The temporomandibular joint disorders in the special forces of the Italian Navy subjected to extreme mental and physical stress : standard vs customized devices

Aims: Scuba divers deal with an extreme psychophysical effort during their activities showing neuromuscular, postural and cranio mandibular disorders. The aim is to determine the prevalence of temporomandibular disorders and the neuromuscular system variations in scuba divers of the Italian Navy with Commercial (CM) and Personalized Mouthpiece (PM), and to identify the risk factors for the development of TMD signs and symptoms before and after diving. Materials and Methods: Forty males (23-30 years) undergone to neuromuscular tests, spirometric and postural exams before and after diving, MRI and CBCT exams too. Results: The prevalence of TMD symptoms after diving was about 93% with CM and 38% with PM versus a 32% before diving; with CM use the neuromuscular answers after diving (T3) were highly different from rest situation before immersion (T0) (p<0,001); also postural aspects were different after diving (p<0.01); there were no changes by PM use. Conclusion: Scuba divers exhibiting TMD-related symptoms have met the greatest risk of developing TMJ dysfunction during and after the dive. Also in asymptomatic divers, before the dive, TMD was a common problem after it. Customized mouthpiece have reduced symptoms, significantly.