Temporomandibular joint disorders among dental patients attending Muhimbili National Hospital

Objective: To determine prevalence, management modalities and treatment outcome of temporomandibular joint disorders (TMJD) among dental patients treated at Muhimbili National Hospital, Tanzania. Materials and Methods: This descriptive prospective cross sectional hospital based study involved in and out- patients who attended treatment in the department of Oral and Maxillofacial Surgery between Sept 2009 and Feb 2010. Patients diagnosed to have TMJD were included in the study, interviewed using a structured questionnaire and later physically and radiographically examined. Data collected were recorded on a special clinical form and later analysed using SPSS version 13. Results: Of the 4661 patients majority were females (56.7%;n=2643). Age range was 4-80 years (mean age= 35 yrs). TMJD was diagnosed in 61(1.37%) patients with majority having TMJ ankylosis (36%; n=22) followed by Myofacial pain dysfunction syndrome (MPDS) (32.9%; n=20) and TMJ dislocation (31.1%; n=19). TMJ ankylosis was more among age group 11-20 years (31.8%;n=7) who presented mainly with history of trauma (50%;n= 11). On examination all patients had limited mouth opening and obliterated joint spaces radiographically while 20(90.9%) patients had facial disfigument. Surgical treatment (81.8%;n=18) to  patients involved mostly condylectomy (50%;n=11).  Recurrence was found in 6(33.3%) patients. MPDS affected more females (70%;n=14) and age range 21–50 years. All presented with masticatory muscle tenderness. Radiographically all joints were normal. All patients were put on mediacation whereby 80% of patients improved. Prosthesis were provided to patients with missing posterior teeth. TMJ dislocation affected more females (57.9%;n= 11) and age group 21-30 years (36.8%; n=7). All had open mouth  (100%) and anterior dislocation; mainly treated by closed manual reduction (89.5%;n=17). Conclusion: TMJDs prevalence is low, presenting mainly as TMJ ankylosis, MPD and TMJ dislocation. Management modalities entailed surgical treatment for ankylosis and long standing TMJ dislocation and manual reduction for other dislocations. Treatment of MPD was mainly medication.