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"A young girl 20 years old with mandibular prognatism has been treated with orthodontics and surgical treatment in between. Mandibular set back was done intra orally 5mm length with bilateral sagital split ramus osteotomy method. And rigid fixation was done by inserting three 2mm bicortical screws for stabilizing the fragment. This method allowed the bony segments to heal properly and allowed the patients to function sooner."

"Latar Belakang: Prognati mandibula merupakan kasus maloklusi skeletal yang dapat ditemukan dengan fekuensi 15-23% dari seluruh populasi orang di asia tenggara. Koreksi terhadap kondisi ini dapat dilakukan secara bedah ortognatik mandibular setback dengan teknik Bilateral Sagital Split Osteotomy (BSSO). Penelitian telah mengkategorikan bahwa tindakan mandibular setback sebagai prosedur dengan stabilitas paling rendah di antara prosedur bedah ortognatik lainnya. Namun demikian bebrapa penelitian menyatakan bahwa hasil pasca operasinya masih dapat dikatakan stabil dengan kategori tertentu. Tujuan: Mengetahui perbedaan relaps pada varian kategori besaran mandibular setback pasca tindakan tersebut dengan teknik BSSO saja dan BSSO dengan prosedur bedah ortognatik tambahan pada maksila pada pasien-pasien prognati mandibula.Material dan Metode: Rekam medis dan radiograf sefalometri pasien pre operasi, pasca operasi dan H+6 bulan pasca operasi BSSO dan BSSO dengan prosedur bedah ortognatik tambahan pada maksila selama periode tahun 2001 sampai 2017 dari divisi Bedah Mulut dan Divisi Ortodonti R.S. Cipto Mangunkusumo, Jakarta dikumpulkan dan didapatkan 16 sampel sesuai kriteria inklusi. Hubungan antar variabel dievaluasi dengan Uji Fishers Exact pada Chi Square dan Uji hipotesis dengan Mann-Whitney U TestKesimpulan: Tidak ditemukan perbedaan bermakna bermakna antara relaps pada mandibular setback sedang, dan besar pada kelompok BSSO dan BSSO dengan Prosedur bedah ortognatik tambahan pada maksila (Le Fort I). Dari analisis yang dilakukan terdapat kemiripan dengan penelitian sebelumnya yaitu lebih dari 50% sampel terjadi relaps pasca operasi lebih dari 2mm.

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Background: Mandibular prognathism has the frequency among 15% to 23% of the entire population of southeast Asian people. Correction of such malocclusion can be done by performing mandibular setback using Bilateral Sagital Split Osteotomy (BSSO) method. Few research has categorized that setback mandibular as procedure with the low rate of stability among other orthognathic surgery procedures. However, this has become the method of choice until now. Objective: To observe significant difference among post operative relapse on each small, moderate, and large mandibular setback after BSSO and BSSO combined with adjunct orthognathic surgery procedures on the maxilla in patients with mandibular prognathism. Materials and Methods: Patients medical records including cephalometric radiographs preoperative, postoperative, and 6 months after BSSO and BSSO with adjunct orthognathic surgery procedures in the maxilla during year 2001 to 2017 gained from Oral Surgery Division and Orthodontics Division of Cipto Mangunkusumo Hospital, Jakarta was collected. Based on inclusion criteria, 16 samples was observed. Data correlation was analyzed using Fishers Exact test in Chi Square and hypothesis was evaluated using Mann-Whitney U TestConclusion: There is no significant difference was found in term of relapse on each small, moderate, and large mandibular setback in BSSO group and BSSO with adjunct orthognathic surgery procedures in the maxilla (Le Fort I). This study tend to have similarity as the past studies stated in term of more than 50% with post operative relaps more than 2mm"

"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 155-158The causes of TMD are complex and multifactorial, therefore the management should be done by several disciplines. ln this report, a 27-year-old man came to the teaching hospital of the University of Indonesia Faculty of Dentistry's Prosthodontic Department complaining about clicking sound and pain around his right joint. He received orthodontic treatment 9 years ago with removable appliance at a private practice and had 4 premolar extraction. The patient's face looked asymmetric, with a low vertical dimension, a Class II occlusion, and an anterior deep bite. Besides that, he clenched his teeth during emotional stress. Lateral tanscranial photo showed that the position of the left condyle was relatively normal or slightly anterior, and the right condyle was in the superoposterior position in the fossa with an abnormal shape. To solve this problem, the patient was referred to the Orthodontic Deparment to get a correct vertical dimension and normal anterior overbite. After 6 years, the patient was again referred to the prosthodontic Department, but the result was not successful. In order to get the right vertical dimension, an occlusal splint was fabricated to achieve a comfort jaw relation. In this position, the overbite was 2 mm, but space between the upper and lower posterior teeth was 5 mm. In this situation, full veneer crowns were not impossible to fabricate. Finally, to maintain this comfort position, the patient was suggested to wear the occlusal splint and come regularly for control every 6 months."

"Latar Belakang: Perubahan degeneratif pada TMJ dapat menyebabkan perubahan morfologi kondilus mandibula. Salah satu faktor yang mempengaruhi perubahan degeneratif TMJ yaitu kehilangan gigi posterior yang tidak diganti. Modalitas CBCT memberikan gambar multiplanar bidang aksial, sagital dan koronal sehingga mempermudah visualisasi TMJ secara menyeluruh, sehingga CBCT dapat menjadi modalitas alternatif untuk mengevaluasi keadaan TMJ terutama morfologi kondilus. Penelitian ini dilakukan untuk meneliti perubahan morfologi kondilus mandibula pada evaluasi CBCT yang berhubungan dengan jumlah kehilangan gigi posterior, kelompok usia dan jenis kelamin. Tujuan: Mengetahui hubungan perubahan morfologi kondilus mandibula berdasarkan jumlah kehilangan gigi posterior pada kelompok usia 30 – 45 tahun dengan kelompok usia 55 – 70 tahun pada evaluasi CBCT. Metode: Penelitian ini merupakan penelitian retrospektif analitik cross sectional. Pengumpulan sampel dilakukan menggunakan metode Non-Probability Sampling dengan teknik Purposive Sampling dan didapatkan sebanyak 70 sampel volume data CBCT. Rekonstruksi dilakukan menggunakan Software CS Imaging Patient Browser 7.0.23 dan CS 3D Imaging v3.8.7. Carestream Health Inc. Kondilus mandibula dibedakan antara sisi kanan dan kiri, hasil rekonstruksi diambil dari potongan sagital dan koronal anteroposterior. Pengamatan dilakukan dua orang, sebanyak dua kali dalam jangka waktu berbeda dan jarak waktu dua minggu. Uji reliabilitas hasil pengamatan dilakukan menggunakan Uji Cohen’s Kappa dan hasil uji intraobserver dan intraobserver menunjukan angka 0.814 – 1.000 yang termasuk dalam kategori almost perfect agreement. Hasil: Terdapat hubungan yang bermakna antara perubahan morfologi kondilus mandibula dengan jumlah kehilangan gigi posterior pada kelompok usia 30 – 45 tahun dan kelompok usia 55 – 70 tahun dalam bentuk erosi, flattening, dan sklerosis (p= <0.005). Pada variabel jenis kelamin tidak ditemukan hubungan yang bermakna (p= >0.005). Kesimpulan: Dari keseluruhan hasil penelitian dapat ditarik kesimpulan bahwa semakin banyak jumlah kehilangan gigi dan semakin bertambahnya usia, memiliki hubungan dan dapat menyebabkan terjadinya perubahan morfologi kondilus mandibula.

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Background: Degenerative changes in the TMJ can lead to changes in the morphology of the mandibular condyle. One of the factors that affect degenerative changes in the TMJ is the loss of posterior teeth that are not replaced. CBCT modality provides multiplanar images in axial, sagittal, and coronal planes making it easier to visualize the TMJ thoroughly, therefore CBCT can be an alternative modality to evaluate the TMJ condition, specifically the morphology of the condyles. This study aimed to examine the morphological changes of the mandibular condyle on CBCT evaluation with the number of missing posterior teeth, age group, and gender. Objective: To determine the relationship between changes in the morphology of the mandibular condyle based on the number of missing posterior teeth in the age group 30-45 years and the age group 55-70 years. Methods: This study is a cross-sectional analytic retrospective study. Sample collection was carried out using the Non-Probability Sampling method with the Purposive Sampling technique. Reconstruction was performed using CS Imaging Patient Browser 7.0.23 and CS 3D Imaging v3.8.7 Software from Carestream Health Inc. The mandibular condyle was divided into right and left, and the results of the reconstruction were taken from the sagittal and coronal anteroposterior sections. Observations were made by two people, two times in different periods with an interval of two weeks. The reliability test from the observations using Cohen's Kappa test and the results showed almost perfect agreement category with Kappa value 0.814 - 1.000. Results: There was a significant relationship between changes in the morphology of the mandibular condyle in the form of erosion, flattening, and sclerosis with the number of missing posterior teeth in the age group 30-45 years and the age group 55-70 years (p = <0.005). In the gender variable, there was no significant relationship with changes in the morphology of the condyle (p = > 0.005). Conclusion: It can be concluded that the greater number of missing teeth and the older the subject gets has relationship with and can cause changes in the morphology of the mandibular condyle."

"PendahuluanSuprakondiler humerus merupakan fraktur terbanyak kedua pada anak setelah distal radius, menjadikannya fraktur yang paling banyak membutuhkan intervensi bedah pada anak. Malunion merupakan salah satu komplikasi yang banyak terjadi di negara berkembang. Cubitus varus sering terjadi pada malunion supracondylar humerus anak, yang menyebabkan masalah kosmetik dan fungsional. Teknik osteotomi korektif pada cubitus varus meliputi lateral closing-wedge, step-cut, dome, distraksi osteogenesis, dan osteotomi multiplanar 3D dengan bantuan komputer. Sampai saat ini, belum terdapat systematic review terupdate mengenai luaran dari berbagai teknik osteotomi korektif terhadap cubitus varus pada malunion supracondylar humerus anak. Penelitian ini dilakukan untuk mengetahui teknik osteotomi korektif yang memiliki luaran paling baik terhadap cubitus varus pada malunion supracondylar humerus anak berdasarkan telaah sistematis literatur yang ada.MetodePencarian literatur secara sistematis dilakukan pada database PubMed, EMBASE, Scopus, dan Cochrane Library, yang diterbitkan hingga April 2023 dengan mengikuti pedoman PRISMA. Artikel yang telah lolos seleksi dilakukan review oleh dua orang reviewer untuk dinilai kembali eligibilitas nya sesuai kriteria inklusi yang telah ditentukan. Kualitas dan bias masing-masing artikel dinilai menggunakan The Newcastle- Ottawa Scale (NOS) untuk studi non-randomized dan Cochrane Risk of Bias Tool untuk studi randomized.HasilSebanyak 39 dari total 754 artikel yang teridentifikasi disertakan dalam penelitian telaah sistematis ini, meliputi 2 studi Randomized Controlled Trial dan 37 studi Cohort Prospective. Didapatkan total 863 pasien yang telah dilakukan berbagai macam osteotomi korektif, terdiri atas 348 (40,3%) pasien lateral wedge osteotomy, 225 (26,0%) pasien step-cut osteotomy, 132 (15,3%) pasien dome osteotomy, 120 (13,9%) pasien multiplanar 3D osteotomy, dan 38 (4,4%) pasien distraction osteogenesis. Rerata usia saat dilakukan koreksi 9 tahun dengan usia paling muda 2 tahun dan paling tua 17 tahun. Keseluruhan pasien dalam sample dilakukan follow-up minimal 6 bulan hingga 61 bulan dengan rerata 27,3 bulan. Data mengenai peningkatan lingkup gerak sendi, besar koreksi humerus-elbow-wrist angle dan Baumann angle sebagai variabel luaran klinis dikumpulkan dan dibandingkan secara statistik. Kriteria penilaian luaran fungsional yang digunakan cukup beragam, sebanyak 3 studi menggunakan Mayo Elbow Performance Index (MEPI), 3 studi Flynn criteria, 11 studi Oppenheim criteria, 3 studi Bellemore criteria. Komplikasi yang dilaporkan meliputi infeksi sebanyak 34 pasien, cidera saraf 19 pasien, re-operasi 7 pasien, deformitas varus tersisa pada 1 pasien, serta tidak ada penonjolan lateral condyle berdasarkan LCPI (lateral condyle prominence index).DiskusiDesain penelitian Randomized controlled trial ditemukan sangat sedikit pada telaah sistematik osteotomi korektif untuk tatalaksana cubitus varus. Kesulitan dalam pembuatan RCT terkait dengan kendala randomisasi, surgical learning curve untuk teknik operasi yang berbeda, kesetaraan atau keberimbangan pasien dan operator (patient and surgeon equipoise) yang secara langsung berkorelasi dengan pertimbangan etik. Telaah sistematis ini hanya melibatkan studi prospektif untuk menghindari kekurangan yang dapat ditemukan pada studi retrospektif seperti pengaruh confounding factor yang tidak diperhatikan sehingga mempengaruhi bias dalam menarik kesimpulan pada studi tersebut. Hasil luaran fungsional yang excellent dapat dicapai dengan berbagai teknik osteotomi korektif dan tidak ada satu teknik yang unggul dalam segala aspek. Pemilihan teknik osteotomi suprakondiler humerus dapat dilakukan dengan mempertimbangkan kelebihan dan kekurangan dari masing-masing teknik. Lateral closing wedge dapat direkomendasikan pada pasien dengan defisit ruang lingkup sendi pre operasi karena terbukti memberikan peningkatan paling tinggi post operasi. Selain itu, peningkatan HEW angle juga cukup tinggi. Proporsi tidak memuaskan secara luaran fungsional pun paling rendah dibandikan teknik lainnya meskipun memiliki proporsi kejadian ulnar nerve injury paling tinggi. Oleh karena itu, penulis menilai bahwa preservasi ulnar nerve penting untuk dilakukan pada teknik ini. Step-cut osteotomy memiliki kemampuan koreksi Humerus-elbow-wrist angle yang paling tinggi. Komplikasi berupa ulnar nerve injury juga banyak ditemui pada dome osteotomy. Teknik ini juga memiliki risiko infeksi paling tinggi bila dibandingkan teknik osteotomy lainnya, hal ini mungkin disebabkan karena permukaan osteotomy yang luas dan membentuk hematoma yang massif. Meta- analisis hanya dapat dilakukan pada sebagian kecil studi yang membandingkan dome dan lateral closing wedge osteotomy serta multiplanar 3D dan lateral closing wedge osteotomy. Uji statistic menunjukkan perbedaan bermakna hasil memuaskan (satisfactory) luaran fungsional berdasarkan Oppenheim criteria yang 1,8 lebih tinggi pada teknik lateral closing wedge osteotomy dibandingkan dome osteotomy. Hasil ini masih harus dipahami dengan lebih berhati-hati mengingat keterbatasan studi yang dapat disertakan dalam meta-analisis tersebut.

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Introduction

Supracondylar humerus fractures are the second most common fractures in children after distal radius fractures, making them the most frequently requiring surgical intervention in pediatric patients. Malunion is a prevalent complication, particularly in developing countries. Cubitus varus frequently ensues as a consequence of malunion in supracondylar humerus fractures in children, leading to cosmetic and functional issues. Corrective osteotomy techniques for cubitus varus include lateral closing-wedge, step- cut, dome, distraction osteogenesis, and computer-assisted multiplanar 3D osteotomies. To date, there is no up-to-date systematic review available on the outcomes of various corrective osteotomy techniques for cubitus varus in pediatric malunion of the supracondylar humerus. This study aims to ascertain the most effective corrective osteotomy technique for cubitus varus in paediatric malunion of the supracondylar humerus based on a systematic literature review.

Method

A systematic literature search was conducted across the PubMed, EMBASE, Scopus, and Cochrane Library databases, encompassing publications up to January 2023, following the PRISMA guidelines. Selected articles underwent a review process by two independent reviewers to reassess their eligibility based on predefined inclusion criteria. The quality and potential biases of each article were assessed utilizing The Newcastle-Ottawa Scale (NOS) for non-randomized studies and the Cochrane Risk of Bias Tool for randomized studies.

Result

A total of 39 out of 754 identified articles were included in this systematic review, comprising of 2 RCTs and 37 Prospective Cohort Studies. The cumulative study population consisted of 863 patients who underwent various corrective osteotomies, comprising of 348 (40.3%) patients undergoing lateral wedge osteotomy, 225 (26.0%) undergoing step-cut osteotomy, 132 (15.3%) undergoing dome osteotomy, 120 (13.9%) undergoing multiplanar 3D osteotomy, and 38 (4.4%) undergoing distraction osteogenesis. The mean age at the time of correction was 9 years, with the youngest patient being 2 years old and the oldest 17 years. All patients in the sample were followed up for a minimum of 6 months to a maximum of 61 months, with an average follow-up duration of 27.3 months. Data regarding the improvement in range of motion, the extent of humerus-elbow-wrist angle correction, and Baumann angle as clinical outcome variables were collected and statistically compared. The assessment criteria used for functional outcomes were quite diverse, with 3 studies using the Mayo Elbow Performance Index (MEPI), 3 studies using the Flynn criteria, 11 studies using the Oppenheim criteria, and 3 studies using the Bellemore criteria. Reported complications included infections in 34 patients, nerve injuries in 19 patients, re-operations in 7 patients, residual varus deformity in 1 patient, and no lateral condyle prominence based on the LCPI (lateral condyle prominence index).

Discussion

The design of RCTs was found to be notably scarce in the systematic review of corrective osteotomies for the management of cubitus varus. The challenges associated with conducting RCTs in this context include difficulties in achieving randomization, navigating the surgical learning curve for different operative techniques, and ensuring patient and surgeon equipoise, which directly correlates with ethical considerations. This systematic review exclusively incorporated prospective studies to circumvent the limitations that may be encountered in retrospective studies, such as the influence of unaccounted confounding factors, thereby mitigating bias in drawing conclusions from the studies. Excellent functional outcomes can be achieved with various corrective osteotomy techniques, with no single technique demonstrating superiority in all aspects. The selection of a supracondylar humerus osteotomy technique can be made by considering the advantages and disadvantages of each technique. Lateral closing wedge osteotomy can be recommended for patients with preoperative joint range of motion (ROM) deficits, as it has been shown to provide the highest postoperative improvement. Additionally, it yields a substantial increase in the HEW angle. The proportion of unsatisfactory functional outcomes is also the lowest compared to other techniques, despite a higher incidence of ulnar nerve injury. Therefore, preserving the ulnar nerve is deemed crucial for this technique. Step-cut osteotomy exhibits the highest capability for correcting the HEW angle. Ulnar nerve injuries are also frequently observed with dome osteotomy. This technique carries the highest risk of infection compared to other osteotomy techniques, possibly due to its extensive osteotomy surface and the formation of massive hematomas. Meta-analysis could only be performed on a small subset of studies comparing dome and lateral closing wedge osteotomy, as well as multiplanar 3D and lateral closing wedge osteotomy. Statistical tests indicated a significant difference in satisfactory functional outcomes based on the Oppenheim criteria, with a 1.8-fold higher rate in favor of lateral closing wedge osteotomy over dome osteotomy. These results should be interpreted cautiously, due to the limitations of the studies eligible for inclusion in the meta-analysis."

"Oral splints have been frequently used in the treatment of bruxism to protect teeth and periodontium from damage, but the mechanism of action and efficacy of oral splints remain controversial. It has been suggested that they can be used to treat bruxism, based on the assumption that the device can eliminate or remove occlusal interference. Currently there are no reliable data to support the assumption of occlusion as an etiologic factor for bruxism, because several other factors have a role in bruxism, such as psychiatric, neurological and systemic disorders. In this paper, the mechanism of action and efficacy of oral splints in bruxism are discussed. Conclusions: although oral splint may be beneficial in protecting the dentition, the efficacy of this device in reducing bruxism is still not confirmed. There are several aspects that would support the broad usage of oral splints in the treatment of bruxism, but there are also limitations associated with each of these aspects. In conclusion, oral splints can be considered as useful adjuncts in the management of sleep bruxism but not as a definitive treatment."

"A case of unilateral bony ankylosis of the temporomandibular joint (TMJ) in a thirteen year old girl was reported. Maximum opening was minimal (4 mm) with hypoplastic mandible and also facial and dental asymmetry. There was no palpable movement over the left TMJ and only slight rotation on the right side. It may be caused by trauma, but the parents didn't notice. She had a problem with sleep apneu and sometimes felt sleepy during school time. She was refered to Oral Surgery Department Hasan Sadikin Hospital in Bandung from a private dental practitioner in Jakarta. Treatment for this patient is divided into three operations. The first operation was gap arthroplasty, second operation is osteodistraction and followed by orthognatic surgery. This paper discusses only gap arthoplasty with temporoparietalis muscle interposition. Twenty days after surgery maximum opening was 26 mm."

"The increase of pain symptoms in the temporomandibular joint (TMJ) challenges the scientists to find a more effective therapy. The popular treatment of the temporomandibular disorder (TMD) are eg occlusal splints, orthodontic treatment, electromyographic biofeedback, medication, etc. Among these splint therapy is more successful than the others especially in dealing with pain in the TMJ. Orthodontics as a treatment for the TMD quite often creates new complains on TMJ during and/or after treatment. The extrusion of the posterior teeth in reducing anterior deep overbite have been proposed as possible cause of TMD. This paper reported that a relaxation splint was an effective solution to relieve the pain in the TMJ for the orthodontic patients where occlusal factors were related. One mounth after the splint therapy, the pain in the TMJ was slowly dissapeared, and the orthodontic treatment can be continued with the splint as an occlusal height guidance."

"Pre-prosthetic treatment is very important step to get a successful prosthodontic treatment. This study reported a case of a patient with missing teeth on left and right lower first and second molar with TMJ symptoms. Other symptoms felt by the patients were car pain and shoulder pain. After detailed examination, pre-prosthetic treatment needed by the patient was the TMH treatment. The usage of occlusal splint as one of the methods to treat the TMD where i.e. eliminate the occlusal disorder to reduce the neuromuscular activity and to regain a stable centric relation. After the splint treatment, an open bite on the posterior teeth appeared. To solve this problem, a removable frame prosthesis enhanced with overlay rest was fabricated. With this prosthesis, the TMJ symptoms stopped recurring. It was concluded that to achieve a successful prosthesis a detailed and comprehensive treatment was needed including the pre-prosthetic treatment along with the patient's motivation and cooperation."

"ABSTRAKLatar Belakang: Proses penuaan dapat menyebabkan perubahan fisiologis pada jaringan gigi dan mulut, termasuk fungsi pada sendi temporomandibula. Mastikasi merupakan salah satu fungsi sistem stomagtonati yang dapat dipengaruhi oleh gangguan sendi temporomandibula (Temporomandibula Disorders). Tujuan: Menganalisis hubungan antara gangguan sendi temporomandibula terhadap kemampuan mastikasi, serta menganalisis pengaruh faktor sosiodemografi terhadap gangguan sendi temporomandibula dan kemampuan mastikasi. Metode: Penelitian ini dilakukan dengan desain cross sectional pada 100 pasien Puskesmas Kecamatan Kramat Jati berusia 60 tahun ke atas. Dilakukan pencatatan diri responden, pemeriksaan klinis intraoral, dan wawancara menggunakan kuesioner kemampuan mastikasi dan ID-TMD. Hasil penelitian: Gangguan sendi temporomandibula memiliki hubungan (p < 0,05) terhadap kemampuan mastikasi. Terdapat hubungan antara usia dengan gangguan sendi temporomandibula, tetapi tidak terdapat hubungan antara jenis kelamin, tingkat pendidikan dan status ekonomi dengan gangguan sendi temporomandibula. Terdapat hubungan antara usia, tingkat pendidikan, dan status ekonomi dengan kemampuan mastikasi, tetapi tidak ada hubungan antara jenis kelamin dengan kemampuan mastikasi. Kesimpulan: Terdapat pengaruh gangguan sendi temporomandibula terhadap kemampuan mastikasi pada lansia.

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ABSTRACTBackground: Aging process involve physiological changes in the teeth and mouth tissues, including temporomandibular joint function. Mastication is one of the main functions of the stomatognathic system that may be affected by temporomandibular disorders. Objectives: To analyze the relationship between temporomandibular disorder towards masticatory ability, to analyze sociodemographic factors (age, gender, educational level, and economic status) towards temporomandibular disorder and masticatory ability. Methods: Cross-sectional study was conducted on 100 patients of Puskesmas Kramat Jati aged 60 years and over. Subject's data and oral examination were obtained, and interview for masticatory ability and ID-TMD were conducted. Results: There was correlation (p < 0.05) between temporomandibular disorder towards masticatory ability. There was correlation between age towards temporomandibular disorder, but there was no correlation between gender, educational level and economic status towards temporomandibular disorder. There was correlation between age, educational level, and economic status towards masticatory ability, but there was no correlation between gender towards masticatory ability. Conclusion: This study shows that temporomandibular disorders negatively influence masticatory ability in elderly."