Mandibular Movement in Healthy Individuals from 4-17 Years of Age

Peter Stoustrup¹, Kasper Dahl Kristensen^2,3, Annelise Küseler⁴, Thomas Klit Pedersen^5,6 and Troels Herlin⁷, ¹Section of Orthodontics, University of Aarhus, Aarhus C, Denmark, ²Section of Orthodontics, University of Aarhus, Denmark, 8000 Aarhus, Denmark, ³Specialist Oral Health Center for Western Norway, Rogaland Stavanger, Norway, ⁴Section of Orthodontics, Aarhus University, Aarhus, Denmark, ⁵Section or Orthodontics, Aarhus University, Aarhus, Denmark, ⁶Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark, ⁷Pediatric Rheumatology Clinic, Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Clinical practice, Diagnostic Tests, juvenile idiopathic arthritis-enthesitis (ERA) and temporomandibular joint

Session Information

Title: ACR/ARHP Combined Abstract Session: Pediatric Rheumatology

Session Type: Combined Abstract Sessions

Background/Purpose:

Assessment of mandibular movement capacity is an important part of the clinical orofacial examination of patients with juvenile idiopathic arthritis (JIA). The aim of the present study was twofold: 1) To establish age-related normative values for maximal mouth opening capacity and mandibular laterotrusion in healthy individuals. 2) To establish a universal cut-off value for “normal” range of motion in children and adolescent patients to be used in future clinical orofacial examinations of patients with JIA

Methods:

A total of 1114 healthy Danish individuals between the ages of 4-17 years were included in this cross-sectional population-based study. During a routine dental examination the maximal mouth opening capacity and laterotrusion capacity (the sideway excursion of the mandible) were assessed in each individual according to a standardized measurement protocol with calibrated metallic rulers. The measurements were adjusted for overbite and midline deviations. Exclusion criteria: diagnosis with temporomandibular dysfunction, previous orofacial complaints, jaw fractures or hypermobility.

Results

The mean maximal mouth opening gradually increased from 38 mm (SD 6.1 mm) at age four to 54.5 mm (SD 6.8 mm) at age 17. A linear increase in the opening capacity was observed between the age of four to 11; Beyond the age of 11 only minor changes of 4 millimeters were observed. No inter-gender difference in maximal mouth opening capacity was observed (p>0.15).

The mean total laterotrusion capacity (right excursion + left excursion) gradually increased from 15.4 mm (SD 3.1 mm) at age four to 20.1 mm (SD 3.7 mm) at age 17. A statistical significant inter-gender difference of 0.8 mm (SD 0.4 mm) was observed in relation to the total laterotrusion capacity; however, the clinical relevance of this significant difference is questionable.

Conclusion

Normative values of maximal mouth opening capacity and laterotrusion capacity in individuals between four and 17 years of age were established. Our findings oppose the use of a single universal cut-off value for “normal” range of motion in children and adolescent patients. Instead we recommend including the age-related normative values of mandibular range of motion in the orofacial examination of patients with JIA.

Disclosure:

P. Stoustrup,
None;

K. D. Kristensen,
None;

A. Küseler,
None;

T. K. Pedersen,
None;

T. Herlin,
None.

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