Фактори ризику розвитку дисфункції скронево-нижньощелепного суглоба у жінок: гормональні зміни та психоемоційний стрес

M. Drohomyretska; M. Kiriuk

doi:10.33295/1992-576X-2025-5-31

Authors

M. Drohomyretska Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-5646-8791
M. Kiriuk Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine https://orcid.org/0009-0001-1971-0593

DOI:

https://doi.org/10.33295/1992-576X-2025-5-31

Keywords:

comorbidity, hormonal pathologies, reproductive age, menopause, osteoporosis, emporomandibular joint (TMJ), muscle disorders, TMJ osteoarthritis, women’s health, age-related changes

Abstract

Introduction. Temporomandibular joint disorders (TMD) are a common issue (affecting 34% of the global population), with a multifactorial etiology including hormonal changes and stress. The higher incidence of TMD in women of reproductive age suggests a possible role of estrogen. The relevance of this study lies in examining the connection between hormonal disorders, age, stress, and the manifestations of TMD in women.
Aim. To study the prevalence of TMD in women of different ages with hormonal imbalances and to establish the relationship between age, hormonal status, psycho-emotional stress, and clinical manifestations of temporomandibular joint dysfunction.
Material and Methods. The study involved 153 women with diagnosed hormonal disorders, divided into six age subgroups (age 18–65 years). The comparison group (88 women) had TMD without hormonal disorders. Hormonal status, stress levels (PSS-10), and TMJ condition (clinical examination, DC/TMD) were assessed. Data were statistically analyzed using chi-square, Mann-Whitney U test, and Spearman’s rank correlation (p < 0.05).
Results. The dimensions of the anterior, superior, and posterior joint spaces measured by two different methods completely coincided in patients with an articular tubercle height of up to 5.1 mm, and in 93.2% of cases with a tubercle height of 5.2–10 mm. Two variants of the central position of the articular head within the joint socket were identified after deprogramming the masticatory muscles and fixation with a bite block during CT examination. In the central position with reduced joint spaces, the anterior and posterior joint spaces measured 1.97 ± 0.22 mm (right side), 1.91 ± 0.21 mm (left side), 2.22 ± 0.21 mm (right side), and 2.29 ± 0.17 mm (left side). In the central position with enlarged joint spaces, the anterior and posterior joint spaces measured 2.7 ± 0.48 mm (right side) and 2.7 ± 0.46 mm (left side), and 2.9 ± 0.41 mm (right side) and 2.9 ± 0.45 mm (left side).
Conclusions. The size of the anterior joint space, measured by two different methods, does not match when the articular tubercle height is 7.8 mm, provided that the width of the articular head is less than its height. The central position of the articular head within the fossa with reduced joint spaces is associated with a TMJ structural type determined by the difference between the AEI-BFL and AEI-TRL angles within 16 ± 7°, provided that the width of the articular head is greater than or equal to its height. The central position with enlarged joint spaces corresponds to a TMJ structural type determined by the difference between the AEI-BFL and AEI-TRL angles within 29 ± 6°, provided that the width of the articular head is greater than or equal to its height.

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