Temporomandibular joint problems and self-registration of mandibular opening capacity among adults with Ehlers-Danlos syndrome. A questionnaire study

Orthod Craniofac Res. 2004 Feb;7(1):40-6. doi: 10.1046/j.1601-6335.2003.00269.x.


Objectives: To study maximal mandibular opening capacity and the prevalence of temporomandibular joint (TMJ) problems reported among a larger group of adults with Ehlers-Danlos syndrome (EDS). Furthermore, to compare proportions of disorders with those in a cohort of randomized population- based controls.

Design: A questionnaire study with self-registration of maximal mandibular opening capacity.

Setting and sample population: One hundred and fourteen persons with EDS and 114 controls in a randomized population-based cohort. Experimental variables - Self-registered maximal mandibular opening capacity values that were calculated from the markings of maximal interincisal distance on spatulas and the assessments of overbite with the aid of photos. Questions concerning EDS, TMJ problems and other related questions.

Outcome measure: Mean values of maximal mandibular opening capacity compared between groups. Proportions of affirmative answers about TMJ problems compared between persons with EDS and controls who did not have the syndrome.

Results: The EDS persons who reported problems with poor mouth opening capacity when biting into thick pieces of food had a lower mean maximal mandibular opening value compared with the other EDS persons (p < 0.05). The proportions of affirmative answers concerning mobile joints during mouth opening, present TMJ problems, poor mouth opening capacity when biting into thick food, clicking, crepitations and permanent locking were greater compared with the controls (p < 0.05).

Conclusion: These data corroborate the reports in literature that persons with EDS are naturally predisposed to TMJ problems. The self-registration of maximal mandibular opening capacity was a useful diagnostic tool to provide an objective clinical measure of movement capacity of the TMJ. The clinical measure was in line with the affirmative answers on having problems with poor mouth opening capacity among the EDS persons.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Ehlers-Danlos Syndrome / complications*
  • Female
  • Humans
  • Male
  • Masticatory Muscles / physiopathology
  • Middle Aged
  • Range of Motion, Articular
  • Self-Assessment
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders / complications
  • Temporomandibular Joint Disorders / diagnosis*
  • Temporomandibular Joint Disorders / physiopathology*