Journal of Craniomandibular Function, 03/2016

Background: Temporomandibular dysfunction (TMD) and malocclusion in children are often investigated in study populations with wide age ranges. In such populations, prevalences and associations of certain traits can be blurred because of growth-related variances. An investigation among children within a smaller age spectrum might provide further insights. Aim: The aim of this study was to assess the prevalence of TMD symptoms among schoolchildren in the early mixed dentition period and to detect if there are any interrelations with malocclusal traits. Methods: In a prospective, cross-sectional setting, a randomly generated sample of 157 Tyrolean schoolchildren underwent anamnesis and a clinical examination to assess malocclusal traits and the functional condition of the temporomandibular joint (TMJ). Results: The overall prevalence of TMD symptoms was low. TMJ limitation (11.5%) and clicking (10.2%) were the most common findings, followed by joint hypermobility (4.5%) and tenderness upon palpation (1.9%). Associations with malocclusal traits were only found for posterior crossbite and increased overjet. Conclusion: Although malocclusions do not seem to play a major role in the development of TMD, severe malocclusal traits are likely to exert some influence. Therefore, orthodontic screening should contain a brief checkup of the functional condition of the temporomandibular system. Keywords: malocclusions, mouth opening capacity, temporomandibular joint, TMD

The basic principles and content of the treatment of craniomandibular dysfunction (CMD) have seen considerable development in recent years. In contrast, the updated German Dental Fee Schedule (GOZ) of 2012 is largely similar to the previous version of 1998 with respect to the invoicing of services pertaining to functional analysis. On the other hand, however, dentists in Germany are required by law to practice dentistry according to the current state of science. This would not be possible on the sole basis of the old fee schedule, as its content is outdated. Despite this, the legislator has identified the problem and has not only maintained but also supported the possibility of billing dental services according to the type, cost, time input involved, and degree of difficulty of comparable services (so-called analogous services) in the GOZ 2012. With reference to the example of CMD screening, the present article describes the legal and dental background, and the consequences for implementation of the GOZ 2012 in daily clinical practice. Keywords: craniomandibular dysfunction (CMD), basic diagnostic procedures, CMD screening, (abridged) brief symptom inventory CMD, specificity, sensitivity