A STUDY FOR ASSOCIATION BETEWEEN THE EAR SYMPTOMS AND OCCLUSAL DISTURBANCE, PSYCHOLOGIACL FACTORS N TMD PATIENTS.

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The aural symptoms such as tinnitus, earache, vertigo, are commonly observed in Temporomandibular Disorders (TMD). The purpose of this study was to clarify the otological characteristics of aural symptoms in TMD and the relationship to the occlusal factors as an etiological factor. Twenty-five TMD patients (age : ranged 16-69, mean 43.4+-17.1y) with tinnitus were involved in this study. Signs and symptoms of TMD were examined by dentists. TMJs of the patients were examined by MR imaging. Aural symptoms in the patients were diagnosed with otologic examinations.Side with tinnitus were coincided with the main symptomatic side of TMD in all patients. Twelve patients were diagnosed with disorders of ear function ; 10 patients had sensory hearing loss at tinnitus side, 2 patients had vestibular dysfunction. Tinnitus score in 15 patients with disc displacement of TMJ were significantly higher than those in 10 patients with normal disc position. Eight out of 15 with disc displacement had ear disorders and 2 out of 10 with normal disc had ear disorders. The ratio of ear disorders was significantly different between these groups. Occlusal treatment, such as occlusal adjustment, splint therapy, for TMD were effective on the aural symptoms. Otologic examination after occlusal treatment indicated improvement of ear disorders diagnosed before treatment. These results indicate that aural symptoms such as tinnitus observed in TMD are related to TMD.Those might be related to condylar position and disc position in TMJ, which are caused by occlusal factors such as loss of posterior support and displacement of jaw position.