Assessment of Temporomandibular Joint Dysfunction in Patients with Stroke

J Stroke Cerebrovasc Dis. 2018 Aug;27(8):2141-2146. doi: 10.1016/j.jstrokecerebrovasdis.2018.03.007. Epub 2018 Apr 9.


Goal: The aim of this study was to assess temporomandibular joint dysfunction in patients with stroke.

Materials and methods: Total of 100 participants, 50 healthy and 50 who had stroke, were recruited into this study. Digital caliper and algometer were used to assess temporomandibular joint range of motion and masticatory muscle pressure pain threshold. Labial commissure angle measurement was used for the assessment of facial paralysis severity. Fonseca questionnaire was used for temporomandibular joint dysfunction assessment and categorization. In addition, dominant mastication shift was measured by the question that asks the pre and poststroke dominant mastication side.

Findings: In intergroup comparison, significant decrease was found in all temporomandibular range of motion parameters in favor of stroke group (P < .05). Despite the fact that no significant difference was found between groups for the pain threshold in masticatory muscles except for middle part of the left temporalis muscle, values were higher in healthy group (P > .05). As a result of intergroup examination of labial commissure angle degree, Fonseca questionnaire score, it was found that labial commissure angle and Fonseca questionnaire scores were higher in stroke group (P < .05). Intragroup examination of patients with stroke showed that dominant mastication side shift was seen in patients with stroke (P < .05).

Conclusion: It was concluded that, temporomandibular joint dysfunction prevalence was higher in stroke group compared with healthy group and use of modalities specific to temporomandibular joint dysfunction treatment would be beneficial.

Keywords: Hemiplegia; chewing; disorder; dysfunction; mastication; stomatognathic system.

MeSH terms

  • Diabetes Complications / epidemiology
  • Diabetes Complications / physiopathology
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Mastication
  • Masticatory Muscles / physiopathology
  • Middle Aged
  • Pain Threshold
  • Prevalence
  • Range of Motion, Articular
  • Stroke / complications*
  • Stroke / diagnosis
  • Stroke / epidemiology
  • Stroke / physiopathology
  • Surveys and Questionnaires
  • Temporomandibular Joint Dysfunction Syndrome / complications*
  • Temporomandibular Joint Dysfunction Syndrome / diagnosis*
  • Temporomandibular Joint Dysfunction Syndrome / epidemiology
  • Temporomandibular Joint Dysfunction Syndrome / physiopathology