Tmd in ehler-danlos syndromes

Ehlers-Danlos syndromes are characterized by underdiagnosed heritable connective tissue disorders such as synovial joints hypermobility, hyperextensible skin and associated muscoskeletal, visceral, pelvic and neurologic dysfunctions. Temporomandibular joints and related structures are also involved with pain, dysfunctions and presence of associated comorbidities. Aim of the study. To focus typical cranio-cervico-mandibular features of EDS patients and psychological implications of the syndrome in order to assess a targeted and integrated treatment plan. Material and methods. 30 patients with Ehler-Danlos Syndromes and TMD were examined. Psychological tests, gnatological evaluation, according to Diagnostic Criteria for Temporomandibular disorders and surface electromyography with BTS JOINT device were submitted to patients. Results. Psychological tests. Significative percentage values of the sample were found out for what concerning somatization, depression, anxiety and obsessive-compulsive behavior. Gnatological evaluation. Most common disorders were headache associated to TMD, arthralgia, myalgia, disc displacement with reduction and subluxation. Electromyographic evaluation. Almost all patients had BAR (occluso-muscular centre of gravity) and IMP (fatigue index and parafunction) out of normal. Simmetry indexes were also alterated. Conclusion. Early diagnosis and interception are needed in order to prevent TMJ injuries. Multidisciplinary treatments are available to approach all the aspects of the syndrome.