ pain/discomfort and bone characteristics on the activities of daily living in a population based study. Methods: The study included 95 randomly selected participants. The impact of temporomandibular joint pain/discomfort on the daily activeties was assessed by using the daily living scale by List and Helkimo (1995). The levels of serum type I collagen telopeptide fragments (P1NP), C-telopeptide crosslaps of type I collagen (CTX-1), and vitamin D (25 (OH) D) were analysed. The Mann-Whitney U-test, Spearman rank correlation coefficent (rs) were used for statistical analyses. Results: Activities of daily living were influenced by temporomandibular joint pain/discomfort to varying degrees. The degree of pain/discomfort during eating was correlated with the level of C-telopeptide crosslaps of type I collagen (p = 0.02) and type 1 collagen telopeptide fragments (p = 0.04). The females in the study had significantly lower vitamin D levels compared to males (p = 0.04). Conclusions: This population based study indicates that TMJ pain/discomfort exerts a significant negative influence on activities of daily living and is related to the biochemical markers of bone turnover and 25 (OH) D level. Several functions of daily activities such as social life, exercising and eating are the most disturbed.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Jagur, O. , Kull, M. , Leibur, E. , Kallikorm, R. , Lember, M. and Voog-Oras, Ü. (2012) The associations of TMJ pain and bone characteristics on the activities of daily living. Open Journal of Stomatology, 2, 237-243. doi: 10.4236/ojst.2012.24042.


[1] Katz, W.A. and Barkin, R.L. (2010) Dilemmas in chronic/ persistent pain management. Disease-A-Month, 56, 233- 250. doi:10.1016/j.disamonth.2009.12.006
[2] Magni, G., Caldieron, C., Rigatti-Luchini, S., et al. (1990) Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st national health and nutrition examination survey data. Pain, 43, 299-307. doi:10.1016/0304-3959(90)90027-B
[3] Brattberg, G., Thorslund, M. and Wikman, A. (1989) The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain, 37, 215-222. doi:10.1016/0304-3959(89)90133-4
[4] Dworkin, S.F., Huggins, K.H., LeResche, L., et al. (1990) Epidemiology of signs and symptoms in temporoman-dibular disorders: Clinical signs in cases and controls. Journal of the American Dental Association, 120, 273-281.
[5] LeResche, L. (1997) Epidemiology of temporoman-dibular disorders: Implications for the investigation of etiologic factors. Critical Reviewers in Oral Biology & Medicine, 8, 291-305. doi:10.1177/10454411970080030401
[6] John, M.T., Dworkin, S.F. and Mancl, L.A. (2005) Reliability of clinical temporomandibular disorder diagnoses. Pain, 118, 61-69. doi:10.1016/j.pain.2005.07.018
[7] Svensson, P. (2007) What can human experimental pain models teach us about clinical TMD? Archives of Oral Biology, 52, 391-394. doi:10.1016/j.archoralbio.2006.11.015
[8] Benoliel, R., Svensson, P., Heir, G.M., et al. (2011) Persistent orofacial muscle pain. Oral Disease, 7, 23-41. doi:10.1111/j.1601-0825.2011.01790.x
[9] Voog, ü., Alstergren, P., Leibur, E., et al. (2003) Impact of temporomandibular joint pain on activities of daily living in patients with rheumatoid arthritis. Acta Odontologica Scandinavica, 61, 278-282. doi:10.1080/00016350310005989
[10] Bucks, S.R. and Haworth, J. (2002) Bristol activities of daily living scale: A critical evaluation. Expert Review of Neurotherapeutics, 2, 669-676. doi:10.1586/14737175.2.5.669
[11] Feinstein, A.R., Josephy, B.R. and Wells, C.K. (1986) Scientific and clinical problems in indexes of functional disability. Annals of Internal Medicine, 105, 413-420.
[12] Katz, S., Ford, A.B., Moskowitz, R.W., et al. (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychological function. The Journal of the American Medical Association, 185, 914-919. doi:10.1001/jama.1963.03060120024016
[13] List, T. and Helkimo, M. (1995) A scale for measuring the activities of daily living (ADL) of patients with craniomandibular disorders. Swedish Dental Journal, 19, 33-40.
[14] Clark, G.T., Seligman, D.A., Solberg, W.K., et al. (1989) Guidelines for the examination and diagnosis of temporomandibular disorders. Journal of Craniomandibular Disorders, 3, 7-14.
[15] Sokka, T. (2003) Assessment of pain in patients with rheumatic diseases. Best Practise & Research Clinical Rheumatology, 17, 427-449. doi:10.1016/S1521-6942(03)00020-2
[16] Von Korff, M., Ormel, J., Keefe, F.J., et al. (1992) Grading the severity of chronic pain. Pain, 50, 133-149. doi:10.1016/0304-3959(92)90154-4
[17] Wahlund, K., List, T. and Dworkin, S.F. (1998) Temporomandibular disorders in children and adolescents: Reliability of questionnaire, clinical examination, and diagnosis. Journal of Orofacial Pain, 12, 42-51.
[18] Schiffman, E.L., Ohrbach, R., Truelove, E.L., et al. (2010) The Research Diagnostic Criteria for Temporomandibular Disorders. V: Methods used to establish and validate revised Axis I diagnostic algorithms. Journal of Orofacial Pain, 24, 63-78.
[19] List, T. and Axelsson, S. (2010) Management of TMD: Evidence from systematic reviews and meta-analyses. Journal of Oral Rehabilitation, 37, 430-451. doi:10.1111/j.1365-2842.2010.02089.x
[20] Garnero, P., Ferreras, M., Karsdal, M.A., et al. (2003) The type I collagen fragments ICTP and CTX reveal distinct enzymatic pathways of bone collagen degradation. Journal of Bone and Mineral Research, 18, 859-867. doi:10.1359/jbmr.2003.18.5.859
[21] Kull, M.Jr., Kallikorm, R., Tamm, A., et al. (2009) Seasonal variance of 25-(OH) vitamin D in the general population of Estonia, a Nothern European country. BMC Public Health, 9, 22-33. doi:10.1186/1471-2458-9-22
[22] Jagur, O., Kull, M., Leibur, E., et al. (2011) Relationship between radiographic changes in the temporomandibular joint and bone mineral density: A population based study. Stomatologija, Baltic Dental and Maxillofacial Journal, 13, 42-48.
[23] Chopin, F., Garnero, P., le Henanff, A., et al. (2008) Longterm effects of infliximab on bone and cartilage turnover markers in patients with rheumatoid arthritis. Annals of the Rheumatic Diseases, 67, 353-357. doi:10.1136/ard.2007.076604
[24] Reid, I.R., Davidson, J.S., Wattie, D., et al. (2004) Comparative responses of bone turnover markers to bisphosphonate therapy in Paget’s disease of bone. Bone, 35, 224-230. doi:10.1016/j.bone.2004.03.023
[25] Dietrich, T., Joshipura, K.J., Dawson-Hughes, B., et al (2004). Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. The American Journal of Clinical Nutrition, 80, 108-113.
[26] Houston, D.K., Tooze, J.A., Davis, C.C., et al. (2011) Serum 25-hydroxyvitamin D and physical function in older adults: The cardiovascular health study all stars. Journal of the American Geriatrics Society, 59, 1793-1801. doi:10.1111/j.1532-5415.2011.03601.x
[27] Vlasiadis, K.Z., Damilakis, J., Velegrakis, G.A., et al. (2008) Relationship between BMD, dental panoramic radiographic findings and biochemical markers of bone turnover in diagnosis of osteoporosis. Maturitas, 59, 226-233. doi:10.1016/j.maturitas.2008.01.006
[28] Undt, G., Murakami, K., Clark, G.T., et al. (2006) Crosscultural adaptation of the JPF-Questionnarie for German speaking patients with functional temporomandibular joint disorders. Journal of Cranio-Maxillofacial Surgery, 34, 226-233. doi:10.1016/j.jcms.2005.12.005
[29] Tjakkes, G.H., Reinders, J.J., Tenvergert, E.M., et al. (2010) TMD pain: The effect on health related quality of life and the influence of pain duration. Health and Quality of Life Outcomes, 8, 46. doi:10.1186/1477-7525-8-46
[30] Chong, D.K. (1995) Measurement of instrumental activities of daily living in stroke. Stroke, 26, 1119-1122. doi:10.1161/01.STR.26.6.1119
[31] Dao, T.T. and LeResche, L. (2000) Gender differences in pain. Journal of Orofacial Pain, 14, 169-184.
[32] Unell, L., Johansson, A., Carlsson, G.E., et al. (2006) Changes in reported orofacial symptoms over a ten-year period as reflected in two cohorts of fifty-year-old subjects. Acta Odontologica Scandinavica, 64, 202-208. doi:10.1080/00016350500520276
[33] Lund, I. and Lundeberg, T. (2008) Is it all about sex? Acupuncture for the treatment of pain from a biological and gender perspective. Acupuncture in Medicine, 26, 33-45. doi:10.1136/aim.26.1.33
[34] Dworkin, S.F., Huggins, K.H., Wilson, L., et al. (2002) A randomized clinical trial using research diagnostic criteria for temporomandibular disordersaxis II to target clinic cases for a tailored self-care TMD treatment program. Journal of Orofacial Pain, 16, 48-63.
[35] ?berg, T., Carlsson, G.E. and Fajers, C.M. (1971) The temporomandibular joint. A morphologic study on a human autopsy material. Acta Odontologica Scandinavica, 29, 349-384. doi:10.3109/00016357109026526
[36] Nakamura, K. (2006) Vitamin D and prevention of osteoporosis: Japanese perspective. Environmental Health and Preventive Medicine, 11, 271-276. doi:10.1007/BF02898016
[37] Von Korff, M., Dworkin, S.F. and Le Resche, L. (1990) Graded chronic pain status: An epidemiologic evaluation. Pain, 40, 279-291. doi:10.1016/0304-3959(90)91125-3
[38] Pincus, T. (2010) Are patient questionnaire scores as “scientific” as laboratory tests for rheumatology clinical care? Bull NYU Hospital for Joint Diseases, 68, 130-139.
[39] Hansson, T.L. (1992) Pathological aspects of arthritides and derangements. In: Sarnat, B.G. and Laskin, D.M, Eds., The Temporomandibular Joint: A Biological Basis for Clinical Practice, Saunders W.B. Company, Philadelpia, 165-182.
[40] Abdel-Fattah, R.A. (1992) Evaluating TMJ injuries. Wiley Law Publications, New York.

comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.