TMD Prelevance in War Veterans with PTSD

The aetiology of temporomandibular disorders (TMD) remains controversial. The role of stress is stil under discussion. Aim: The aim of this study was to determine the prevalence of clinical signs of TMD in a group of Croatian War Veterans with posttraumatic stress disorder (PTSD) occuring as a conseguence of exposure to war stress. Methods: A group of 100 male subjects (x=35.56± ; ; ; ; 6.12, range 25-52) who had participated in the War in Croatia and had PTSD was examined. The control group comprised 96 subjects of the same sex and age (x=34.5± ; ; ; ; 7.67, range 24-51) who hadn't participated in the war and hadn't PTSD (Harvard trauma Questionaire). The examination was performed by means of an original clinical protocol. Results: Eighty two per cent of the group with PTSD had at least one sign of TMD compared to 24% of the healthy subjects (Chi-square 55.26 ; p<0.0001). Sound in TMJ was the most frequent sign in both groups (61, 7% in PTSD group, 18% in healthy subjects, Chi-square 19.42 ; p<0.0001). The greatest difference between the groups is related to pain during mandibular movements (36, 2% PTSD group, 2% healthy subjects, Chi-square 18.72 ; p<0.0001), and masticatory muscle and TMJ tenderness (53, 2% PTSD group, 2% healthy subjects, Chi-square 32.36 ; p<0.0001). Conclusion: High presence of clinica signs in exameenes with PTSD and statistically significant difference compare to healthy control group confirms the important role of war stress on the genesis of TMD.