Craniomandibular Dysfunction and Violin Playing: Prevalence and the Influence of Oral Splints on Head and Neck Muscles in Violinists

Abstract

Previous studies have shown a significant higher prevalence of craniomandibular dysfunction (CMD) in violin players compared with controls. CMD is related to increased muscular load in the muscles of mastication, the trapezius and sternocleidomastoid muscles, which can possibly predispose to overuse syndromes. To examine whether CMD can also cause overuse syndromes in violinists, we investigated a group of 31 violinists by questionnaire, mandibular tracking, and a clinical examination to elicit overuse and CMD symptoms. The influence of CMD on muscular tension during violin playing was assessed with surface EMG; this was performed twice on each violinist, once with and once without an occlusal splint, in order to work out the effect of CMD on the muscular load. CMD could be diagnosed in 74% of the investigated violinists. The occlusal splints significantly decreased the load in the masseter, temporalis, trapezius, and sternocleidomastoid muscles during musical performance. Occlusal splints appear to decrease the muscular load in asymptomatic violinists as well, suggesting a possible preventive and therapeutic role in overuse symptoms in the setting of preexisting CMD.