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The Relationship Between Malocclusion, Bruxism, Clicking Sound and Hypertonus of Masseter Muscle In Austism Spectrum Disorders


Abstract:                                                               Objective: To determine the relationship between malocclusion, bruxism, clicking sound, and hypertonus masseter muscle in autism spectrum disorders.Methods: The study was conducted on 20 children of autism spectrum disorder at Prananda Autism Education Institute in Bandung. Examination was carried out on the sample to determine the type of malocclusion, the presence of bruxism, clicking sound, and hypertonus of masseter muscle.Results: The data obtained was processed to see the relationship of each variable. Statistical tests used Kendall's rank correlation and Spearman's rank correlation to see further interrelationships of significance between groups. The correlation value W = 0.58 with chi-square = 34,480 and p-value = 0,00000016  (p-value <0.01) which was statistically significant.Conclusion: The results showed significant relationship between malocclusion, bruxism, cliking sound and hypertonus of masseter muscle in autism spectrum disorders. However, there was no association between malocclusion with bruxism, malocclusion with clicking, malocclusion with hypertonus of masseter and bruxism with clicking. There was an association between bruxism and hypertonus of masseter. 


  1. Morales-Chávez MC. Oral health assessment of a group of children with autism disorder. J Clin Pediatr Dent 2017;41(2):147–9.
  2. Du RY, Yiu CKY, King NM, Wong VCN, McGrath CPJ. Oral health among preschool children with autism spectrum disorders: A case-control study. Autism 2015;19(6):746–51.
  3. Anggraini LD. Kesehatan gigi anak autis: Autis’s health teeth. Mutiara Med 2007;7(2):104–8.
  4. Putri DMB. Kajian interior pada ruang kelas paud autis di klinik terapi our dreams Bandung. e-Proceeding Art Des 2015;2(2):856–64.
  5. Reynolds CR, Kamphaus RW. DSM-V Criteria for ASD. 00:0–2.
  6. Gandhi RP, Klein U. Autism spectrum disorders: An update on oral health management. J Evid Based Dent Pract. 2014;14:115–26.
  7. Udhya J, Varadharaja MM, Parthiban J, Srinivasan I. Autism disorder (AD): An updated review for paediatric dentists. J Clin and Diag Res. 2014;8: 275–9.
  8. Cagetti MG, Mastroberardino S, Campus G, Olivari B, Faggioli R, Lenti C. Dental care protocol based on visual supports for children with autism spectrum disorders. Med Oral Patol Oral Cir Bucal. 2015;20(5):598–604.
  9. Naidoo M, Singh S. The oral health status of children with autism spectrum disorder in KwaZulu-Nata, South Africa. BMC Oral Health. 2018;18(1):1–9.
  10. Al-Sehaibany FS. Occurrence of oral habits among preschool children with autism spectrum disorder. Pakistan J Med Sci. 2017;33(5):1156–60.
  11. Seraj B, Ahmadi S, Mirkarimi S BG. Temporomandibular disorders and parafunctional habits in children and adolescence: A review. J Dent. 2009;6(1):37–45.
  12. Bilgiç F, Gelgör İE. Prevalence of temporomandibular dysfunction and its association with malocclusion in children: An epidemiologic study. J Clin Pediatr Dent. 2017;41(2):161–5.
  13. Howard JA. Temporomandibular joint disorders in children. Dent Clin North Am. 2013;57(1):99–127.
  14. Muthu M, Prathibha K. Management of a child with autism and severe bruxism: A case report. J Indian Soc Pedod Prev Dent. 2008;26(2):82.
  15. Pizolato A. Anxiety/depression and orofacial myofacial disorders as factors associated with TMD in children. Braz Oral Res. 2013;27(2):7–9.
  16. Almǎşan OC, Bǎciut M, Almǎşan HA, Bran S, Lascu L, Iancu M, et al. Skeletal pattern in subjects with temporomandibular joint disorders. Arch Med Sci. 2013;9(1):118–26.
  17. Williamson EH, Lundquist DO. Anterior guidance: its effect on electromyographic activity of the temporal and masseter muscles. J Prosthet Dent. 1983;49(6):816–23.
  18. Thilander B, Rubio G, Pena L, de Mayorga C. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: an epidemiologic study related to specified stages of dental development. Angle Orthod. 2002;72(2):146–54.
  19. Gesch, D, Hensel E, John U, Kocher T, Alte D, Bernhardt O. Association of malocclusion and functional occlusion with signs of temporomandibular disorders in adults. Angle Orthod. 2004;74(4):512–20.
  20. Thilander B, Bjerklin K. Posterior crossbite and temporomandibular disorders (TMDs): Need for orthodontic treatment?. Eur J Orthod. 2012;34(6):667–73.
  21. Sari S, Sonmez H. The relationhip between occlusal factors and bruxism in permanent and mixed dentition in Turkish children. J Clin Pediatr Dent. 2015;25(3):191–4.
  22. Henrikson T, Ekberg EC, Nilner M. Symptoms and signs of temporomandibular disorders in girls with normal occlusion and class II malocclusion. Acta Odontol Scand. 1997;55(4):229–35.
  23. Gonçalves LP, de Toledo OA, Otero SAM, Patrícia L, Gonçalves V, Toledo OA, et. The relationship between bruxism, occlusal factors and oral habits. Dental Press J Orthod. 2010;15(2):97–104.
  24. Ghafournia M, Hajenourozali TM. Relationship between bruxism and malocclusion among preschool children in Isfahan. J Dent Res Dent Clin Dent Prospects. 2012;6(4):138–42.
  25. Pahkala R, Qvarnstrom M. Can temporomandibular dysfunction signs be predicted by early morphological or functional variables?. Eur J Orthod. 2004;26(4):367–73.
  26. Rasheed SA, Prabhu NT, Munshi AK. Electromyographic and ultrasonographic observations of masseter and anterior temporalis muscles in children. J Clin Pediatr Dent. 1996;20(2):127–32.
  27. Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, masticatory muscle pain, and disc displacement: A systematic review. Eur J Orthod. 2013;35(6):737–44.
  28. Lauriti L, Motta LJ, De Godoy CHL, Biasotto-Gonzalez DA, Politti F, Mesquita-Ferrari RA, et al. Influence of temporomandibular disorder on temporal and masseter muscles and occlusal contacts in adolescents: An electromyographic study. BMC Musculoskelet Disord. 2014;15(1):123.
  29. Fathy Arafa A, Mostafa NM, Moussa SA. Assessment Of Schoolchildren’s Temporomandibular Joint Sounds Associated With Bruxism. J Dent Oral Disord Ther. 2019;7(1):1–6.
  30. Motta LJ, Silva PF, Godoy CHL, Bortoletto CC, Garcia PR. Assessment of temporomandibular joint sounds in children with bruxism. Rev CEFAC. 2015;17(1):111–5.
  31. Baba K, Haketa T, Sasaki Y, Ohyama T, Clark GT. Association between masseter muscle activity levels recorded during sleep and signs and symptoms of temporomandibular disorders in healthy young adults. J Orofac Pain. 2005;19(3):226–31.
  32. Dawson PE. Functional Occlusion from TMJ to Smile design. ST. louis: Mosby;2007. p.262–83.
  33. Hegab A. Pediatric temporomandibular joint disorders. J Dent Heal Oral Disord Ther. 2015;2(3):47-8.

How to Cite

Damayanti, L., Atherton, C., Kurnikasari, E., & Sasmita, I. S. (2022). The Relationship Between Malocclusion, Bruxism, Clicking Sound and Hypertonus of Masseter Muscle In Austism Spectrum Disorders. Journal of Dentomaxillofacial Science, 7(1), 44–48.




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