Does the frequency of temporomandibular myofascial dysfunction differ in patients treated for different mandibular and zygomatic fractures?

Abstract

Aim: To determine whether the frequency of Temporomandibular myofascial dysfunction (TMD) differs in patients treated for different mandibular and zygomatic fractures. Materials and Methods: This was a 9-year prospective study. The diagnosis of TMD was based on standard diagnostic criteria and was made during follow-up reviews of patients after the treatment of the fractures. Additional information obtained from the patients and their case files were age, gender, site of fracture (s), and treatment methods. One-way analysis of variance was used to compare the presence of TMD among the study groups. Results: Overall, 42/587 (7.2%) patients were diagnosed with TMD between 2.3 and 4.7 years after treatment commenced. Patients who presented with TMD were those treated for isolated zygomatic (n = 5/42, 11.9%), isolated condylar (n = 7/63, 10.0%), and multiple mandibular (n = 30/475, 6.3%) fractures, which was significant (P = 0.01) in favor of those treated for isolated zygomatic and isolated condylar fractures. Patients who were treated for unilateral zygomatic complex/arch(P == 0.001), unilateral intracapsular condyle (P = 0.001), and parasymphyseal/body/angle/condyle (P = 0.01) fractures also had higher frequencies of TMD. Conclusions: Patients who were treated for isolated zygomatic or condylar fractures had higher frequencies of TMD than those with multiple mandibular fractures. Future research work needs to be directed toward the description of the pathogenesis of the different types of TMD symptoms so that more information can be gathered on the natural course of the disorders and identify the risk factors for pain persistence and chronicity.