Functional path of closure of mandible and its association with temporomandibular disorders - a case control study

Introduction: The significance of occlusion and its importance as a causative factor and aggravator of temporomandibular disorders (TMD) is a much debated subject. Objectives: The primary objective of this study was to investigate the association between varying path of closure and TMD. Materials and Method: 90 subjects aged from 12 to 25 year subjects were divided into four groups comprising patients exhibiting forward, backward, lateral and normal path of closure. The Helkimo Anamnestic and Dysfunction Index modified by Athanasiou and Melsen (HI) was used for the clinical evaluation of the temporomandibular joint (TMJ) in order to classify the TMD and the amount of severity. Results: Patients having an altered path of closure of the showed substantially higher scores of Helkimo Anamnestic index. Among the three different subject groups more severe form of TMD were associated with the forward path of closure followed by backward, and then lateral path of closure. Conclusion: Patients having an altered path of closure of the mandible showed increased association with TMD as compared to the patients having the normal path of closure which makes it imperative to evaluate the TMJ in patients with altered path of closure.