The Relationship Between Temporomandibular Disorder Risk, Temporal Muscle Thickness, Headache Severity, and Jaw Movements in Individuals with Tooth Loss
Objective: This study was conducted to evaluate the relationship between the risk of temporomandibular joint disorder (TMD), headache severity, ultrasonographic temporal muscle thickness, and functional jaw movements in individuals presenting with tooth loss.
Methods: Thirty-eight individuals aged 21-55 years (mean 32.23±9.6) with one or more missing teeth were included in the study. TMD risk and headache intensity were documented using the Turkish-validated Fonseca Anamnestic Index (FAI) and the Visual Analog Scale (VAS), respectively. Temporal muscle thickness was assessed using a B-mode ultrasonographic device equipped with a high-frequency linear transducer in the relaxed jaw position while the participant was seated. Jaw movements were measured using a mouth goniometer.
Results: A strong positive association was identified between the risk of TMD and headache severity (r=0.96, P<0.001). In contrast, TMD risk showed strong negative associations with temporal muscle thickness (r=-0.73 (left) and r=-0.82 (right), P<0.001) and maximum mouth opening (r=-0.87, P<0.001). TMD risk exhibited moderate inverse associations with both jaw protrusion (r=-0.52) and retrusion (r=-0.61), with significance levels at P<0.05).
Conclusion: This cross-sectional correlational study suggests that early identification and management of biomechanical alterations associated with tooth loss may be important for reducing long-term functional complications through preventive dental care, timely prosthetic rehabilitation, and targeted physiotherapy.
1. Tallents RH, Macher DJ, Kyrkanides S, Katzberg RW, Moss ME. Prevalence of missing posterior teeth and intraarticular temporomandibular disorders. J Prosthet Dent. 2002;87(1):45-50. doi: 10.1067/mpr.2002.121487.
2. Kurkcuoglu A, Pelin C. Volumetric and morphologic changes due to effect of unilateral extraction of teeth. Marmara Med J. 2016;29(2):88-94. doi: 10.5472/MMJoa.2902.05.
3. Javed MU, Asim MA. Association of tooth loss with temporomandibular disorders. Khyber Med Univ J. 2020;12(1):29-33. doi: 10.35845/kmuj.2020.196.58.
4. Zuccolotto MC, Vitti M, Nóbilo KA, Regalo SC, Siéssere S, Bataglion C. Electromyographic evaluation of masseter and anterior temporalis muscles in rest position of edentulous patients with temporomandibular disorders, before and after using complete dentures with sliding plates. Gerodontology. 2007;24(2):105-110. doi: 10.1111/j.1741-2358.2007.00152.x.
5. Ayaz BH, Al-Khudhairy MW. Correlation between posterior teeth loss and temporomandibular joint disorder symptoms in adult patients. F1000Research. 2025;14:428. doi: 10.12688/f1000research.161006.1.
6. Al-Jabrah OA, Al-Shumailan YR. Prevalence of temporomandibular disorder signs in patients with complete versus partial dentures. Clin Oral Investig. 2006;10(3):167-173. doi: 10.1007/s00784-006-0046-3.
7. Zheng H, Shi L, Lu H, et al. Influence of edentulism on the structure and function of temporomandibular joint. Heliyon. 2023;9(10):e20307. doi: 10.1016/j.heliyon.2023.e20307.
8. Petridis HP, Tsiggos N, Michail A, Kafantaris SN, Hatzikyriakos A, Kafantaris NM. Three-dimensional positional changes of teeth adjacent to posterior edentulous spaces in relation to age at time of tooth loss and elapsed time. Eur J Prosthodont Restor Dent. 2010;18(2):78-83.
9. Wang MQ, Xue F, He JJ, Chen JH, Chen CS, Raustia A. Missing posterior teeth and risk of temporomandibular disorders. J Dent Res. 2009;88(10):942-945. doi: 10.1177/0022034509344387.
10. World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA. 2025;333(1):71-74. doi: 10.1001/jama.2024.21972.
11. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-1160. doi: 10.3758/BRM.41.4.1149.
12. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Routledge. 2013.
13. Kaynak BA, Tas S, Salkin Y. The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders. Cranio. 2023;41(1):78-83. doi: 10.1080/08869634.2020.1812808.
14. Arikan H, Citaker S, Ucok C. Psychometric properties of the Fonseca Anamnestic Index (FAI) for temporomandibular disorders: Turkish version, responsiveness, reliability, and validity study. Disabil Rehabil. 2024;46(7):1408-1415. doi: 10.1080/09638288.2023.2199221.
15. Schiffman E, Ohrbach R, Truelove E, et al; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache. 2014;28(1):6-27. doi: 10.11607/jop.1151.
16. Yildiz NT, Kocaman H, Bingol H. Validity and reliability of the Turkish version of the 20-item jaw functional limitation scale. Physiother Theory Pract. 2025;41(2):377-389. doi: 10.1080/09593985.2024.2329959.
17. Maskos A, Schmidbauer ML, Kunst S, et al. Diagnostic Utility of Temporal Muscle Thickness as a Monitoring Tool for Muscle Wasting in Neurocritical Care. Nutrients. 2022;14(21):4498. doi: 10.3390/nu14214498.
18. Cuellar ME, Oommen E. Objective physiological measures of lingual and jaw function in healthy individuals and individuals with dysphagia due to neurodegenerative diseases. MethodsX. 2021;8:101461. doi: 10.1016/j.mex.2021.101461.
19. Hidecker MJ, Ho NT, Dodge N, et al. Inter-relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children. Dev Med Child Neurol. 2012;54(8):737-742. doi: 10.1111/j.1469-8749.2012.04312.x.
20. Diernberger S, Bernhardt O, Schwahn C, Kordass B. Self-reported chewing side preference and its associations with occlusal, temporomandibular and prosthodontic factors: results from the population-based Study of Health in Pomerania (SHIP-0). J Oral Rehabil. 2008;35(8):613-620. doi: 10.1111/j.1365-2842.2007.01790.x.
21. Nasseri G, Dermawan T, Morito P, et al. Evaluating Masticatory Performance of Removable Partial Denture Wearers Using Color-Changeable Chewing Gum and Gummy Jelly. J Int Dent Med Res. 2019;12(4):1555-1562.
22. Rues S, Lenz J, Türp JC, Schweizerhof K, Schindler HJ. Muscle and joint forces under variable equilibrium states of the mandible. Clin Oral Investig. 2011;15(5):737-747. doi: 10.1007/s00784-010-0436-4.
23. Tseng ZJ, DeSantis LRG. Relationship between tooth macrowear and jaw morphofunctional traits in representative hypercarnivores. PeerJ. 2024;12:e18435. doi: 10.7717/peerj.18435.
24. Sasaki K, Yokoyama M, Yamaguchi K, Itoh M. Biological responses induced by mechanical stresses—bone metabolism by bone scintigraphy at residual alveolar bone beneath the denture and TMJs. Int Congr Ser. 2005;1284:28-36. doi: 10.1016/j.ics.2005.07.066
25. Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants. 2013;28(6):e393-414. doi: 10.11607/jomi.te20.
26. Mariana Sampaio Menezes, Sandra Kalil Bussadori, Kristianne Porta Santos Fernandes, Daniela Aparecida Biasotto-Gonzalez. Correlation between headache and temporomandibular joint dysfunction. Fisioter Pesqui. 2008;15(2):183-187. doi: 10.1590/S1809-29502008000200012.
27. Minye HM. Neuroplasticity and Central Sensitization in Orofacial Pain and TMD. OBM Neurobiol. 2020;4(2):057. doi: 10.21926/obm.neurobiol.2002057.
28. Costa YM, Conti PC, de Faria FA, Bonjardim LR. Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(3):288-297. doi: 10.1016/j.oooo.2016.12.005.
29. van der Meer HA, Speksnijder CM, Engelbert RHH, Lobbezoo F, Nijhuis-van der Sanden MWG, Visscher CM. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms. Clin J Pain. 2017;33(9):835-843. doi: 10.1097/AJP.0000000000000470.
30. Lecaros AMC, Palinkas M, Nassar MSP, et al. Effects of Muscular Temporomandibular Disorder on Masticatory Muscles’ Thickness. Annu Res Rev Biol. 2017;15(2):1-7. doi: 10.9734/ARRB/2017/35330.
31. Zhang Y, Shao S, Zhang J, Wang L, Wang K, Svensson P. Temporal summation and motor function modulation during repeated jaw movements in patients with temporomandibular disorder pain and healthy controls. Pain. 2017;158(7):1272-1279. doi: 10.1097/j.pain.0000000000000911.
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Article Information
- Article Type Research Article
- Submitted April 9, 2026
- Accepted June 5, 2026
- Published August 1, 2026
- Issue Forthcoming Issue: Volume 12 - Issue 8 (August 2026)
- Section Research Article
- Categories
The data that support the findings of this study are available from the corresponding author upon reasonable request.
