Prevalence of temporomandibular disorders and parafunctional habits in health sciences students

Prevalência de disfunções temporomandibulares e dos hábitos parafuncionais em estudantes da área da saúde

ABSTRACT

Objective:  This study evaluated the prevalence of symptoms of temporomandibular disorders and parafunctional habits in health science students at a higher education institution.

Methods:  This was an observational, cross-sectional, descriptive, quantitative, and census-based field study. The population (N=1687) consisted of students from health science courses at the Patos University Center, and the sample size (n=385) was determined through sample size calculation. Data were collected using a virtual questionnaire on the Google Forms platform. The questions regarding temporomandibular dysfunction considered the simplified anamnesis index, developed from the work of Fonseca et al. To determine the presence of parafunctional habits, the questionnaire was adapted.

Results:  The sample was predominantly female, aged between 18 and 30 years. The most prevalent degree of temporomandibular disorders was mild temporomandibular disorders. The most prevalent habit among students was resting their chin on their hands. The prevalence of temporomandibular disorders was higher in females. The course of study did not influence the presence or degree of temporomandibular disorders.

Conclusion:  Women present more temporomandibular disorders than men, regardless of the degree of severity and the undergraduate course in the health field.

Indexing terms
Habits; Prevalence; Students; Temporomandibular Joint Dysfunction Syndrome

RESUMO

Objetivo:  Esse estudo avaliou a prevalência de sintomas das disfunções temporomandibulares e dos hábitos parafuncionais em estudantes da área da saúde de uma instituição de ensino superior.

Métodos:  Tratou-se de uma pesquisa de campo observacional, transversal, descritiva, quantitativa e censitária. A população (N=1687 ) foi composta por estudantes dos cursos da área da saúde do Centro Universitário de Patos e a amostra (n=385 ) foi determinada por meio do cálculo amostral. Os dados foram coletados através de um questionário virtual na plataforma Formulários Google. As questões referentes à disfunção temporomandibular levaram em consideração o índice anamnésico simplificado, desenvolvido a partir do trabalho de Fonseca et al. Para determinar a presença dos hábitos parafuncionais, houve uma adaptação do referido questionário.

Resultados:  A amostra foi majoritariamente feminina, com idade entre 18 e 30 anos. O grau mais prevalente foi a disfunção temporomandibular leve. O hábito mais prevalente em estudantes foi o de apoiar o queixo com as mãos. A prevalência de disfunção temporomandibular foi maior no sexo feminino. O curso não influenciou a presença nem o grau de disfunção temporomandibular.

Conclusão:  As mulheres apresentam mais disfunção temporomandibular do que os homens, independente do grau de severidade e do curso de graduação da área da saúde.

Termos de indexação
Hábitos; Prevalência; Estudantes; Síndrome da Disfunção da Articulação Temporomandibular

INTRODUCTION

The Temporomandibular Joint (TMJ) is the only movable joint of the skull and is classified as a complex joint because it allows both rotational and translational movements. Proper function requires harmony among the temporomandibular joint structures, dental occlusion, and neuromuscular balance [¹].

Temporomandibular Disorders (TMD) occur when this balance is disrupted and are characterized by a set of clinical conditions involving the masticatory muscles, the temporomandibular joints, and associated structures. TMD may present signs and symptoms such as pain in the masticatory muscles and/or TMJ, limitation or deviation of mandibular movements, joint sounds, and associated otologic symptoms [²].

The etiology of TMD is considered multifactorial, involving biological, psychological, and social factors. Potential contributing factors include trauma, parafunctional behaviors, psychological conditions, physiopathological mechanisms, systemic conditions, local factors, behavioral and cognitive aspects, nutritional factors, and genetic predisposition [³]. Psychological factors, particularly anxiety and depression, play an important role in the onset and persistence of TMD, as they are associated with increased muscle activity and heightened pain perception in the orofacial region [⁴].

Parafunctional behaviors are defined as nonfunctional neuromuscular activities of the stomatognathic system that are repetitive in nature and may occur consciously or unconsciously. Although such behaviors may be perceived as harmless or even pleasurable, they can exceed the adaptive capacity of the stomatognathic system and contribute to tissue overload [⁵]. Common parafunctional behaviors include object biting, nail biting (onychophagia), excessive gum chewing, resting the chin or face on the hands or shoulder, mandibular retrusion, lateral excursions or protrusion, unilateral chewing, frequent light tooth contact, and biting of the lips, tongue, or cheeks [⁶].

Deleterious parafunctional behaviors have frequently been associated with TMD and may act as perpetuating factors rather than primary causes. These behaviors are often interpreted as mechanisms for the release of emotional or muscular tension [²]. Myogenous TMD, particularly those involving the masticatory muscles, may originate from mechanical overload associated with parafunctional activities, leading to pain and dysfunction in the orofacial region [⁷].

Recent studies have demonstrated that TMD-related pain, especially chronic pain, results in significant physical and psychological impairment, negatively affecting quality of life and oral health-related well-being [²,⁴,⁸]. In individuals diagnosed with TMD, parafunctional behaviors contribute to the progression of muscular disorders and intra-articular conditions, as well as to the manifestation of a wide range of clinical signs and symptoms associated with the TMJ [⁹].

In the academic environment, an increased prevalence of mental health complaints among students has been observed, particularly stress and anxiety [¹⁰]. According to the DC/TMD biopsychosocial model, psychological distress and emotional stress are considered important predisposing and perpetuating factors for TMD, especially among university students [¹¹]. Moreover, health sciences students and professionals show a higher susceptibility to developing stomatognathic system disorders related to anxiety, which often begins during undergraduate training and may be associated with the development or exacerbation of parafunctional behaviors [¹²].

TMD can affect individuals of any age; however, it is more prevalent in women between 20 and 45 years of age. Epidemiological data indicate that approximately 40% of the general population present at least one sign or symptom of TMD, while among university students this prevalence may reach up to 70% [¹³]. Psychological factors related to daily stress have been shown to influence the development of TMD in undergraduate students at some point during their academic life [¹⁴].

Given the multifactorial and biopsychosocial nature of TMD, patient management should involve a multidisciplinary approach, including dentists, psychologists, nutritionists, physical therapists, and speech-language pathologists. Treatment goals include pain reduction, minimization of muscle overload, improvement of muscular coordination and occlusal stability, as well as reduction of stress and anxiety levels [¹⁵].

According to DC/TMD recommendations, initial management of TMD should prioritize conservative, noninvasive, and reversible therapies. These include patient education, self-management strategies, psychological interventions, pharmacological management, physical therapy, low-level laser therapy, occlusal splints, therapeutic exercises, and acupuncture [¹⁶]. Invasive TMJ treatments, such as surgical interventions, are reserved for exceptional and non-elective cases due to their complexity and higher risk of complications, emphasizing the importance of accurate diagnosis and multidisciplinary follow-up in clinical decision-making [¹⁷].

Considering the association between parafunctional behaviors and temporomandibular disorders, as well as their relevance for diagnosis and early intervention, the present study aimed to evaluate the prevalence of TMD symptoms and parafunctional behaviors among health sciences students at a higher education institution.

METHODS

The present field research was an observational, cross-sectional, descriptive, quantitative, and census-based study conducted at the Patos University Center (UNIFIP), located in the city of Patos, Paraíba State, Brazil.

The study population consisted of health sciences students enrolled in the Dentistry, Nursing, Physical Therapy, Nutrition, Medicine, Biomedicine, and Pharmacy programs at UNIFIP (N=1,687). The sample comprised students from the aforementioned programs who agreed to participate in the study and was determined through sample size calculation (n = 385).

Eligible participants were health sciences students enrolled from the 1st to the 10th academic semester of the Dentistry, Nursing, Physical Therapy, Nutrition, Medicine, Biomedicine, and Pharmacy programs at UNIFIP, who were duly registered and aged 18 years or older. Questionnaires that were incompletely answered were excluded from the analysis.

Data were collected using an online questionnaire developed on the Google Forms platform, consisting of objective questions addressing the prevalence of temporomandibular disorders and parafunctional habits among health sciences students.

Questions related to temporomandibular disorders were based on the Simplified Anamnestic Index developed by Fonseca et al. [¹⁸]. Response options included “Yes,” “No,” and “Sometimes.” A score of 10 points was assigned to “Yes,” 0 points to “No,” and 5 points to “Sometimes.” Participants were classified as having no TMD when the total score ranged from 0 to 15 points; mild TMD from 20 to 40 points; moderate TMD from 45 to 65 points; and severe TMD from 70 to 100 points.

To assess the presence of parafunctional habits, an adapted questionnaire was used, including a list of parafunctional behaviors. Responses were recorded as “Yes” to indicate the presence of the habit and “No” to indicate its absence.

This research project was submitted to the Research Ethics Committee of the Patos University Center and, after evaluation, was approved for execution under opinion number 6677013. Following approval by the Research Ethics Committee, the research instrument was administered to health sciences students at UNIFIP by distributing a link via messaging app and email, allowing participants to access and complete the questionnaire on the Google Forms platform.

Collected data were analyzed using descriptive statistics and inferential statistical methods. The chi-square test was applied to determine associations between the study variables.

RESULTS

The estimated sample size of the study was 385 students duly enrolled in health sciences programs at UNIFIP. However, a total of 386 questionnaires were collected, with the majority of participants being female (70.9%). Regarding age, 87.3% of the participants were between 18 and 30 years old. Most respondents were single and reported a family income ranging from one to three minimum wages. Among the undergraduate programs, most participants were enrolled in Dentistry and Nursing (table 1).

Table 1
Descriptive distribution of the sample according to sociodemographic and academic characteristics.

Variables	n	%
Sex
Female	274	70.9
Male	112	29.1
Age
18 - 30 years	337	87.3
>30 years	49	12.7
Marital status
Single	325	84.0
Married/Common-law marriage	61	16.0
Family income
1 - 3 salaries	290	74.7
4 - 5 salaries	70	18.4
>5 salaries	26	6.8
Undergraduate courses in health
Dentistry	104	26.9
Physiotherapy	41	10.6
Medicine	38	9.8
Nursing	80	20.7
Nutrition	45	11.7
Biomedicine	41	10.6
Pharmacy	37	9.6
Current semester
Between 1st and 3rd	148	38.2
Between 4th and 7th	125	32.5
Between 8th and 10th	113	29.4

• Note: Absolute (n) and relative (%) frequencies are presented.

The most prevalent parafunctional habits (table 2) were resting the chin on the hands (68.8%), followed by object biting (54.9%) and tooth clenching (42%). The most prevalent degree of temporomandibular disorder was mild TMD (table 3).

Table 2
Sample distribution according to parafunctional habits.

Variable	n	%
Do you have a habit of clenching your teeth?
Yes	162	42.0
No	224	58.0
Do you have a habit of grinding your teeth?
Yes	117	30.4
No	268	69.6
Do you have a habit of biting objects (e.g., pens, toothpicks, etc.)?
Yes	212	54.9
No	174	45.1
Do you have a habit of chewing gum?
Yes	130	33.7
No	256	66.3
Do you have a habit of biting your nails?
Yes	127	32.9
No	259	67.1
Do you have a habit of sucking your fingers?
Yes	21	5.4
No	365	94.6
Do you have a habit of biting your lips?
Yes	121	31.3
No	265	68.7
Do you have a habit of biting your cheek?
Yes	88	22.9
No	297	77.1
Do you have a habit of chewing only on one side?
Yes	133	34.5
No	252	65.5
Do you have a habit of resting your chin on your hands?
Yes	265	68.8
No	120	31.2

• Note: Absolute (n) and relative (%) frequencies are presented.

Table 3
Severity level of temporomandibular disorders.

Degree of TMD	n	%
Absence of TMD	130	033.3
Mild TMD	178	045.9
Moderate TMD	59	015.2
Severe TMD	23	0 5.9
Total	386	100.0

• Note: Absolute (n) and relative (%) frequencies are presented; TMD: Temporomandibular Disorders.

In the analysis of the association between sex and the presence of TMD (table 4), a statistically significant difference was observed (p=0.0248), indicating a higher prevalence of TMD among female participants (table 4). When considering the severity of TMD (table 5), no statistically significant difference was found between sexes (p=0.0776).

Table 4
Association between sex and the presence of temporomandibular disorders.

Sex\TMD	Absence of TMD	Presence of TMD	Total	χ2	p-value
Female	100	173	273
Male	27	84	111	7.43	0.0248*
I prefer not to answer	1	0	1
Total	128	257	385

• Note: Association analysis between categorical variables was performed using the Pearson chi-square test (χ²); p-values <0.05 were considered statistically significant; TMD: Temporomandibular Disorders.

Table 5
Association between sex and severity of temporomandibular disorders.

Sex\TMD	Without TMD	Mild TMD	Moderate TMD	Severe TMD	Total	χ2	p-value
Female	100	120	42	11	273
Male	27	57	16	11	111	6.88	0.0776
I prefer not to answer	1	0	0	0	1
Total	128	177	58	22	385

• Note: Association analysis between categorical variables was performed using the Pearson chi-square test (χ²); p-values <0.05 were considered statistically significant; TMD: Temporomandibular Disorders.

Regarding undergraduate program enrollment (table 6), no significant associations were found with the presence of TMD (p=0.6120), suggesting a homogeneous distribution of the disorder across the different health sciences programs.

Table 6
Association between the course and the presence of temporomandibular disorders.

Course\TMD	Absence of TMD	Presence of TMD	Total	χ2	p-value
Biomedicine	15	26	41
Nursing	28	52	80
Pharmacy	10	27	37
Fisioterapia	10	31	41	4.91	0.6120
Medicine	10	28	38
Nutrition	17	28	45
Dentistry	39	65	104
Total	129	257	386

• Note: Association analysis between categorical variables was performed using the Pearson chi-square test (χ²) p-values <0.05 were considered statistically significant; TMD: Temporomandibular Disorders.

DISCUSSION

The perception of probable signs and symptoms of temporomandibular disorders is an important means of achieving early diagnosis of these conditions [¹⁹]. The use of instruments that allow diagnosis and promote accurate and reliable data collection is essential to obtain valid results that truly represent the studied reality [²⁰]. The questionnaire used to determine participants’ degree of TMD was based on the Anamnestic Index proposed by Fonseca et al. [¹⁸]. It is important to note that this questionnaire is one of the few instruments available in the Portuguese language to characterize symptom severity. Its simplicity allows its application in epidemiological and population-based studies; however, the data obtained using this index are limited to the classification of TMD signs and symptom severity [²⁰].

Characterization of the participants according to TMD severity revealed that most individuals presented with mild TMD. This finding corroborates the results of another study conducted with 336 university students in 2012 [¹⁹]. In addition, a more recent study evaluating students’ profiles according to TMD severity, based on the Fonseca Anamnestic Index (1994), demonstrated that most participants exhibited some degree of TMD [²¹].

In the present study, women showed a higher prevalence of TMD compared to men, although disease severity did not differ significantly between sexes. Similar findings were reported by Medeiros et al. [⁶], who observed that most individuals diagnosed with TMD were female. This characteristic may be attributed to the fact that women seek healthcare services more frequently than men, in addition to having greater pain perception and potentially higher susceptibility to joint disorders [²,⁶,⁹,¹⁴].

Analysis of questionnaire responses revealed that 77.2% of participants answered affirmatively to the question, “Do you consider yourself a tense (stressed or anxious) person?” This finding demonstrates the influence of stress- and anxiety-related factors in the etiology of TMD [¹,⁴,¹¹,¹⁹]. Furthermore, according to Godinho et al. [²], TMD has been more frequently associated with students in the final years of their programs, likely due to the transition from basic to clinical disciplines, increased academic demands, concerns regarding the job market, and course completion.

When considering the undergraduate programs of Dentistry, Physical Therapy, Medicine, Nursing, Nutrition, Biomedicine, and Pharmacy, TMD was observed at some level in all programs. Notably, the Physical Therapy program showed the highest percentage (63.4%) of students classified as having no TMD. This finding contrasts with the study by Queiroz et al. [⁹], which reported that only 10% of Physical Therapy students were free of TMD. These differences suggest that TMD prevalence may vary according to the higher education institution, although no statistically significant association was found between the presence or severity of TMD and the undergraduate program. In this context, Bezerra et al. [¹⁹] reported that academic training, particularly in health-related fields, imposes higher demands on students, reflecting increased performance pressure among health sciences students.

Regarding TMD-related symptoms, health sciences students most commonly reported frequent headaches, neck pain, and cervical pain. Other studies have similarly identified headaches and neck pain as frequent symptoms in patients with TMD, followed by muscle pain or fatigue during mastication, TMJ sounds during chewing or mouth opening, and ear or TMJ pain [²,⁴,¹¹].

The most prevalent parafunctional behaviors in the studied university population were resting the chin on the hands (68.8%), followed by object biting (54.9%) and tooth clenching (42%). Medeiros et al. [⁶] also identified resting the chin on the hands as the most prevalent parafunctional habit, affecting 36.3% of students. A more recent study conducted in 2019 further corroborated this finding, highlighting the potential influence of this habit on irregular mandibular positioning relative to the cranial and cervical regions [¹²].

Godinho et al. [²] and Medeiros et al. [⁶] also emphasized the high prevalence of resting the chin on the hands among university students; however, previous studies did not evaluate this habit across all health sciences programs addressed in the present study.

With respect to parafunctional behaviors, it is noteworthy that tooth clenching was reported by 42% of the sample. Studies suggest that this habit is more easily detected by participants compared to tooth grinding, as clenching more frequently occurs during wakefulness, facilitating self-perception [⁶,²²].

Analysis of the relationship between TMD and parafunctional behaviors indicates that stress and parafunction are strongly associated with TMD etiology [²³]. Muscular alterations involving the masticatory muscles may originate from parafunctional behaviors that generate overload in the musculature, orofacial region, and stomatognathic system, thereby favoring the onset of TMD symptoms [⁷]. According to Godinho et al. [²], parafunctional behaviors may act as mechanisms for muscle tension release and are therefore associated with TMJ alterations. Queiroz et al. [⁹] further stated that in individuals with TMD, parafunctional behaviors contribute to disease etiology, progression of muscular and intra-articular changes, and the development of TMJ-related signs and symptoms.

Evaluation of parafunctional behaviors and TMD severity indicates that health sciences students generally present at least one parafunctional habit and some degree of temporomandibular dysfunction. Studies have demonstrated that health professionals show a higher tendency toward stomatognathic system disorders, particularly TMD and parafunctional behaviors, which often originate during undergraduate education [¹⁰-¹²].

Considering the multifactorial etiology of TMD and parafunctional behaviors, management of these conditions should involve a multiprofessional and multidisciplinary approach [¹⁵–¹⁷]. Fonseca et al. [¹⁸] recommended that individuals classified with moderate or severe TMD be referred for specialized treatment.

The studies cited above predominantly evaluated epidemiological samples of young adult populations. In the present study, a higher prevalence of mild TMD was observed compared to moderate and severe forms, in addition to a greater proportion of individuals presenting some degree of TMD compared to those without TMD. Therefore, the importance of TMD diagnosis and appropriate referral for stomatognathic system evaluation within routine clinical practice is evident [⁶].

CONCLUSION

The study profile was characterized by a predominantly female sample, aged between 18 and 30 years. The presence of TMD symptoms was more prevalent among female participants.

Based on the collected data, most university students in the studied sample presented some degree of TMD, with mild TMD being the most prevalent condition.

Parafunctional behaviors were also observed among university students, with resting the chin on the hands being the most prevalent habit in the studied sample.

Therefore, these findings highlight the importance of early diagnosis of TMD and parafunctional behaviors in order to develop appropriate treatment strategies that improve patients’ quality of life, minimize potential damage, and enhance the prognosis of temporomandibular disorders.

• Article aligned with the Good Health and well-being goal of the Sustainable Development Goals (SDGs).
• How to cite this article
  Farias GL, Morais JLC, Dias VN, Dias JN. Prevalence of temporomandibular disorders and parafunctional habits in health sciences students. RGO, Rev Gaúch Odontol. 2026;74:e20260024. http://dx.doi.org/10.1590/1981-86372026002420260010

Data Availability

The research data are available in the body of the document.

REFERENCES

• ¹ Aguiar AM, Sousa BS, Silva MSL. Association between temporomandibular disorders in people with anxiety. Res Soc Dev. 2022;11(14):1-11. doi: http://dx.doi.org/10.33448/rsd-v11i14.36023
  » https://doi.org/10.33448/rsd-v11i14.36023
• ² Godinho DCA, Melo SR, Lemos MES, Furlan RMMM. Correlação entre sintomas de disfunção temporomandibular, hábitos orais deletérios e sintomas de estresse em estudantes universitários. Dist Comun. 2019;31(3):481-92. doi: https://doi.org/10.23925/2176-2724.2019v31i3p481-492
  » https://doi.org/10.23925/2176-2724.2019v31i3p481-492
• ³ Araújo IRS, Silveira AS, Cardoso M, Tannure PN. Conhecimento de cirurgiões-dentistas sobre a relação entre disfunção temporomandibular e fatores oclusais. Rev Odontol Unesp. 2019;48:1-10. doi: https://doi.org/10.1590/1807-2577.06519
  » https://doi.org/10.1590/1807-2577.06519
• ⁴ Maia IH, Rifane T, Oliveira AS, Silvestre FA, Freitas BFB, Leitão AKA, et al. Disfunção temporomandibular e fatores psicológicos: uma revisão de literatura. Res Soc Dev. 2021;10(3):1-8. doi: https://doi.org/10.33448/rsd-v10i3.13123
  » https://doi.org/10.33448/rsd-v10i3.13123
• ⁵ Leão BLC, Gabriel FCT, Cruz KR, Kagawa AL, Zeigelboim BS, Neto JS. Prevalência de sintomas otológicos e hábitos parafuncionais em pacientes com disfunção temporomandibular. Rev CEFAC. 2019;21(1):1-5. doi: http://dx.doi.org/10.1590/1982-0216/20192115318
  » https://doi.org/10.1590/1982-0216/20192115318
• ⁶ Medeiros SP, Batista AUD, Forte FDS. Prevalência de sintomas de disfunção temporomandibular e hábitos parafuncionais em estudantes universitários. RGO, Rev Gaúch Odontol. 2011;59(2):201-8.
• ⁷ Sarrazin HC, Maia P. Disfunção temporomandibular e hábitos parafuncionais em policiais militares: um estudo transversal. Arq Odontol. 2020;56(21):1-9. doi: https://doi.org/10.7308/aodontol/2020.56.e21
  » https://doi.org/10.7308/aodontol/2020.56.e21
• ⁸ Paulino MR, Moreira VG, Lemos GA, Silva PLP, Bonan PRF, Batista AUD. Prevalence of signs and symptoms of temporomandibular disorders in college preparatory students: associations with emotional factors, parafunctional habits, and impact on quality of life. Ciênc Saúde Colet. 2015;23(1):173-86. doi: https://doi.org/10.1590/1413-81232018231.18952015
  » https://doi.org/10.1590/1413-81232018231.18952015
• ⁹ Queiroz NBD, Magalhães KM, Machado J, Viana MO. Prevalência de disfunção temporomandibular e associação com hábitos parafuncionais em alunos do curso de fisioterapia da universidade de Fortaleza. Rev Rede Cuid Saúde. 2015;9(1):1-14.
• ¹⁰ Nascimento DSB, Martins AJLP. A influência do estresse na saúde bucal: uma revisão integrativa. Rev FT. 2025;29(152). doi: https://doi.org/10.69849/revistaft/ni10202511201602
  » https://doi.org/10.69849/revistaft/ni10202511201602
• ¹¹ Almeida AFN, Medina PB, Rosa M, Machado CS. Incidência de disfunção temporomandibular em universitários brasileiros. Braz J Dev. 2022;8(3):18106-19. doi: https://doi.org/10.34117/bjdv8n3-175
  » https://doi.org/10.34117/bjdv8n3-175
• ¹² Oliveira SCFS, Queiroz RG, Vieira BR, Costa MJF, Penha ES, Filho AAO, et al. Prevalência de hábitos parafuncionais em graduandos de odontologia em uma universidade pública federal. Braz J Surg Clin Res. 2019;27(3):18-21.
• ¹³ Takamiya AS, Haddad MF, Valene VB, Túrcio KH, Zuim PRJ, Brandini DA. Impact of chronic orofacial pain of temporomandibular disorder and anxiety on the academic performance of dental students. ABCS Health Sci. 2021;47:1-7. doi: https://doi.org/10.7322/abcshs.2020116.1567
  » https://doi.org/10.7322/abcshs.2020116.1567
• ¹⁴ Maia CR, Almeida GCM, Moura JMBO, Pessoa DMV. Prevalência da disfunção temporomandibular associada aos fatores psicológicos em universitários. Braz J Dev. 2022;8(7):50375-87. doi: https://doi.org/10.34117/bjdv8n7-111
  » https://doi.org/10.34117/bjdv8n7-111
• ¹⁵ Cruz JHA, Sousa LX, Oliveira BF, Júnior FPA, Alves MASG, Filho AAO. Disfunção temporomandibular: revisão sistematizada. Arch Health Invest. 2020;9(6):570-575. doi: https://doi.org/10.21270/archi.v9i6.3011
  » https://doi.org/10.21270/archi.v9i6.3011
• ¹⁶ Sassi FC, Silva AP, Santos RKS, Andrade CRF. Tratamento para disfunções temporomandibulares: uma revisão sistemática. Audiol Comun Res. 2018;23:1-13. doi: http://dx.doi.org/10.1590/2317-6431-2017-1871
  » https://doi.org/10.1590/2317-6431-2017-1871
• ¹⁷ Grossmann E, Grossmann TK. Cirurgia da articulação temporomandibular. Rev Dor. 2011;12(2):152-9. doi: https://doi.org/10.1590/S1806-00132011000200012
  » https://doi.org/10.1590/S1806-00132011000200012
• ¹⁸ Fonseca DM, Bonfante G, Valle AL, Freitas SFT. Diagnóstico pela anamnese da disfunção craniomandibular. RGO, Rev Gaúch Odontol. 1994;42(1):23-8.
• ¹⁹ Bezerra BPN, Ribeiro AIM, Farias ABL, Farias ABL, Fontes LBC, Nascimento SR, et al. Prevalência da disfunção temporomandibular e de diferentes níveis de ansiedade em estudantes universitários. Revista Dor. 2012;13(3):235-42. doi: https://doi.org/10.1590/S1806-00132012000300008
  » https://doi.org/10.1590/S1806-00132012000300008
• ²⁰ Chaves TC, Oliveira AS, Grossi DB. Principais instrumentos para avaliação da disfunção temporomandibular, parte I: índices e questionários; uma contribuição para a prática clínica e de pesquisa. Fisioter Pesq. 2008;15(1):92-100. doi: https://doi.org/10.1590/S1809-29502008000100015
  » https://doi.org/10.1590/S1809-29502008000100015
• ²¹ Barreto BR, Drumond CL, Carolino RA, Júnior JKO. Prevalência de disfunção temporomandibular e ansiedade em estudantes universitários. Arch Health Invest. 2021;10(9):1386-91. doi: https://doi.org/10.21270/archi.v10i9.5401
  » https://doi.org/10.21270/archi.v10i9.5401
• ²² Winocur E, Gavish A, Finkelshtein T, Halachmi M, Gazit E. Oral habits among adolescent girls and their association with symptoms of temporomandibular disorders. J Oral Rehabil. 2001;28(7):624-9. doi: https://doi.org/10.1046/j.1365-2842.2001.00708.x
  » https://doi.org/10.1046/j.1365-2842.2001.00708.x
• ²³ Bortolleto, PPB, Moreira APSM, Madureira, PR. Análise dos hábitos parafuncionais e associação com Disfunção das Articulações Temporomandibulares. Rev Assoc Paul. 2013;67(3):1-6.

Edited by

• Editor
  Ney Soares de Araújo

Publication Dates

• Publication in this collection
  17 Aug 2026
• Date of issue
  2026

History

• Received
  27 Jan 2026
• Accepted
  30 Apr 2026