Prevalence of craniomandibular disorders in navy scuba divers and raiders : diagnostic tools

Aim: To determine the prevalence of temporomandibular disorders and the neuromuscular system variations in scuba divers of the Navy and to identify the risk factors for the development of TMD signs and symptoms before and after diving by the use of a questionnaire, electromyography, stabilography, spirometry, and Cone Beam CT. Materials and Methods: 20 males individuals participated in the research aged 30 to 42 years. Each diver answered a questionnaire and undergone to neuromuscular tests, muscular and postural exams before and after diving, to CBCT and to spirometry to evaluate respiratory function. Results: The prevalence of TMD symptoms after diving was about 93% versus a 32% before diving, the neuromuscular answers after diving (T3) were highly different from rest situation before immersion (T0): percent overlapping coefficient T0-T3 p=0,0001 (p<0,001); impact T0-T3 p=0.0087 (p<0,01); also postural aspect were different after diving (p<0.01). Clenching seemed to be the greatest risk factor for pain in the masticatory muscle system while holding the mouth piece and after diving. Limited mouth opening and clenching were responsible for the symptoms in temporomandibular joint after the dive. Exposure to cold water for long periods of time causes the mandible to protrude and, together the tendency to bite harder on one side, can bring to dysfunction. Conclusion: Scuba divers exhibiting TMD-related symptoms have met the greatest risk of developing TMJ dysfunction and neuromuscular changes during and after the dive. But also in asymptomatic divers, before the dive, TMD is a common problem after it.