# Association Between the Severity of Periodontitis and Temporomandibular Joint Symptoms in Patients Requiring Prosthodontic Rehabilitation: A Cross-Sectional Study

## TL;DR

This study found that severe periodontitis is linked to worse temporomandibular joint symptoms, affecting prosthodontic treatment outcomes.

## Contribution

The study establishes a novel link between periodontitis severity and TMJ symptoms in prosthodontic patients.

## Key findings

- Severe periodontitis correlates with increased TMJ tenderness and altered condylar morphology.
- Functional impairments like reduced mouth opening worsen with periodontitis severity.
- PCA revealed a TMJ pathology continuum driven by periodontitis progression.

## Abstract

Introduction

Periodontitis and temporomandibular joint (TMJ) disorders are prevalent conditions that may influence prosthodontic treatment outcomes, owing to their impact on occlusal stability and jaw function. Understanding this association is critical for optimizing treatment planning and improving patient outcomes. This study investigated the relationship between the severity of periodontitis and clinical TMJ symptoms in patients requiring prosthodontic restoration, with the aim of providing evidence-based guidance for integrated clinical management.

Materials and methods

A cross-sectional observational study was conducted on 80 adult patients (aged 18-55 years) with different stages of periodontitis and a clinical indication for prosthodontic rehabilitation, excluding those with systemic diseases affecting the TMJ or prior TMJ surgery. Periodontal status was assessed using probing depth, clinical attachment loss, and cone-beam computed tomography (CBCT) to evaluate condylar morphology and the articular eminence angle. TMJ symptoms were evaluated through clinical examination of jaw movement, joint sounds, and tenderness. The Fonseca Anamnestic Index (FAI) was used to assess the presence and intensity of symptoms of temporomandibular joint disorders (TMDs). Prosthodontic treatment plans and occlusal characteristics were documented. Data were analyzed using the chi-square test, the Kruskal-Wallis test, and principal component analysis (PCA), with a significance level of p < 0.05.

Results

Significant associations were found between the severity of periodontitis and TMJ symptoms, particularly tenderness on palpation and changes in condylar morphology. Functional impairments, including reduced mouth opening and increased deviation, worsened with the severity of periodontitis. The FAI, which reflects pain and dysfunction, progressively escalated across the periodontal groups. Structural changes, such as steeper articular eminence inclination, were prominent in patients with severe periodontitis. PCA identified a TMJ pathology continuum driven by periodontitis severity.

Conclusion

The severity of periodontitis was correlated with worsened TMJ symptoms, impacting prosthodontic treatment planning. Integrated periodontal and TMJ management is essential for optimizing functional restoration and patient comfort during prosthodontic care.