Relationship Between TMD and Facial Asymmetry in Dentofacial Deformity Patient

Objectives: This study classified the types and prevalences of facial asymmetries present in a pre-surgical dentofacial deformity population undergoing orthognathic correction through the utilization of posterio-anterior (PA) and submentovertex (SMV) radiographs. Correlations between craniofacial morphology, pre-surgical malocclusion diagnosis, as well as the presence of temporomandibular disorders (TMD) were analyzed.
Methods: Digital tracing of 58 PAs utilizing Grummons’ frontal analysis (Dolphin Imaging) and 58 SMVs via the refined Ritucci and Burstone system proposed by Arnold et al (ImageJ) were performed. SMV angular measurements for assessment were obtained by constructing two triangles formed by the 2 Foramen Spinosa points and maxillary or mandibular dental midlines, respectively. Asymmetry was classified into subtypes and prevalence of each was calculated. A score greater than 6 on the pre-surgical Jaw Pain and Function Questionnaire (JPFQ) was used to positively diagnose TMD. JPFQ scores were correlated to the subclassifications.
Results: Symmetric (5.067±4.763) versus asymmetric (5.607±5.600) JPFQ scores were compared via t-test yielding non-significant results in general (p = 0.9414) as well as by gender (female p = 0.8558; male p = 0.9928). Eight females (34.78%) and one male (14.29%) in the clinically non-significant asymmetry group in comparison to eight females (44.44%) and two males (20%) of those diagnosed as asymmetric were found to have a positive JPFQ TMD diagnosis. Classification of asymmetry with statistics provided by gender in regards to mean JPFQ scores and percentage of positive TMD diagnoses are provided below.
Conclusions: While statistically significant results were not obtained, it is not surprising due to the numerous subclassifications of facial asymmetry that are present in a dentofacial deformity population and the corresponding small sample sizes within each grouping. Future larger studies are needed to provide conclusive results.