Prevalence of Temporomandibular Disorders and their association with Facial Biotype in Chilean Children and Adolescents: A Cross-Sectional Study

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Methods A cross-sectional study assessed the association between temporomandibular disorders and facial biotypes in 83 children and adolescents aged 7 to 14. Participants were evaluated using Axis I of the DC/TMD adapted for non-adult populations to identify the presence of temporomandibular disorders. Additionally, cephalometric analysis using Ricketts’ VERT index was performed to determine each participant's facial biotype. Results A prevalence of 27.71% for temporomandibular disorders was identified in the study population. A significant association was observed between the dolichofacial biotype and articular disorders, specifically disc displacement with reduction and arthralgia. Conclusion The prevalence of temporomandibular disorders in Chilean individuals aged 7 to 14 years was 27.71%. Furthermore, an association was found between the dolichofacial biotype and the presence of articular disorders, namely disc displacement with reduction and arthralgia. Temporomandibular Joint Disorders Cephalometry Facial Pattern Child Adolescent INTRODUCTION Temporomandibular disorders (TMD) are a group of musculoskeletal and neuromuscular conditions that affect the masticatory muscles, temporomandibular joint and/or related structures (Bertoli et al. 2007 ; Manns Freese 2013 ; Sharma et al. 2011 ). The etiology of TMD is controversial. Evidence supports a multifactorial etiology, with several risk factors interacting at the individual level, described as a biopsychosocial nature (Rongo et al. 2022 ; Sharma et al. 2011 ; Velasco-Ortega et al. 2002 ). Approximately 70% of the general population shows signs of TMD; however, only 1 in 4 individuals is aware of the problem and seeks medical attention (Sharma et al. 2011 ). Regarding prevalence, it is estimated to range from 5–30% in adults, whereas in children and adolescents, it fluctuates between 4.2% and 90%, reflecting considerable heterogeneity in the preexisting data (Bavia and Rodrigues Garcia 2016 ; Cerda-Peralta et al. 2019 ; Inda-Velázquez et al. 2019 ; Minervini et al. 2023 ; Restrepo et al. 2020 ; Rongo et al. 2021 ; Sánchez-Tito and Yañez-Chávez 2015 ; Sharma et al. 2011 ). Ricketts introduced the concept of Facial Biotype (FB) as “the set of morphological and functional characteristics that determine the direction of growth and behavior of the face” (Sánchez-Tito and Yañez-Chávez 2015 ). This term describes the phenotypic variations among individuals of the same species regarding certain common traits of the facial skeleton. These variations result from interactions between genetic and environmental factors that mold the growth and development of facial structures (Cerda-Peralta et al. 2019 ). Based on the proportions of the facial skeleton, facial biotypes can be classified into three categories: dolichofacial, characterized by a predominance of facial height over width; brachyfacial, where width is predominant over height; and mesofacial, which represents a balance between these dimensions (Cerda-Peralta et al. 2019 ; Poveda Roda et al. 2007 ). Several methods are available to determine FB, including clinical examination and, more accurately, cephalometric analysis using lateral radiographs. This latter method measures various facial structures and compares the results with reference values specific to each facial biotype, enabling detailed and objective analysis (Barahona-Cubillo and Benavides-Smith 2006; Fernández and da Silva 2009 ; Rodríguez 2019; Sánchez-Tito and Yañez-Chávez 2015 ). Since 2014, the International Standard for TMD Evaluation has been the Diagnostic Criteria for TMD (DC/TMD), aimed to provide a common language for TMDs conditions. However, this instrument was developed for the adult population (Schiffman et al. 2014 ). Historically, TMDs were not always considered pediatric conditions. Nevertheless, evidence has shown that TMDs are present in children and adolescents, with the prevalence increasing with age. Consequently, in recent years, efforts have been made to adapt the DC/TMD system for non-adult populations by modifying the numeric pain scale to a graduated facial expression scale and simplifying the language used in questionnaires (Hicks et al. 2001 ; Restrepo et al. 2020 ; Rongo et al. 2021 ). Given that the research on prevalence of TMDs in children and adolescents is relatively recent, the results available in the literature are inconsistent and exhibit a wide range of variability. Therefore, it is essential to provide data to help elucidate the reasons behind this broad range of prevalence reported in the literature (Minervini et al. 2023 ). Additionally, investigating the potential association between the presence of TMD and FB is crucial, as this could contribute to the development of preventive and therapeutic strategies targeting profiles with higher risk of developing TMD. FB directly influences occlusion, facial harmony, masticatory muscles, and stomatognathic functions (Rodríguez 2019). However, the literature does not yet describe a definitive association between different FBs and the development of various TMDs. This underscores the need for more detailed and comprehensive research in this area(Bavia and Rodrigues Garcia 2016 ; Fernandes et al. 2015 ; Manfredini et al. 2016 ). This study aims to determine the prevalence of TMD and its association with FB in Chilean children and adolescents attending a university clinic during 2023. MATERIALS AND METHODS A cross-sectional study was conducted with a sample of 83 children and adolescents aged 7 to 14 years who attended a teaching-assistance clinic in Chile in 2023. The sample size was determined based on the availability of individuals willing to participate in the study. Inclusion criteria required participants to be between 7 and 14 years old, have received dental care at the University Clinic of Universidad de los Andes (Chile) in 2023, and possess a lateral cephalometric radiograph stored in the clinic's radiographic database. Patients with a history of facial trauma, craniofacial malformations, surgical procedures in the orofacial region, cervical malformations, prior joint pathology, or ongoing or previous orthodontic treatment were excluded. This article was structured following the STROBE checklist for observational studies (von Elm et al. 2007). Ethical Aspects The study was approved by the Scientific Ethics Committee of Universidad de los Andes (Chile) (CEC2022062). Written informed consent was obtained from the guardians, and written informed assent was secured from the participants before their involvement in the study. Operational Definition of Variables The study variables were categorized into two groups. On one hand, the independent variables were: Temporomandibular Disorders (TMDs): Refer to a group of musculoskeletal and neuromuscular conditions that affect the temporomandibular joints (TMJs), masticatory muscles, and related structures. This variable is dichotomous and categorical, indicating the presence or absence of TMD, and is measured using the DC/TMD protocol (Sharma et al. 2011). Facial Biotype: Describes a set of common morphological characteristics in individuals of the same species, determined by genetic and environmental factors. This variable is polytomous categorical: brachyfacial, mesofacial, and dolichofacial, identified through Ricketts’ VERT cephalometric analysis (Cerda-Peralta et al. 2019). Sex: Dichotomous categorical variable consisting of female or male. On the other hand, the dependent variables of TMD included myalgia, arthralgia, disc displacement with reduction, and headaches attributed to TMD. All these were dichotomous variables assessed based on the presence or absence of the aforementioned signs. Assessment of TMD in Children and Adolescents To assess the presence of TMD in participants, the Axis 1 protocol of the DC/TMD was employed. This instrument has been utilized since 2014 for the diagnosis of TMD, and a version validated for children and adolescents was used in this study (Rongo et al. 2021). Initially, a validated questionnaire translated into Spanish was performed to all participants (Restrepo et al. 2020). The questionnaire aimed to collect information on the history of orofacial pain symptoms, headaches, and mandibular function. Subsequently, clinical evaluations were conducted for all participants following the International Network for Orofacial Pain and Related Methodologies (INFORM) guidelines (Rongo et al. 2021). During the clinical evaluation, muscular and joint palpation was performed by maintaining for 2 seconds a pressure point with a force magnitude of 500 or 1000 g, depending on the size of the structure examined. If pain was detected, the pressure was reapplied to the same point but for 5 seconds. A standardized palpation device (Palpeter, BUTLER©, Switzerland) that applies exact and predictable pressures of 500 and 1000 g was used to ensure consistency and reduce potential bias. Technique for Determining Facial Biotype Facial biotype analysis was performed using the participants’ lateral cephalometric radiographs. The following measurements were taken: lower anterior facial height, facial axis, facial depth, mandibular plane, and mandibular arch. These results were compared with normative values to determine the patient’s VERT index, which was subsequently compared to the standards established by Ricketts to identify the facial biotype. Operator Calibration For facial biotype determination and the DC/TMD protocol, an experienced operator conducted a calibration session with two researchers (FZV and MRR). The DC/TMD protocol was applied to five patients during this session. Additionally, cephalometric analyses of the radiographs for 40 patients were performed individually using Dolphin® software (Madrid, Spain). The inter-examiner agreement was assessed, resulting in a kappa coefficient of 0.9. Statistical Analysis Descriptive and inferential statistical measures were reported using Chi-square and Fisher’s exact tests to examine associations between categorical variables and logistic regression models to estimate the risk among relevant variables. A significance level of 95% was applied, and analyses were conducted using Stata SE 17.0 software (StataCorp®, USA). RESULTS A total of 83 participants met the inclusion criteria and were administered the Axis 1 DC/TMD protocol. They then underwent a clinical evaluation following the guidelines of the International Network for Orofacial Pain and Related Methodologies. The clinical and sociodemographic characteristics of the sample are presented in Table 1 . Table 1 Clinical and Sociodemographic Characteristics of the Participants Variables n (%) Gender Female 51 (61.45%) Male 32 (38.55%) Age Group 7–10 years 67 (80.72%) 11–14 years 16 (19.28%) Myalgia No 69 (83.13%) Yes 14 (16.87%) Arthralgia No 71 (85.54%) Yes 12 (14.46%) Headache Attributed to TMD No 70 (84.34%) Yes 13 (15.66%) Disc Displacement with Reduction No 77 (92.77%) Yes 6 (7.23%) Temporomandibular Disorders No 60 (72.29%) Yes 23 (27.71%) Total n = 83 (100%) Based on the participants' lateral cephalometric radiographs, a facial biotype diagnosis was established (Table 2 ). Table 2 Facial Biotype Diagnosis according to Ricketts VERT Index in the Participants Facial Biotype n (%) Mesofacial 38 (45.78%) Dolichofacial 17 (20.48%) Brachyfacial 28 (33.73%) Total n = 83 (100%) Table 3 presents the relationship between facial biotype (FB) and the other variables of interest. Statistically significant associations were found between facial biotype and sex and between the presence of arthralgia and disc displacement with reduction. Table 4 presents the risk estimates for facial biotypes and variables associated with temporomandibular disorders (TMDs). A significant association was observed between the female sex and both dolichofacial and brachyfacial biotypes, with an exceptionally high risk in females with a dolichofacial biotype (adjusted OR = 5.76; p = 0.02). Table 3 Distribution and Association of Facial Biotype with Other Variables Facial Biotype Mesofacial n (%) Dolichofacial n (%) Brachyfacial n (%) Association between variables Gender Female 17 (44.74%) 14 (82.35%) 20 (71.43%) p = 0.01 b Male 21 (55.26%) 3 (17.65%) 8 (28.57%) Myalgia No 32 (84.21%) 15 (88.24%) 22 (78.57%) p = 0.8 a Yes 6 (15.78%) 2 (11.76%) 6 (21.43%) Arthralgia No 34 (89.47%) 11 (64.71%) 26 (92.86%) p = 0.03 a Yes 4 (10.53%) 6 (35.29%) 2 (7.14%) Headache Attributed to TMD No 32 (84.21%) 13 (76.47%) 25 (89.29%) p = 0.54 a Yes 6 (15.78%) 4 (23.53%) 3 (10.71%) Disc Displacement with Reduction No 37 (97.37%) 12 (70.59%) 28 (100%) p = 0.001 a Yes 1 (2.63%) 5 (29.41%) 0 (0%) Temporomandibular Disorders No 29 (76.32%) 10 (58.82%) 21 (75%) p = 0.39 a Yes 9 (23.68%) 7 (41.18%) 7 (25%) Total n = 38 (100%) n = 17 (100%) n = 28 (100%) a Fisher’s Exact Test b Chi-squared Test Table 4 Risk Estimation Between Facial Biotype Levels and Other Variables Variable Odds Ratio a p-value Adjusted Odds Ratio b 95% C.I. c p-value Female Gender Dolichofacial 5.76 0.02 5.73 1.41–23.36 0.01 Brachyfacial 3.09 0.04 3.12 1.07–9.12 0.03 Presence of Myalgia Dolichofacial 0.71 0.69 0.76 0.13–4.28 0.76 Brachyfacial 1.45 0.55 1.23 0.33–4.56 0.76 Presence of Arthralgia Dolichofacial 4.63 0.03 4.57 1.08–19.33 0.04 Brachyfacial 0.65 0.64 0.68 0.11–4.12 0.67 Presence of Headache Attributed to TMD Dolichofacial 1.64 0.49 1.78 0.42–7.53 0.43 Brachyfacial 0.64 0.55 0.52 0.11–2.49 0.42 Presence of Disc Displacement with Reduction Dolichofacial 15.42 0.02 20.46 1.88–223.22 0.01 Brachyfacial 1 – – – – Presence of Temporomandibular Disorders Dolichofacial 2.26 0.19 2.37 0.69–8.12 0.17 Brachyfacial 1.07 0.9 0.97 0.29–3.13 0.95 Reference category: Mesofacial Biotype a Crude Odds Ratio (OR) b Adjusted for age c 95% Confidence Interval of the adjusted model Regarding the presence of arthralgia and disc displacement with reduction, the dolichofacial biotype showed a significantly higher risk (adjusted OR = 4.57 and 20.46, respectively). Although no statistically significant results were found for the remaining variables, the dolichofacial biotype emerged as a risk factor for TMD-associated headache and the overall presence of TMD. An exception was myalgia, where the brachyfacial biotype appeared to be more frequently associated with risk in the studied sample. DISCUSSION The aim of this study was to assess the prevalence of temporomandibular disorders (TMDs) and their association with facial biotype (FB) in individuals aged 7 to 14 years within a Chilean population. The findings revealed a TMD prevalence of approximately 28% in the study sample, which falls within the broad range reported in children and adolescents, spanning from 4.2–90% (Minervini et al. 2023 ; Rongo et al. 2021 ). This significant variability reflects an unclear pattern that complicates the interpretation, comparison, and integration of existing literature. Such heterogeneity may be partly explained by the inconsistent approach to TMDs in this age group. Historically, TMDs have not always been acknowledged as a significant condition in children and adolescents, leading to a limited number of studies in this population. Furthermore, variations in the methodologies used, the diagnostic criteria applied, and the differences in participant selection have contributed to the significant disparity in reported outcomes (Ekberg et al. 2023 ; Katsikogianni et al. 2021 ; Minervini et al. 2023 ). Regarding the distribution of facial biotypes, mesofacial profiles were predominant in the study sample, followed by brachyfacial and, finally, dolichofacial profiles. These results do not align with those reported by Ballero et al. and Tintaya et al., who found a higher prevalence of brachyfacial patterns compared to mesofacial ones (Apaza Tintaya 2021; Ballero Llaneza 2018), highlighting the disparity in findings and emphasizing the need for further research using more consistent and comparable methods. Such efforts would help clarify trends in the distribution of facial biotypes and their potential relationship with other significant variables. In the present study, a statistically significant association was found between the dolichofacial biotype and two specific conditions: disc displacement with reduction (DDwR) and arthralgia. These results indicate that dolichofacial profiles may be considered as a risk factor, putting children and adolescents with this facial profile at a potential risk for developing TMDs, both now and in the future. The link between dolichofacial patients and articular disorders has also been highlighted in a systematic review by Manfredini et al. (2015), whose findings correspond with those presented here. Their review noted that hyper divergent growth patterns are often associated with a higher frequency of DDwR and degenerative joint disorders (Manfredini et al. 2016 ). On the other hand, assessing the association between different facial biotypes and the presence of TMDs revealed no statistically significant results in this investigation. However, within the study sample, a higher prevalence of TMDs was noted among individuals with a dolichofacial biotype, aligning with existing literature that describes a greater predisposition for this facial pattern to develop TMDs (Ballero Llaneza 2018). Despite these efforts, the study had certain important limitations. First, while the initial sample size was larger, the lack of lateral cephalograms and limited patient availability reduced the final sample to 83 individuals. This small sample size is not representative of the general population, which limits the ability to generalize these findings. Additionally, the cross-sectional nature of the study does not permit establishing causal relationships between facial biotype and TMD presence. This underscores the importance of longitudinal research to track TMD prevalence in children and adolescents while identifying and analyzing associated risk factors. Such studies will yield a stronger foundation for evaluating cause-and-effect relationships between these variables, thus revealing patterns and trends in TMD development over time. Moreover, the exclusion of diagnoses such as subluxation, disc displacement with reduction accompanied by intermittent locking, and disc displacement with reduction accompanied by limited opening may indicate a potential limitation of the study. However, considering the low or virtually nonexistent frequency of these conditions among children, excluding these criteria streamlined the methodology without impacting the results, as reported by Restrepo et al. (Restrepo et al. 2020 ). Despite these limitations, this study offers relevant data on a potential link between facial biotype and TMDs, particularly considering the lack of evidence regarding these factors in the studied age group. These findings highlight the need for possible preventive measures focused on early intervention to mitigate the risk of progression to both acute and chronic presentations. Moreover, future studies using a biopsychosocial approach, as suggested by Axis II of the DC/TMD, could prove especially beneficial. This approach would enable the identification of various factors affecting TMD development, such as psychological, social, and behavioral variables, thus deepening our understanding of these conditions in the target population and aiding the implementation of more comprehensive therapeutic strategies. CONCLUSION TMDs are a common issue in the general population, affecting both children and adults. Despite its limitations, this study revealed a TMD prevalence of 27.71% among Chilean children aged 7 to 14 years. Additionally, an association was found between the dolichofacial biotype and the presence of articular disorders—specifically, disc displacement with reduction and arthralgia. These findings encourage further research in this area for preventive, early detection, and therapeutic purposes. Declarations CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest to declare that are relevant to the content of this article. Author Contribution Fiorella Zambrano Verduga: Conceptualization, Methodology, Validation and Writing the original draft; Mariana Ramírez Rodríguez: Conceptualization, Methodology, Validation and Writing the original draft; Nicolás Flores Palominos: Investigation, Writing the original fraft, Visualization; Gabriel Andrade Cabrera: Investigation, Formal analysis, Writing-Reviewing and Editing; Claudio Gamboa Vidal: Conceptualization, Resources and Supervision. Acknowledgement The authors would like to express their gratitude to the staff of the Teaching Assistance Clinic at Universidad de los Andes (Chile) and the participating children, adolescents, and their families for their cooperation throughout this study. References Apaza Tintaya JA. 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Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II. J. Oral Rehabil. 2022 May;49(5):541–52. Sánchez-Tito MA, Yañez-Chávez EE. Asociación entre el biotipo facial y la sobremordida: Estudio piloto. Rev. Estomatológica Hered. 2015 Jan;25(1):05–11. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet J-P, et al. 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. Sharma S, Gupta DS, Pal US, Jurel SK. Etiological factors of temporomandibular joint disorders. Natl. J. Maxillofac. Surg. 2011 Jul;2(2):116–9. Velasco-Ortega E, Cruz Rodríguez D, Velasco Ponferrada M del C, Monsalve Guil L, Bullón Fernández P. Los trastornos temporomandibulares en la práctica odontológica. I: clasificación y etipatogenia. Avances Médico Dentales; 2002;18(3):177–89. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6330924","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":436204831,"identity":"e19c03a6-a0c4-4ea7-9495-9cd1f2b15774","order_by":0,"name":"Fiorella Zambrano Verduga","email":"","orcid":"","institution":"Universidad de Los Andes, Chile","correspondingAuthor":false,"prefix":"","firstName":"Fiorella","middleName":"Zambrano","lastName":"Verduga","suffix":""},{"id":436204832,"identity":"c89ac96f-997e-4778-98ad-9f28872a2c8c","order_by":1,"name":"Mariana Ramírez Rodríguez","email":"","orcid":"","institution":"Universidad de Los Andes, Chile","correspondingAuthor":false,"prefix":"","firstName":"Mariana","middleName":"Ramírez","lastName":"Rodríguez","suffix":""},{"id":436204833,"identity":"e91a5884-b0aa-4bfc-85dc-245ad16fdd06","order_by":2,"name":"Nicolás Flores Palominos","email":"","orcid":"","institution":"Universidad de Los Andes, Chile","correspondingAuthor":false,"prefix":"","firstName":"Nicolás","middleName":"Flores","lastName":"Palominos","suffix":""},{"id":436204834,"identity":"2491e70d-8cf3-4ffa-be02-296cead11d8e","order_by":3,"name":"Gabriel Andrade Cabrera","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYJACCQYGZgZ+EIsHRLATq0WyAaaFmVgtBgeI1SLvfvbg7YoaaznjG8nPHrypqGPgbyagxfBMXrLlmWPpxmY30swN55w5zCBxmJCWhhwzyQa2w4nbbiSYSfO2HWAwIOQww/43QC3/DtdvnpH+TZr3Xx1hLfISQFsa2w4nGAAZ0rwNzIS1GEi8MbZs7Es3nHHmTZnknGOHeQj6Rb4/x/Bmwzdref729G0Sb2rq5PjbGwjYcgBNgIeAHUBbCBg5CkbBKBgFo4CBAQAhzT2TJMV5/QAAAABJRU5ErkJggg==","orcid":"","institution":"Universidad de Los Andes, Chile","correspondingAuthor":true,"prefix":"","firstName":"Gabriel","middleName":"Andrade","lastName":"Cabrera","suffix":""},{"id":436204835,"identity":"323a9dec-8a80-4288-b2ed-4bf8fb00c037","order_by":4,"name":"Claudio Gamboa Vidal","email":"","orcid":"","institution":"Universidad de Los Andes, Chile","correspondingAuthor":false,"prefix":"","firstName":"Claudio","middleName":"Gamboa","lastName":"Vidal","suffix":""}],"badges":[],"createdAt":"2025-03-28 22:08:11","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6330924/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6330924/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":80038055,"identity":"0f0f4c87-2fcb-46ab-9a61-6210354961fb","added_by":"auto","created_at":"2025-04-07 08:46:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":965040,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6330924/v1/6646a417-4732-40c5-b281-77a756c5b1c0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of Temporomandibular Disorders and their association with Facial Biotype in Chilean Children and Adolescents: A Cross-Sectional Study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eTemporomandibular disorders (TMD) are a group of musculoskeletal and neuromuscular conditions that affect the masticatory muscles, temporomandibular joint and/or related structures (Bertoli et al. \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2007\u003c/span\u003e; Manns Freese \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Sharma et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe etiology of TMD is controversial. Evidence supports a multifactorial etiology, with several risk factors interacting at the individual level, described as a biopsychosocial nature (Rongo et al. \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Sharma et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Velasco-Ortega et al. \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2002\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eApproximately 70% of the general population shows signs of TMD; however, only 1 in 4 individuals is aware of the problem and seeks medical attention (Sharma et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Regarding prevalence, it is estimated to range from 5\u0026ndash;30% in adults, whereas in children and adolescents, it fluctuates between 4.2% and 90%, reflecting considerable heterogeneity in the preexisting data (Bavia and Rodrigues Garcia \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Cerda-Peralta et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Inda-Vel\u0026aacute;zquez et al. \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Minervini et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Restrepo et al. \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Rongo et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; S\u0026aacute;nchez-Tito and Ya\u0026ntilde;ez-Ch\u0026aacute;vez \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Sharma et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRicketts introduced the concept of Facial Biotype (FB) as \u0026ldquo;the set of morphological and functional characteristics that determine the direction of growth and behavior of the face\u0026rdquo; (S\u0026aacute;nchez-Tito and Ya\u0026ntilde;ez-Ch\u0026aacute;vez \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). This term describes the phenotypic variations among individuals of the same species regarding certain common traits of the facial skeleton. These variations result from interactions between genetic and environmental factors that mold the growth and development of facial structures (Cerda-Peralta et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBased on the proportions of the facial skeleton, facial biotypes can be classified into three categories: dolichofacial, characterized by a predominance of facial height over width; brachyfacial, where width is predominant over height; and mesofacial, which represents a balance between these dimensions (Cerda-Peralta et al. \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Poveda Roda et al. \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral methods are available to determine FB, including clinical examination and, more accurately, cephalometric analysis using lateral radiographs. This latter method measures various facial structures and compares the results with reference values specific to each facial biotype, enabling detailed and objective analysis (Barahona-Cubillo and Benavides-Smith 2006; Fern\u0026aacute;ndez and da Silva \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2009\u003c/span\u003e; Rodr\u0026iacute;guez 2019; S\u0026aacute;nchez-Tito and Ya\u0026ntilde;ez-Ch\u0026aacute;vez \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSince 2014, the International Standard for TMD Evaluation has been the Diagnostic Criteria for TMD (DC/TMD), aimed to provide a common language for TMDs conditions. However, this instrument was developed for the adult population (Schiffman et al. \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Historically, TMDs were not always considered pediatric conditions. Nevertheless, evidence has shown that TMDs are present in children and adolescents, with the prevalence increasing with age. Consequently, in recent years, efforts have been made to adapt the DC/TMD system for non-adult populations by modifying the numeric pain scale to a graduated facial expression scale and simplifying the language used in questionnaires (Hicks et al. \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2001\u003c/span\u003e; Restrepo et al. \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Rongo et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eGiven that the research on prevalence of TMDs in children and adolescents is relatively recent, the results available in the literature are inconsistent and exhibit a wide range of variability. Therefore, it is essential to provide data to help elucidate the reasons behind this broad range of prevalence reported in the literature (Minervini et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdditionally, investigating the potential association between the presence of TMD and FB is crucial, as this could contribute to the development of preventive and therapeutic strategies targeting profiles with higher risk of developing TMD. FB directly influences occlusion, facial harmony, masticatory muscles, and stomatognathic functions (Rodr\u0026iacute;guez 2019). However, the literature does not yet describe a definitive association between different FBs and the development of various TMDs. This underscores the need for more detailed and comprehensive research in this area(Bavia and Rodrigues Garcia \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Fernandes et al. \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Manfredini et al. \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis study aims to determine the prevalence of TMD and its association with FB in Chilean children and adolescents attending a university clinic during 2023.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\u003cp\u003eA cross-sectional study was conducted with a sample of 83 children and adolescents aged 7 to 14 years who attended a teaching-assistance clinic in Chile in 2023.\u003c/p\u003e\n\u003cp\u003eThe sample size was determined based on the availability of individuals willing to participate in the study. Inclusion criteria required participants to be between 7 and 14 years old, have received dental care at the University Clinic of Universidad de los Andes (Chile) in 2023, and possess a lateral cephalometric radiograph stored in the clinic's radiographic database. Patients with a history of facial trauma, craniofacial malformations, surgical procedures in the orofacial region, cervical malformations, prior joint pathology, or ongoing or previous orthodontic treatment were excluded.\u003c/p\u003e\n\u003cp\u003eThis article was structured following the STROBE checklist for observational studies (von Elm et al. 2007).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Aspects\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Scientific Ethics Committee of Universidad de los Andes (Chile) (CEC2022062). Written informed consent was obtained from the guardians, and written informed assent was secured from the participants before their involvement in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational Definition of Variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study variables were categorized into two groups. On one hand, the independent variables were:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eTemporomandibular Disorders (TMDs):\u0026nbsp;\u003c/strong\u003eRefer to a group of musculoskeletal and neuromuscular conditions that affect the temporomandibular joints (TMJs), masticatory muscles, and related structures. This variable is dichotomous and categorical, indicating the presence or absence of TMD, and is measured using the DC/TMD protocol\u0026nbsp;(Sharma et al. 2011).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFacial Biotype:\u003c/strong\u003e Describes a set of common morphological characteristics in individuals of the same species, determined by genetic and environmental factors. This variable is polytomous categorical: brachyfacial, mesofacial, and dolichofacial, identified through Ricketts’ VERT cephalometric analysis\u0026nbsp;(Cerda-Peralta et al. 2019).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSex:\u0026nbsp;\u003c/strong\u003eDichotomous categorical variable consisting of female or male.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eOn the other hand, the dependent variables of TMD included myalgia, arthralgia, disc displacement with reduction, and headaches attributed to TMD. All these were dichotomous variables assessed based on the presence or absence of the aforementioned signs.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of TMD in Children and Adolescents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo assess the presence of TMD in participants, the Axis 1 protocol of the DC/TMD was employed. This instrument has been utilized since 2014 for the diagnosis of TMD, and a version validated for children and adolescents was used in this study (Rongo et al. 2021).\u003c/p\u003e\n\u003cp\u003eInitially, a validated questionnaire translated into Spanish was performed to all participants (Restrepo et al. 2020). The questionnaire aimed to collect information on the history of orofacial pain symptoms, headaches, and mandibular function.\u003c/p\u003e\n\u003cp\u003eSubsequently, clinical evaluations were conducted for all participants following the International Network for Orofacial Pain and Related Methodologies (INFORM) guidelines (Rongo et al. 2021).\u003c/p\u003e\n\u003cp\u003eDuring the clinical evaluation, muscular and joint palpation was performed by maintaining for 2 seconds a pressure point with a force magnitude of 500 or 1000 g, depending on the size of the structure examined. If pain was detected, the pressure was reapplied to the same point but for 5 seconds. A standardized palpation device (Palpeter, BUTLER©, Switzerland) that applies exact and predictable pressures of 500 and 1000 g was used to ensure consistency and reduce potential bias.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTechnique for Determining Facial Biotype\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFacial biotype analysis was performed using the participants’ lateral cephalometric radiographs. The following measurements were taken: lower anterior facial height, facial axis, facial depth, mandibular plane, and mandibular arch. These results were compared with normative values to determine the patient’s VERT index, which was subsequently compared to the standards established by Ricketts to identify the facial biotype.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperator Calibration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor facial biotype determination and the DC/TMD protocol, an experienced operator conducted a calibration session with two researchers (FZV and MRR). The DC/TMD protocol was applied to five patients during this session. Additionally, cephalometric analyses of the radiographs for 40 patients were performed individually using Dolphin® software (Madrid, Spain). The inter-examiner agreement was assessed, resulting in a kappa coefficient of 0.9.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive and inferential statistical measures were reported using Chi-square and Fisher’s exact tests to examine associations between categorical variables and logistic regression models to estimate the risk among relevant variables. A significance level of 95% was applied, and analyses were conducted using Stata SE 17.0 software (StataCorp®, USA).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eA total of 83 participants met the inclusion criteria and were administered the Axis 1 DC/TMD protocol. They then underwent a clinical evaluation following the guidelines of the International Network for Orofacial Pain and Related Methodologies. The clinical and sociodemographic characteristics of the sample are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical and Sociodemographic Characteristics of the Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51 (61.45%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (38.55%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67 (80.72%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u0026ndash;14 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (19.28%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMyalgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (83.13%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (16.87%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eArthralgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71 (85.54%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (14.46%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHeadache Attributed to TMD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (84.34%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (15.66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDisc Displacement with Reduction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (92.77%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (7.23%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTemporomandibular Disorders\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (72.29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (27.71%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u0026thinsp;=\u0026thinsp;83 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBased on the participants' lateral cephalometric radiographs, a facial biotype diagnosis was established (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFacial Biotype Diagnosis according to Ricketts VERT Index in the Participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFacial Biotype\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMesofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (45.78%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (20.48%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (33.73%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u0026thinsp;=\u0026thinsp;83 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the relationship between facial biotype (FB) and the other variables of interest. Statistically significant associations were found between facial biotype and sex and between the presence of arthralgia and disc displacement with reduction.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the risk estimates for facial biotypes and variables associated with temporomandibular disorders (TMDs). A significant association was observed between the female sex and both dolichofacial and brachyfacial biotypes, with an exceptionally high risk in females with a dolichofacial biotype (adjusted OR\u0026thinsp;=\u0026thinsp;5.76; p\u0026thinsp;=\u0026thinsp;0.02).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution and Association of Facial Biotype with Other Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFacial Biotype\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMesofacial\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAssociation between variables\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (44.74%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (82.35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (71.43%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.01\u003c/b\u003e\u003csup\u003e\u003cb\u003eb\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (55.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (17.65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (28.57%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMyalgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (84.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (88.24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22 (78.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.8\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (15.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (11.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (21.43%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eArthralgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (89.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (64.71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (92.86%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.03\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (10.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (35.29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 (7.14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHeadache Attributed to TMD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (84.21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (76.47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (89.29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.54\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (15.78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (23.53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (10.71%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDisc Displacement with Reduction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (97.37%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (70.59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (2.63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (29.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTemporomandibular Disorders\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29 (76.32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (58.82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.39\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (23.68%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (41.18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003en\u0026thinsp;=\u0026thinsp;38 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en\u0026thinsp;=\u0026thinsp;17 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003en\u0026thinsp;=\u0026thinsp;28 (100%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003ea\u003c/sup\u003e Fisher\u0026rsquo;s Exact Test\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003eb\u003c/sup\u003e Chi-squared Test\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRisk Estimation Between Facial Biotype Levels and Other Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOdds Ratio\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% C.I. \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eFemale Gender\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e5.76\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5.73\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.41\u0026ndash;23.36\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e3.09\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.04\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.07\u0026ndash;9.12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of Myalgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.13\u0026ndash;4.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33\u0026ndash;4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of Arthralgia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e4.63\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e4.57\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.08\u0026ndash;19.33\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.04\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.11\u0026ndash;4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of Headache Attributed to TMD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u0026ndash;7.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.11\u0026ndash;2.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of Disc Displacement with Reduction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e15.42\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e20.46\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.88\u0026ndash;223.22\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026ndash;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePresence of Temporomandibular Disorders\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDolichofacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69\u0026ndash;8.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrachyfacial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.29\u0026ndash;3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eReference category: Mesofacial Biotype\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ea\u003c/sup\u003e Crude Odds Ratio (OR)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003eb\u003c/sup\u003e Adjusted for age\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003csup\u003ec\u003c/sup\u003e 95% Confidence Interval of the adjusted model\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding the presence of arthralgia and disc displacement with reduction, the dolichofacial biotype showed a significantly higher risk (adjusted OR\u0026thinsp;=\u0026thinsp;4.57 and 20.46, respectively).\u003c/p\u003e \u003cp\u003eAlthough no statistically significant results were found for the remaining variables, the dolichofacial biotype emerged as a risk factor for TMD-associated headache and the overall presence of TMD. An exception was myalgia, where the brachyfacial biotype appeared to be more frequently associated with risk in the studied sample.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe aim of this study was to assess the prevalence of temporomandibular disorders (TMDs) and their association with facial biotype (FB) in individuals aged 7 to 14 years within a Chilean population.\u003c/p\u003e \u003cp\u003eThe findings revealed a TMD prevalence of approximately 28% in the study sample, which falls within the broad range reported in children and adolescents, spanning from 4.2\u0026ndash;90% (Minervini et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Rongo et al. \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This significant variability reflects an unclear pattern that complicates the interpretation, comparison, and integration of existing literature.\u003c/p\u003e \u003cp\u003eSuch heterogeneity may be partly explained by the inconsistent approach to TMDs in this age group. Historically, TMDs have not always been acknowledged as a significant condition in children and adolescents, leading to a limited number of studies in this population. Furthermore, variations in the methodologies used, the diagnostic criteria applied, and the differences in participant selection have contributed to the significant disparity in reported outcomes (Ekberg et al. \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Katsikogianni et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Minervini et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding the distribution of facial biotypes, mesofacial profiles were predominant in the study sample, followed by brachyfacial and, finally, dolichofacial profiles. These results do not align with those reported by Ballero et al. and Tintaya et al., who found a higher prevalence of brachyfacial patterns compared to mesofacial ones (Apaza Tintaya 2021; Ballero Llaneza 2018), highlighting the disparity in findings and emphasizing the need for further research using more consistent and comparable methods. Such efforts would help clarify trends in the distribution of facial biotypes and their potential relationship with other significant variables.\u003c/p\u003e \u003cp\u003eIn the present study, a statistically significant association was found between the dolichofacial biotype and two specific conditions: disc displacement with reduction (DDwR) and arthralgia. These results indicate that dolichofacial profiles may be considered as a risk factor, putting children and adolescents with this facial profile at a potential risk for developing TMDs, both now and in the future.\u003c/p\u003e \u003cp\u003eThe link between dolichofacial patients and articular disorders has also been highlighted in a systematic review by Manfredini et al. (2015), whose findings correspond with those presented here. Their review noted that hyper divergent growth patterns are often associated with a higher frequency of DDwR and degenerative joint disorders (Manfredini et al. \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn the other hand, assessing the association between different facial biotypes and the presence of TMDs revealed no statistically significant results in this investigation. However, within the study sample, a higher prevalence of TMDs was noted among individuals with a dolichofacial biotype, aligning with existing literature that describes a greater predisposition for this facial pattern to develop TMDs (Ballero Llaneza 2018).\u003c/p\u003e \u003cp\u003eDespite these efforts, the study had certain important limitations. First, while the initial sample size was larger, the lack of lateral cephalograms and limited patient availability reduced the final sample to 83 individuals. This small sample size is not representative of the general population, which limits the ability to generalize these findings.\u003c/p\u003e \u003cp\u003eAdditionally, the cross-sectional nature of the study does not permit establishing causal relationships between facial biotype and TMD presence. This underscores the importance of longitudinal research to track TMD prevalence in children and adolescents while identifying and analyzing associated risk factors. Such studies will yield a stronger foundation for evaluating cause-and-effect relationships between these variables, thus revealing patterns and trends in TMD development over time.\u003c/p\u003e \u003cp\u003eMoreover, the exclusion of diagnoses such as subluxation, disc displacement with reduction accompanied by intermittent locking, and disc displacement with reduction accompanied by limited opening may indicate a potential limitation of the study. However, considering the low or virtually nonexistent frequency of these conditions among children, excluding these criteria streamlined the methodology without impacting the results, as reported by Restrepo et al. (Restrepo et al. \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite these limitations, this study offers relevant data on a potential link between facial biotype and TMDs, particularly considering the lack of evidence regarding these factors in the studied age group. These findings highlight the need for possible preventive measures focused on early intervention to mitigate the risk of progression to both acute and chronic presentations.\u003c/p\u003e \u003cp\u003eMoreover, future studies using a biopsychosocial approach, as suggested by Axis II of the DC/TMD, could prove especially beneficial. This approach would enable the identification of various factors affecting TMD development, such as psychological, social, and behavioral variables, thus deepening our understanding of these conditions in the target population and aiding the implementation of more comprehensive therapeutic strategies.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eTMDs are a common issue in the general population, affecting both children and adults. Despite its limitations, this study revealed a TMD prevalence of 27.71% among Chilean children aged 7 to 14 years. Additionally, an association was found between the dolichofacial biotype and the presence of articular disorders\u0026mdash;specifically, disc displacement with reduction and arthralgia. These findings encourage further research in this area for preventive, early detection, and therapeutic purposes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCONFLICT OF INTEREST STATEMENT\u003c/h2\u003e \u003cp\u003eThe authors have no conflicts of interest to declare that are relevant to the content of this article.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eFiorella Zambrano Verduga: Conceptualization, Methodology, Validation and Writing the original draft; Mariana Ram\u0026iacute;rez Rodr\u0026iacute;guez: Conceptualization, Methodology, Validation and Writing the original draft; Nicol\u0026aacute;s Flores Palominos: Investigation, Writing the original fraft, Visualization; Gabriel Andrade Cabrera: Investigation, Formal analysis, Writing-Reviewing and Editing; Claudio Gamboa Vidal: Conceptualization, Resources and Supervision.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors would like to express their gratitude to the staff of the Teaching Assistance Clinic at Universidad de los Andes (Chile) and the participating children, adolescents, and their families for their cooperation throughout this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eApaza Tintaya JA. Relaci\u0026oacute;n del biotipo facial con el trastorno temporomandibular en adolescentes de 12 a 17 a\u0026ntilde;os de la Instituci\u0026oacute;n Educativa privada Pedro Paulet Juliaca 2021. Universidad Alas Peruanas; 2021 [cited 2024 Dec 12]; Available from: https://repositorio.uap.edu.pe/xmlui/handle/20.500.12990/5269\u003c/li\u003e\n\u003cli\u003eBallero Llaneza S. Asociaci\u0026oacute;n entre clase esqueletal y biotipo facial en pacientes con trastornos temporomandibulares examinados en el Post\u0026iacute;tulo de Ortodoncia y Ortopedia Dento Maxilo Facial de la FOUCH en el a\u0026ntilde;o 2016. Universidad de Chile; 2018 [cited 2024 Dec 12]; Available from: https://repositorio.uchile.cl/handle/2250/148620\u003c/li\u003e\n\u003cli\u003eBarahona-Cubillo JB, Benavides-Smith J. Principales An\u0026aacute;lisis Cefalom\u0026eacute;tricos Utilizados para el Diagn\u0026oacute;stio Ortod\u0026oacute;ntico. Rev. 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Atlas: Cefalometr\u0026iacute;a y an\u0026aacute;lisis facial. 1\u0026deg;. Madrid, Espa\u0026ntilde;a: Ripianao S.A.; 2009. \u003c/li\u003e\n\u003cli\u003eHicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001 Aug;93(2):173\u0026ndash;83. \u003c/li\u003e\n\u003cli\u003eInda-Vel\u0026aacute;zquez KL, Guti\u0026eacute;rrez-Rojo JF, Guti\u0026eacute;rrez-Villase\u0026ntilde;or J. Relaci\u0026oacute;n del biotipo facial determinado con el VERT y el patr\u0026oacute;n de crecimiento facial. Oral. 2019 Dec 10;20(64):1762\u0026ndash;5. \u003c/li\u003e\n\u003cli\u003eKatsikogianni E, Schweigert-Gabler S, Krisam J, Orhan G, Bissar A, Lux CJ, et al. Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8-12 years. J. Oral Rehabil. 2021 Jan;48(1):18\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eManfredini D, Seg\u0026ugrave; M, Arveda N, Lombardo L, Siciliani G, Alessandro Rossi null, et al. Temporomandibular Joint Disorders in Patients With Different Facial Morphology. A Systematic Review of the Literature. J. Oral Maxillofac. Surg. Off. J. Am. Assoc. Oral Maxillofac. Surg. 2016 Jan;74(1):29\u0026ndash;46. \u003c/li\u003e\n\u003cli\u003eManns Freese AE. Sistema Estomatogn\u0026aacute;tico. Fundamentos Cl\u0026iacute;nicos de Fisiolog\u0026iacute;a y Patolog\u0026iacute;a Funcional. AMOLCA; 2013. \u003c/li\u003e\n\u003cli\u003eMinervini G, Franco R, Marrapodi MM, Fiorillo L, Cervino G, Cicci\u0026ugrave; M. Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular Disorders: A systematic review with meta-analysis. J. Oral Rehabil. 2023 Jun;50(6):522\u0026ndash;30. \u003c/li\u003e\n\u003cli\u003ePoveda Roda R, Bag\u0026aacute;n JV, D\u0026iacute;az Fern\u0026aacute;ndez JM, Hern\u0026aacute;ndez Baz\u0026aacute;n S, Jim\u0026eacute;nez Soriano Y. Review of temporomandibular joint pathology: Part I: Classification, epidemiology and risk factors. Med. Oral Patol. Oral Cir. Bucal Internet. Medicina Oral S.L.; 2007 Aug;12(4):292\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eRestrepo CC, Suarez N, Moratto N, Manrique R. Content and construct validity of the Diagnostic Criteria for Temporomandibular Disorders Axis I for children. J. Oral Rehabil. 2020 Jul;47(7):809\u0026ndash;19. \u003c/li\u003e\n\u003cli\u003eRodr\u0026iacute;guez E. Ortodoncia Contempor\u0026aacute;nea. Diagn\u0026oacute;stico y tratamiento [Internet]. 3\u0026deg; Edici\u0026oacute;n. Madrid, Espa\u0026ntilde;a: AMOLCA; 2019 [cited 2024 Dec 12]. Available from: https://ebooks.amolca.com/library/publication/rodriguez\u003c/li\u003e\n\u003cli\u003eRongo R, Ekberg E, Nilsson I-M, Al-Khotani A, Alstergren P, Conti PCR, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for children and adolescents: An international Delphi study-Part 1-Development of Axis I. J. Oral Rehabil. 2021 Jul;48(7):836\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eRongo R, Ekberg E, Nilsson I-M, Al-Khotani A, Alstergren P, Rodrigues Conti PC, et al. Diagnostic criteria for temporomandibular disorders in children and adolescents: An international Delphi study-Part 2-Development of Axis II. J. Oral Rehabil. 2022 May;49(5):541\u0026ndash;52. \u003c/li\u003e\n\u003cli\u003eS\u0026aacute;nchez-Tito MA, Ya\u0026ntilde;ez-Ch\u0026aacute;vez EE. Asociaci\u0026oacute;n entre el biotipo facial y la sobremordida: Estudio piloto. Rev. Estomatol\u0026oacute;gica Hered. 2015 Jan;25(1):05\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eSchiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet J-P, et al. 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\u0026dagger;. J. Oral Facial Pain Headache. 2014;28(1):6\u0026ndash;27. \u003c/li\u003e\n\u003cli\u003eSharma S, Gupta DS, Pal US, Jurel SK. Etiological factors of temporomandibular joint disorders. Natl. J. Maxillofac. Surg. 2011 Jul;2(2):116\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eVelasco-Ortega E, Cruz Rodr\u0026iacute;guez D, Velasco Ponferrada M del C, Monsalve Guil L, Bull\u0026oacute;n Fern\u0026aacute;ndez P. Los trastornos temporomandibulares en la pr\u0026aacute;ctica odontol\u0026oacute;gica. I: clasificaci\u0026oacute;n y etipatogenia. Avances M\u0026eacute;dico Dentales; 2002;18(3):177\u0026ndash;89.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Temporomandibular Joint Disorders, Cephalometry, Facial Pattern, Child, Adolescent","lastPublishedDoi":"10.21203/rs.3.rs-6330924/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6330924/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis study aims to determine the prevalence of temporomandibular disorders and their association with facial biotypes in Chilean children aged 7 to 14 years, providing valuable data for early intervention.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional study assessed the association between temporomandibular disorders and facial biotypes in 83 children and adolescents aged 7 to 14. Participants were evaluated using Axis I of the DC/TMD adapted for non-adult populations to identify the presence of temporomandibular disorders. Additionally, cephalometric analysis using Ricketts\u0026rsquo; VERT index was performed to determine each participant's facial biotype.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA prevalence of 27.71% for temporomandibular disorders was identified in the study population. A significant association was observed between the dolichofacial biotype and articular disorders, specifically disc displacement with reduction and arthralgia.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of temporomandibular disorders in Chilean individuals aged 7 to 14 years was 27.71%. Furthermore, an association was found between the dolichofacial biotype and the presence of articular disorders, namely disc displacement with reduction and arthralgia.\u003c/p\u003e","manuscriptTitle":"Prevalence of Temporomandibular Disorders and their association with Facial Biotype in Chilean Children and Adolescents: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-01 08:49:36","doi":"10.21203/rs.3.rs-6330924/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c7803ce0-ff30-43e9-8cfc-d07c791ec69d","owner":[],"postedDate":"April 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-07T08:38:41+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-01 08:49:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6330924","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6330924","identity":"rs-6330924","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}