Temporomandibular disorders and the need for stomatognathic treatment in orthodontically treated and untreated girls

The aim of this investigation was to study symptoms of temporomandibular disorders (TMD) and headaches longitudinally in girls with Class II malocclusions receiving orthodontic treatment in comparison with subjects with untreated Class II malocclusions and girls with normal occlusion, and to evaluate the need and demand for stomatognathic treatment. The frequency and location of subjective symptoms of TMD and headaches were registered by means of an interview and a questionnaire in three groups of age-matched adolescent girls. Sixty-five Class II subjects received orthodontic fixed straight-wire appliance treatment (Orthodontic group), 58 with Class I malocclusion were orthodontically untreated (Class II group) and 60 had a normal occlusion (Normal group). Individual fluctuations of reported symptoms of TMD were found in all three groups over the 2-year period of the study. Subjects with untreated Class II malocclusions rated their overall symptoms of TMD as more severe than the Orthodontic and the Normal groups. In the Orthodontic group, the prevalence of symptoms of TMD decreased over the 2 years. The overall prevalence of symptoms of TMD was, however, lower in the Normal group than in the other two groups. The need for stomatognathic treatment in the whole sample was estimated to be 13 per cent, while the actual demand was 3 per cent. The large fluctuation of symptoms of TMD over time leads us to suggest a conservative treatment approach when stomatognathic treatment in children and adolescents is considered. The results show that orthodontic treatment did not increase the risk of TMD.