<?xml version="1.0" encoding="UTF-8"?><?xml-stylesheet type="text/xsl" href="static/style.xsl"?><OAI-PMH xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/ http://www.openarchives.org/OAI/2.0/OAI-PMH.xsd"><responseDate>2026-06-24T13:32:52Z</responseDate><request verb="GetRecord" identifier="oai:docta.ucm.es:20.500.14352/123732" metadataPrefix="qdc">https://docta.ucm.es/rest/oai/request</request><GetRecord><record><header><identifier>oai:docta.ucm.es:20.500.14352/123732</identifier><datestamp>2025-09-06T00:06:10Z</datestamp><setSpec>com_20.500.14352_14</setSpec><setSpec>col_20.500.14352_15</setSpec></header><metadata><qdc:qualifieddc xmlns:qdc="http://dspace.org/qualifieddc/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:dcterms="http://purl.org/dc/terms/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:doc="http://www.lyncode.com/xoai" xsi:schemaLocation="http://purl.org/dc/elements/1.1/ http://dublincore.org/schemas/xmls/qdc/2006/01/06/dc.xsd http://purl.org/dc/terms/ http://dublincore.org/schemas/xmls/qdc/2006/01/06/dcterms.xsd http://dspace.org/qualifieddc/ http://www.ukoln.ac.uk/metadata/dcmi/xmlschema/qualifieddc.xsd">
   <dc:title>Clinical Manifestations of Temporomandibular Disorders and Their Relationship with Sleep Disturbances and Emotional Disorders in a Spanish Pediatric Population: A Cross-Sectional Study</dc:title>
   <dc:creator>Tapia-Sierra, Fanny Esther</dc:creator>
   <dc:creator>Ticona-Flores, Jesús Miguel</dc:creator>
   <dc:creator>Elvira-Tapia, Naomi</dc:creator>
   <dc:creator>Gallardo López, Nuria Esther</dc:creator>
   <dc:creator>Reichard-Monefeldt, Guillermo</dc:creator>
   <dc:creator>Diéguez Pérez, Montserrat</dc:creator>
   <dcterms:abstract>The etiology of temporomandibular disorders (TMDs) has been linked to various factors, including functional and psychological factors, which makes it difficult to identify associations between a single etiological factor and the signs and symptoms of TMDs. 

Objectives: This study aimed to describe the presence of TMD symptoms and their relationship with sleep disturbances and emotional disorders in children and adolescents. 

Methods: This observational study included Spanish children aged between 8 and 13 years. The measurement instruments consisted of the BRUNI survey for sleep disorders and the Educational-Clinical Questionnaire: Anxiety and Depression (CECAD) survey. A clinical examination was subsequently performed following the DC/TMD guidelines for diagnosing TMDs. Frequencies, means, and standard deviations were applied, along with the prevalence ratio as a measure of association and the chi-square test. The significance level was set at 5%. 

Results: A total of 128 participants participated in the study with a mean age of 10.89 (±2.15) years. The prevalence of TMDs was 54%, while the most common symptoms were muscle pain at 26%, joint pain at 14%, and a combination of both at 14%. Children who presented muscle pain had a mean anxiety score of 44.87 (±11.85), whereas those without symptoms had a mean score of 36 (±10.78, and 0.03 p-value). The BRUNI index revealed that 78.13% of patients with TMDs had difficulty initiating and maintaining sleep, with a prevalence ratio (PR) of 3.57 (p-value 0.041). 

Conclusions: The present study reveals that temporomandibular disorders are common in children and adolescents, with 54% presenting at least one clinical sign or symptom. Emotional disturbances and sleep problems were also prevalent, affecting 41% and 56% of participants, respectively. Early interdisciplinary screening is essential to manage the co-occurrence of TMDs, emotional distress, and sleep problems in children.</dcterms:abstract>
   <dcterms:dateAccepted>2025-09-05T09:44:11Z</dcterms:dateAccepted>
   <dcterms:available>2025-09-05T09:44:11Z</dcterms:available>
   <dcterms:created>2025-09-05T09:44:11Z</dcterms:created>
   <dcterms:issued>2025-05-21</dcterms:issued>
   <dc:type>journal article</dc:type>
   <dc:identifier>https://hdl.handle.net/20.500.14352/123732</dc:identifier>
   <dc:identifier>XXXX-XXXX</dc:identifier>
   <dc:identifier>10.3390/jcm14103599</dc:identifier>
   <dc:identifier>2077-0383</dc:identifier>
   <dc:language>eng</dc:language>
   <dc:relation>Tapia-Sierra FE, Ticona-Flores JM, Reichard-Monefeldt G, Elvira-Tapia N, Gallardo-López NE, Diéguez-Pérez M. Clinical Manifestations of Temporomandibular Disorders and Their Relationship with Sleep Disturbances and Emotional Disorders in a Spanish Pediatric Population: A Cross-Sectional Study. J Clin Med. 2025 May 21;14(10):3599. doi: 10.3390/jcm14103599</dc:relation>
   <dc:rights>http://creativecommons.org/licenses/by/4.0/</dc:rights>
   <dc:rights>open access</dc:rights>
   <dc:rights>Attribution 4.0 International</dc:rights>
   <dc:publisher>MDPI</dc:publisher>
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