Assessment of temporomandibular joint dysfunction in stroke patients

The aim of this study was to assess temporomandibular joint dysfunction in stroke patients. Total 100 participants, 50 who were healthy and 50 who had hemiplegia were recruited into this study. Digital caliper, algometer and muscle palpation are the methods and devices that used in our study in order by to assess temporomandibular joint range of motion, muscle pressure pain threshold and muscle tenderness in intraoral, extraoral mastication muscles and muscles related to mastication. Static and dynamic pain test was used to assess the existence of arthrogenic and myogenic temporomandibular joint dysfunction, labial comissure angle measurement used for assessing facial paralysis severity. Fonseca questionnaire and craniomandibular index used for temporomandibular joint dysfunction assessment and temporomandibular joint dysfunction categorization. In addition to these parameters spasticity was assessed with Modified Ashworth Scale in stroke group. In intergroup comparison significant decrease was found in all temporomandibular range of motion parameters in favor of stroke group (p<0,05). In intergroup comparison significant sensitivity was found in intraoral and extraoral muscle palpation in favor of stroke group (p<0,05). In intergroup comparison significant sensitivity was found in stroke group for the palpation of splenius capitis and posterior digastricus muscles which are related to mastication (p<0,05). Despite the fact that no significant difference was found between groups for the pain threshold in masticatory muscles, values were higher in healthy group (p>0,05). As a result of intergroup examination of static and dynamic pain test, labial comissure angle degree, Fonseca and craniomandibular index score, it was found that the dynamic pain test positivity, Fonseca questionnaire and craniomandibular index scores were higher in stroke group (p<0,05). It was concluded that, temporomandibular joint dysfunction prevalence was higher in stroke group compared to healthy group and use of modalities specific to temporomandibular joint dysfunction treatment would be beneficial. Keywords: Hemiplegia, Temporomandibular joint, Mastication, Dysfunction, Stomatognathic system.