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Yao Y, Liu SS, Jin L, Zeng H, Jiang X, Fang ZY, Cai B, Xu L. Mental health and jaw function of patients with anterior disc displacement with reduction. J Oral Rehabil 2024; 51:677-683. [PMID: 38087998 DOI: 10.1111/joor.13637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/08/2023] [Accepted: 11/26/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND The mental health of patients with temporomandibular disorder or other jaw dysfunction is a primary concern in clinical practice, but the extent of these symptoms in this patient subset is not yet well understood. OBJECTIVES This cross-sectional study aimed to compare the mental health and jaw function between patients with anterior disc displacement with reduction (ADDWR) and healthy individuals. METHODS In total, 170 patients with ADDWR and 163 healthy participants enrolled in this study from March 2020 to December 2021. All participants completed a single assessment, including a pain rating and several questionnaires to assess jaw dysfunction, depression, and anxiety. All scores and the grade distribution of somatization, depression and anxiety were analysed between groups. RESULTS Significant differences were found in measures of pain, jaw function and somatization; the ADDWR group had significantly higher pain and functional jaw limitations than the healthy group. The grade distribution of somatic symptoms also differed between groups: the distribution of patients who reported mild and above scores in the ADDWR group was significantly higher than that of the healthy group. Depression and anxiety scores or grade distributions were not significantly different by group. CONCLUSION The jaw function of patients seeking treatment for ADDWR was lower than that of non-TMD individuals. They did not show high anxiety and depression symptoms, but their somatic symptoms were more apparent.
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Affiliation(s)
- Yuan Yao
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sha Sha Liu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Jin
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Zeng
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Jiang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhong Yi Fang
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Cai
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lili Xu
- Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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Minervini G, Marrapodi MM, Siurkel Y, Cicciù M, Ronsivalle V. Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis. BMC Oral Health 2024; 24:299. [PMID: 38431574 PMCID: PMC10909276 DOI: 10.1186/s12903-024-03983-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/04/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient's psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations. METHODS A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II). RESULTS Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80- 1.71; Z:0.82; P = .41), suggesting that there is no difference between Axis I and Axis II. CONCLUSION In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms.
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Affiliation(s)
- Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, Caserta, 81100, Italy
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania, Luigi Vanvitelli, Naples, 80121, Italy.
| | - Yuliia Siurkel
- International European University School of Medicine, Akademika Hlushkova Ave, 42В, Kyiv, 03187, Ukraine.
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
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3
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Marciniak T, Kruk-Majtyka W, Bobowik P, Marszałek S. The Relationship between Kinesiophobia, Emotional State, Functional State and Chronic Pain in Subjects with/without Temporomandibular Disorders. J Clin Med 2024; 13:848. [PMID: 38337542 PMCID: PMC10856771 DOI: 10.3390/jcm13030848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Although there is growing evidence that kinesiophobia is correlated with temporomandibular disorders (TMD), its relationship with other characteristic TMD comorbidities, such as depression, anxiety, functional limitations, and pain in the TMD population, has rarely been investigated. This study aims to evaluate the relationship between kinesiophobia, emotional state, functional state and chronic pain in subjects both with and without TMD. A total of 94 subjects participated in the study and were divided into two groups (47 subjects each)-TMD (subjects with temporomandibular disorders) and nTMD (asymptomatic controls)-on the basis of the RDC/TMD protocol. All measurements were taken with self-administered questionnaires: TSK-TMD for kinesiophobia, PHQ-9 and GAD-7 for psychoemotional state, JFLS-20 for jaw functional limitations, and GCPS for chronic pain. The prevalence of kinesiophobia in the TMD group was 38.3% for moderate risk, and 61.7% for high risk. The TMD group showed significantly higher scores in all categories (kinesiophobia, depression, jaw functional limitations and chronic pain), with the exception of anxiety which was right at the cut-off point. Moreover, a significant correlation was found between kinesiophobia (TSK-TMD) and jaw functional limitations (JFLS-20). Results of this study could provide new insight into the relationship between kinesiophobia and TMD, further improving the diagnosis process.
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Affiliation(s)
- Tomasz Marciniak
- Faculty of Rehabilitation, Józef Piłsudski Academy of Physical Education in Warsaw, 00-968 Warsaw, Poland; (W.K.-M.); (P.B.)
| | - Weronika Kruk-Majtyka
- Faculty of Rehabilitation, Józef Piłsudski Academy of Physical Education in Warsaw, 00-968 Warsaw, Poland; (W.K.-M.); (P.B.)
| | - Patrycja Bobowik
- Faculty of Rehabilitation, Józef Piłsudski Academy of Physical Education in Warsaw, 00-968 Warsaw, Poland; (W.K.-M.); (P.B.)
| | - Sławomir Marszałek
- Department of Physiotherapy, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Faculty of Physical Education in Gorzow Wielkopolski, Poznan University of Physical Education, 61-871 Poznan, Poland
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4
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Sangalli L, Souza LC, Letra A, Shaddox L, Ioannidou E. Sex as a Biological Variable in Oral Diseases: Evidence and Future Prospects. J Dent Res 2023; 102:1395-1416. [PMID: 37967405 DOI: 10.1177/00220345231197143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
The interest of the scientific community on sex and gender differences in health and disease has increased substantially over the past 25 to 30 y as a result of a long process of events and policies in the biomedical field. This is crucial as compelling evidence from human and animal model studies has demonstrated that sex and gender influence health, molecular and cellular processes, and response and predisposition to disease. The present scoping review aims to provide a synthesis of sex differences in oral diseases, ranging from periodontal disease to orofacial pain conditions, from risk of caries development to apical periodontitis. Overall, findings from this review further support a role for sexual dimorphism influencing disease predisposition and/or progression in oral diseases. Of note, this review also highlights the lack of consideration of additional factors such as gender and other psychosocial and external factors potentially influencing oral health and disease. New conceptual frameworks capable of capturing multiple fundamental domains and measurements should be developed in clinical and preclinical studies to inform sex-based individualized preventive and treatment strategies.
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Affiliation(s)
- L Sangalli
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA
| | - L C Souza
- Center for Craniofacial Research, Department of Endodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Letra
- Departments of Oral and Craniofacial Sciences, Endodontics, and Center for Craniofacial and Dental Genetics, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - L Shaddox
- Center for Oral Health Research, Division of Periodontology, University of Kentucky, College of Dentistry, Lexington, KY, USA
| | - E Ioannidou
- UCSF, Department of Orofacial Sciences, San Francisco, CA, USA
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Cundiff-O’Sullivan RL, Wang Y, Thomas S, Zhu S, Campbell CM, Colloca L. Individual Dimensions of Pain Catastrophizing Do Not Mediate the Effect of Sociodemographic and Psychological Factors on Chronic Orofacial Pain Severity, Interference, and Jaw Limitation: A Structural Equation Modeling Approach. THE JOURNAL OF PAIN 2023; 24:1617-1632. [PMID: 37121497 PMCID: PMC10528356 DOI: 10.1016/j.jpain.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 04/01/2023] [Accepted: 04/21/2023] [Indexed: 05/02/2023]
Abstract
Pain catastrophization (PC), involving rumination, magnification, and helplessness, can be viewed as a coping strategy associated with chronic pain. PC is considered a driving force in mediating pain-related outcomes, but it is still unclear whether PC mediates the relationship between psychological and sociodemographic factors with chronic pain when considered in a single model. Using baseline data from a parent study, this study examined the effect of positive and negative psychological and sociodemographic factors on pain severity, interference, and jaw limitation mediated by the PC dimensions in a sample of 397 temporomandibular disorder (TMD) participants using structural equation modeling (SEM). SEM revealed that pain severity regressed on age, sex, education, and income; interference regressed on positive and negative psychological factors, education, and income; and jaw limitation regressed on age. The PC dimensions did not individually mediate these relationships. Although they jointly mediated the relationships between negative psychological factors and pain severity and between age and pain interference, the effect size was small, suggesting that PC is not a critical factor in mediating TMD pain outcomes. Reducing negative cognitions, not just PC, may be of greatest benefit to the most vulnerable TMD populations. PERSPECTIVE: This study examines sociodemographic and psychological factors that affect orofacial pain, finding that the pain catastrophizing dimensions do not mediate these relationships. Understanding which factors most strongly affect pain outcomes will help identify targets for intervention to produce the greatest benefit for the most vulnerable persons suffering from pain.
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Affiliation(s)
- Rachel L. Cundiff-O’Sullivan
- Program in Neuroscience, Graduate Program in Life Sciences, School of Medicine, University of Maryland, Baltimore, US
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, US
| | - Yang Wang
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, US
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, US
| | - Sharon Thomas
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, US
- Doctoral Program in Nursing, School of Nursing, University of Maryland, Baltimore, US
| | - Shijun Zhu
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, US
- Office of Research and Scholarship, School of Nursing, University of Maryland, Baltimore, US
| | - Claudia M. Campbell
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, US
- Department of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, US
| | - Luana Colloca
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, US
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, US
- Department of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, US
- Department of Anesthesiology, School of Medicine, University of Maryland, Baltimore, US
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6
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Sousa CRA, Arsati YBDOL, Velly AM, Silva CALD, Arsati F. Catastrophizing is associated with pain-related disability in temporomandibular disorders. Braz Oral Res 2023; 37:e070. [PMID: 37436293 DOI: 10.1590/1807-3107bor-2023.vol37.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/27/2023] [Indexed: 07/13/2023] Open
Abstract
This study aimed to evaluate the association of pain-related disability with biopsychosocial factors in temporomandibular disorders (TMD) patients. The study was carried out at the Orofacial Pain Outpatient Clinic of the State University of Feira de Santana, Bahia, from September 2018 to March 2020. The sociodemographic aspects, TMD subtypes, presence of pain-induced disability, pressure pain threshold, perceived stress, anxiety, depression, and catastrophizing were evaluated in 61 patients. The studied variables were compared between patients with and without pain-induced disability. Crude and adjusted logistic regression were performed to obtain estimates of odds ratios (OR) and 95% confidence intervals. With the exception of catastrophizing, there was no association between the biopsychosocial factors and pain-induced disability. The presence of catastrophizing increased the chance of having chronic pain-induced disability by 4.02 times. The results of this study indicate a strong association between pain catastrophizing and disability in individuals with chronic painful TMD.
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Affiliation(s)
- Cintia Regina Andrade Sousa
- Universidade Estadual de Feira de Santana - UEFS, Department of Biological Sciences, Feira de Santana, BA, Brazil
| | | | | | | | - Franco Arsati
- Universidade Estadual de Feira de Santana - UEFS, Department of Biological Sciences, Feira de Santana, BA, Brazil
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7
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Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders-An Observational Study. Life (Basel) 2023; 13:life13010229. [PMID: 36676178 PMCID: PMC9866298 DOI: 10.3390/life13010229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p < 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.
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8
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Hietaharju M, Näpänkangas R, Ahtonen P, Kuoppala R, Sipilä K. The role of pain-related disability on treatment outcome and psychosocial symptoms in patients with temporomandibular disorders - a pilot study. Acta Odontol Scand 2023:1-6. [PMID: 36592379 DOI: 10.1080/00016357.2022.2162575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of the pilot study was to investigate the association of pain-related disability with the outcome of conservative treatment of temporomandibular disorders (TMD) and with depressive and non-specific physical symptoms among TMD pain patients utilizing Graded Chronic Pain Scale 1.0 (GCPS1.0) as a screening instrument. MATERIAL AND METHODS The study included 80 adult patients who were referred to the Oral and Maxillofacial Department, Oulu University Hospital, Finland, due to TMD pain. At baseline, pain-related disability was assessed by using the GCPS1.0 according to the Research Diagnostic Criteria for TMD (RDC/TMD), and the patients were categorized into three TMD subtypes, 1-3. Patients were given conservative TMD treatment. At follow-up visits (1, 3, 6, and 12 months), patients evaluated the pain intensity on an NRS and described the treatment outcome and the severity of the TMD symptoms on a numerical scale. RESULTS AND CONCLUSIONS Patients with TMD subtype 3 (moderate/severe disability) had the highest NRS scores and described their symptoms as most severe at each time point, statistically significantly so at 1-month and 6-month follow-up (p < .05). The highest proportion of depressive symptoms was found in TMD subtype 3 (p < .05). The current pilot study showed that moderate/severe TMD-related disability, based on the GCPS 1.0 as a screening tool, may be linked with poor treatment outcome and depressive symptoms. Studies with larger samples are needed to confirm the results.
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Affiliation(s)
- Maria Hietaharju
- Research Unit of Oral Health Sciences Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ritva Näpänkangas
- Research Unit of Oral Health Sciences Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pinja Ahtonen
- Research Unit of Oral Health Sciences Faculty of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ritva Kuoppala
- Research Unit of Oral Health Sciences Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kirsi Sipilä
- Research Unit of Oral Health Sciences Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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9
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Thomas S, Wang Y, Cundiff-O’Sullivan R, Massalee R, Colloca L. How negative and positive constructs and comorbid conditions contribute to disability in chronic orofacial pain. Eur J Pain 2023; 27:99-110. [PMID: 36203350 PMCID: PMC9799734 DOI: 10.1002/ejp.2042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/08/2022] [Accepted: 10/02/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) symptoms develop into chronic pain for some patients, but the reasons for this are unclear. Psychosocial factors and chronic overlapping pain conditions are believed to contribute to the development of pain-related disability. We examined the role of jaw function, negative and positive psychological factors and chronic overlapping pain conditions (COPCs) on pain-related disability whilst controlling for demographic variables. METHODS We collected demographics, medical and psychosocial history and the Graded Chronic Pain Scale, a measure of pain intensity and pain interference from 400 participants with chronic TMD. Structural equation modelling was used to assess a model of COPCs and the latent variables of psychological unease (pain catastrophizing, somatic symptoms and negative affect), positive valence factors (optimism and positive affect), jaw function (chewing, opening and expression limitation) and pain-related disability (pain intensity and pain interference) whilst controlling for demographic variables. RESULTS We achieved good fit of a parsimonious model (root-mean-square error of approximation = 0.063 [90% CI] [0.051-0.075]), comparative fit index = 0.942, standard root-mean-square residual = 0.067. Jaw function was the strongest latent variable predictor, followed by psychological unease and COPCs suggesting resources focused on improving joint function, psychosocial support and management of COPCs will improve pain-related disability in TMDs. CONCLUSIONS These findings not only increase the body of knowledge related to TMD clinical phenotypes but also, have a translational impact in further supporting the potential value of targeting physical therapy such as jaw exercise along with psychological interventions as multidisciplinary nonpharmacological therapeutic solutions.
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Affiliation(s)
- Sharon Thomas
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Yang Wang
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
| | - Rachel Cundiff-O’Sullivan
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
- Program in Neuroscience, Graduate Program in Life Sciences, University of Maryland, Baltimore, MD, US
| | - Rachel Massalee
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
| | - Luana Colloca
- Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
- Departments of Anaesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, USA
- Placebo Beyond Opinions (PBO) Center, School of Nursing, University of Maryland, Baltimore, USA
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10
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Hernández-Nuño de la Rosa MF, Guerrero P, Alturki SA, Scrivani SJ. Masticatory Myofascial Pain Disorders. Dent Clin North Am 2023; 67:1-11. [PMID: 36404071 DOI: 10.1016/j.cden.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Masticatory myofascial pain disorders (MMPD) are a common group of orofacial pain conditions affecting the muscles of mastication, with headache and cervical disorders as well as chronic widespread pain and psychosocial disorders being common comorbid conditions. As their pathophysiology is multifactorial in nature, a multimodal and interdisciplinary approach should be considered. Overall treatment goals include decreasing pain and disability, increasing mandibular range of motion, and improving quality of life. This article describes a complex case exhibiting common characteristics of MMPD while additionally reviewing the literature on classification, pathophysiology, and evidence-based treatment planning.
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Affiliation(s)
| | - Patricia Guerrero
- Department of Diagnostics Sciences, Craniofacial Pain Center, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Shuruq A Alturki
- Department of Diagnostics Sciences, Craniofacial Pain Center, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Steven J Scrivani
- Department of Diagnostics Sciences, Craniofacial Pain Center, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
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11
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Salinas Fredricson A, Krüger Weiner C, Adami J, Rosén A, Lund B, Hedenberg-Magnusson B, Fredriksson L, Naimi-Akbar A. The Role of Mental Health and Behavioral Disorders in the Development of Temporomandibular Disorder: A SWEREG-TMD Nationwide Case-Control Study. J Pain Res 2022; 15:2641-2655. [PMID: 36097536 PMCID: PMC9464023 DOI: 10.2147/jpr.s381333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose There is a well-known association between mental and behavioral disorders (MBD) and temporomandibular disorder (TMD), although the association has not been established in population-based samples. This study aimed to investigate this relationship using national population-based registry data. Patients and Methods This case-control study used prospectively collected data from Swedish national registries to investigate exposure to MBD and the probability of developing TMD in all Swedish citizens with hospital-diagnosed or surgically treated TMD between 1998 and 2016. Odds ratios were calculated using conditional logistic regression adjusted for educational level, living area, country of birth, musculoskeletal comorbidity, and history of orofacial/neck trauma. Results A statistically significant association between MBD and TMD was found for mood affective disorders (OR 1.4), neurotic, stress-related and somatoform disorders (OR 1.7), behavioral syndromes associated with psychological disturbances and physical factors (OR 1.4), disorders of adult personality and behavior (OR 1.4), disorders of psychological development (OR 1.3), behavioral and emotional disorders with onset usually occurring in childhood and adolescence (OR 1.4), and unspecified mental disorder (OR 1.3). The association was stronger for TMD requiring surgery, with the strongest association in patients with disorders of psychological development (OR 2.9). No significant association was found with schizophrenia, schizotypal and delusional disorders, or mental retardation. Conclusion The findings indicate an increased probability of TMD among patients with a history of certain MBD diagnoses, and a stronger association with TMD requiring surgery, specifically repeated surgery. This highlights the need for improved preoperative understanding of the impact of MBD on TMD, as TMD and chronic pain itself may have a negative impact on mental health.
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Affiliation(s)
- Adrian Salinas Fredricson
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carina Krüger Weiner
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Annika Rosén
- Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Bodil Lund
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Medical Unit for Reconstructive Plastic and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Britt Hedenberg-Magnusson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Orofacial Pain and Jaw Function, Stockholm, Sweden
| | - Lars Fredriksson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Orofacial Pain and Jaw Function, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Stockholm, Sweden.,Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.,Health Technology Assessment-Odontology (HTA-O), Malmö University, Malmö, Sweden
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12
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Versluijs Y, Bandell D, Kortlever J, Ring D. The Influence of Symptoms of Anger on Pain Intensity and Activity Intolerance. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09894-5. [PMID: 35750973 DOI: 10.1007/s10880-022-09894-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 10/17/2022]
Abstract
This study assessed the association of anger, anxiety, and depression, and cognitive bias with pain and activity tolerance among patients with a musculoskeletal illness or injury expected to last more than a month. 102 Patients completed emotional thermometers to quantify symptoms of anger, anxiety, depression; the abbreviated Pain Catastrophizing Scale; a pain intensity scale; Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Computer Adaptive Test; the Spielberger State-Trait Anxiety Inventory and demographic questionnaires. Controlling for potential confounding in multivariable analysis we found greater activity intolerance was associated with retired work-status and greater depressive symptoms, but not with greater symptoms of anger. In addition, greater pain intensity was associated with greater symptoms of depression and greater catastrophic thinking, but not with greater symptoms of anger. Anger emotions do not contribute to symptom intensity and activity intolerance in musculoskeletal illness. Attention can be directed at addressing psychological distress and cognitive bias.
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Affiliation(s)
- Yvonne Versluijs
- Department of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78712, USA.,Department of Trauma Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - David Bandell
- Department of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78712, USA
| | - Joost Kortlever
- Department of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78712, USA
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School-The University of Texas at Austin, 1701 Trinity Street, Austin, TX, 78712, USA.
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13
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Influence of Depression and Anxiety in Temporomandibular Disorders Six Months Postarthrocentesis. J Maxillofac Oral Surg 2022; 21:674-677. [DOI: 10.1007/s12663-020-01504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022] Open
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14
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Dubinskaya AD, Yurova OV, Fesyun AD, Kukshina AA. Correction of Psycho-Emotional Status Using Neuromuscular Relaxation of the Face. J Nerv Ment Dis 2022; 210:179-185. [PMID: 34456322 DOI: 10.1097/nmd.0000000000001413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT This article is relevant, as most healthy women face the problem of increased facial muscle tone. The purpose of the study was to investigate current problems of the relationship between tonic activity of the facial muscles and psycho-emotional states. The study included a group of 151 women subjected to psychological testing. According to its results, they were randomized into five study groups depending on sex and age. The frequency and severity of psycho-emotional states and parameters of tonic activity of the facial muscles were studied. Currently accepted methods for the correction of psycho-emotional states based on the feedback mechanism were analyzed. The efficacy of myofascial facial massage as an instrument for psychological status correction was evaluated. The long-term effects of various massage techniques aimed at facial muscle relaxation on the psycho-emotional state were established. The most effective tools for muscle tone correction were proposed for psycho-emotional status correction.
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Affiliation(s)
- Anastasia D Dubinskaya
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of the Moscow Healthcare Department
| | - Olga V Yurova
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of the Moscow Healthcare Department
| | - Anatoliy D Fesyun
- Medical Research Center of Rehabilitation and Balneology of the Ministry of Health of Russian Federation, Moscow, Russian Federation
| | - Anastasia A Kukshina
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of the Moscow Healthcare Department
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15
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Greenberg J, Bakhshaie J, Lovette BC, Vranceanu AM. Association Between Coping Strategies and Pain-Related Outcomes Among Individuals with Chronic Orofacial Pain. J Pain Res 2022; 15:431-442. [PMID: 35177932 PMCID: PMC8846621 DOI: 10.2147/jpr.s350024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/16/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Correspondence: Jonathan Greenberg, Integrated Brain Health Clinical and Research Program & Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital / Harvard Medical School, One Bowdoin Square, 1st Floor, Suite 106, Boston, MA, 02114, USA, Email
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Brenda C Lovette
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- MGH Institute of Health Professions, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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16
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Silva LMCP, Rodrigues BA, Lucena HÍDS, Morais EPGD, Rocha AC, Lucena LBSD, Alves GADS, Benevides SD. Prevalência de cinesiofobia e catastrofização em pacientes com disfunção temporomandibular. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222463222s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RESUMO Objetivo: identificar a frequência e os níveis de cinesiofobia e catastrofização em pacientes com Disfunção Temporomandibular que realizaram terapia fonoaudiológica. Métodos: a amostra compreendeu pacientes com Disfunção Temporomandibular muscular e mista com predominância muscular, grupo de estudo e adultos saudáveis, o grupo controle. Os instrumentos utilizados foram: Diagnostic Criteria for Temporomandibular Disorders, Escala Tampa para Cinesiofobia e Escala de Catastrofização da Dor. A análise estatística foi composta do Teste de Mann-Whitney para comparar as médias entre os grupos de cada escala e o teste de Coeficiente de Correlação de Spearman para analisar a correlação entre as escalas em cada grupo e sua significância. Resultados: foi identificado um alto índice de catastrofização da dor no grupo de estudo em comparação ao grupo controle. Quanto à cinesiofobia, houve maior índice positivo para essa variável no grupo de estudo e menor para o grupo controle. Além disso, identificou-se correlação moderada e positiva entre a cinesiofobia e catastrofização no grupo de estudo. Conclusão: Pacientes com Disfunção Temporomandibular possuem níveis de cinesiofobia e catastrofização mais altos que pacientes que não foram diagnosticados com o distúrbio.
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17
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Silva LMCP, Rodrigues BA, Lucena HÍDS, Morais EPGD, Rocha AC, Lucena LBSD, Alves GADS, Benevides SD. Prevalence of kinesiophobia and catastrophizing in patients with temporomandibular disorders. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222463222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Purpose: to identify the frequency and levels of kinesiophobia and catastrophizing in patients with temporomandibular disorders who had been submitted to speech-language-hearing therapy. Methods: the sample comprised patients with myogenous (predominantly) and mixed temporomandibular disorders in the study group and healthy individuals in the control group. The instruments used were the Diagnostic Criteria for Temporomandibular Disorders, Tampa Scale for Kinesiophobia, and Pain Catastrophizing Scale. Statistical analyses were performed with the Mann-Whitney test (to compare the means on each scale between the groups) and the Spearman’s correlation coefficient test (to analyze the correlation between the scales in each group and its significance). Results: the study group had a higher pain catastrophizing index than the control group. Likewise, the study group had greater kinesiophobia positive indices, whereas the control group had lower ones. A moderate positive correlation was also identified between kinesiophobia and catastrophizing in the study group. Conclusion: patients presented with temporomandibular disorders have higher levels of kinesiophobia and catastrophizing than subjects not diagnosed with the disorder.
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18
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Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, Alstergren P, Conti PCR, Durham J, Goulet JP, Hirsch C, Kalaykova SI, Kapos FP, King CD, Komiyama O, Koutris M, List T, Lobbezoo F, Ohrbach R, Palermo TM, Peck CC, Penlington C, Restrepo C, Rodrigues MJ, Sharma S, Svensson P, Visscher CM, Wahlund K, Michelotti A. Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II. J Oral Rehabil 2021; 49:541-552. [PMID: 34951729 DOI: 10.1111/joor.13301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/27/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established. OBJECTIVES To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. METHODS A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended. RESULTS The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience. CONCLUSION Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.
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Affiliation(s)
- Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ing-Marie Nilsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Center for Oral Rehabilitation, FTV Östergötland, Norrköping, Sweden
| | - Amal Al-Khotani
- Scandinavian Center for Orofacial Neurosciences, Sweden.,East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Paulo Cesar Rodrigues Conti
- 7Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Stanimira I Kalaykova
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, United States
| | - Christopher D King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Center for Understanding Pediatric Pain (CUPP), Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Osamu Komiyama
- Division of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo, Japan
| | - Michail Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden
| | - Frank Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, United States.,Seattle Children's Research Institute, Seattle, United States
| | - Christopher C Peck
- Faculty of Medicine and Health, University of Sydney, Westmead, Australia
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Maria Joao Rodrigues
- Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sonia Sharma
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Peter Svensson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark
| | - Corine M Visscher
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Wahlund
- Department of Stomatognathic Physiology, Kalmar County Hospital, Kalmar, Sweden
| | - Ambrosina Michelotti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
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19
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Häggman-Henrikson B, M Visscher C, Wänman A, Ljótsson B, C Peck C, Lövgren A. Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders. J Oral Rehabil 2021; 48:1193-1200. [PMID: 34462940 DOI: 10.1111/joor.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
AIMS Temporomandibular disorders (TMD) are often associated with psychological comorbidities. One such comorbidity is pain catastrophising, that is, exaggeration of negative consequences of a painful event. The aim was to investigate catastrophising in individuals with painful TMD compared to controls and the association between catastrophising and pain intensity, number of pain sites and functional limitations. METHODS A community-based sample of 110 individuals (83 women; 20-69 yrs) with painful TMDs (myalgia/arthralgia as per Diagnostic Criteria for TMD) and 190 age- and gender-matched controls (119 women; 20-69 yrs) from the Public Dental services in Västerbotten, Sweden, participated. Associations between catastrophising and functional jaw limitations, respectively, and painful TMD were evaluated with ordinal regression adjusted for the effect of gender and age. Associations (Spearman's correlation) of the Pain catastrophising Scale (PCS) with Jaw Functional Limitation Scale (JFLS-20), pain site number (whole-body pain map), and characteristic pain intensity (CPI) and intergroup comparisons (Mann-Whitney U test) of these variables were also calculated. RESULTS Levels of catastrophising were associated with TMD pain (OR 1.6, 95%CI 1.1-2.6). Among individuals with painful TMD, catastrophising was correlated to pain intensity (r=0.458, p<0.01) and functional limitations (r=0.294-0.321, p≤0.002), but not to number of pain sites. CONCLUSION Compared to controls, community-based individuals with painful TMD demonstrated higher levels of pain catastrophising, and this catastrophising was associated with increased pain intensity and jaw dysfunction. The relatively low scores of pain catastrophising suggest that even mild catastrophic thinking is associated with pain perception and jaw function, and should be considered in patient management.
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Affiliation(s)
- Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden.,Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Anders Wänman
- Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Christopher C Peck
- The University of Sydney Westmead Initiative, The University of Sydney, Sydney, Australia
| | - Anna Lövgren
- Department of Odontology/Clinical Oral Physiology, Umeå University, Umeå, Sweden
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20
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Ettlin DA, Napimoga MH, Meira E Cruz M, Clemente-Napimoga JT. Orofacial musculoskeletal pain: An evidence-based bio-psycho-social matrix model. Neurosci Biobehav Rev 2021; 128:12-20. [PMID: 34118294 DOI: 10.1016/j.neubiorev.2021.06.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022]
Abstract
Pain is a multidimensional experience comprising sensory-discriminative, affective-motivational, and cognitive-evaluative dimensions. Clinical and research findings have demonstrated a complex interplay between social burdens, individual coping strategies, mood states, psychological disorders, sleep disturbances, masticatory muscle tone, and orofacial musculoskeletal pain. Accordingly, current classification systems for orofacial pain require psychosocial assessments to be an integral part of the multidimensional diagnostic process. Here, we review evidence on how psychosocial and biological factors may generate and perpetuate musculoskeletal orofacial pain. Specifically, we discuss studies investigating a putative causal relationship between stress, bruxism, and pain in the masticatory system. We present findings that attribute brain structures various roles in modulating pain perception and pain-related behavior. We also examine studies investigating how the nervous and immune system on cellular and molecular levels may account for orofacial nociceptive signaling. Furthermore, we review evidence pointing towards associations between orofacial musculoskeletal pain and neuroendocrine imbalances, sleep disturbances, and alterations of the circadian timing system. We conclude with several proposals that may help to alleviate orofacial pain in the future.
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Affiliation(s)
- Dominik A Ettlin
- Clinic of Masticatory Disorders, Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland.
| | - Marcelo Henrique Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - Miguel Meira E Cruz
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil; Sleep Unit, Cardiovascular Center of University of Lisbon, Lisbon School of Medicine, Lisbon, Portugal
| | - Juliana Trindade Clemente-Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro De Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
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21
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No pain, still gain (of function): the relation between sensory profiles and the presence or absence of self-reported pain in a large multicenter cohort of patients with neuropathy. Pain 2021; 162:718-727. [PMID: 32868752 DOI: 10.1097/j.pain.0000000000002058] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022]
Abstract
ABSTRACT The pathophysiology of pain in neuropathy is complex and may be linked to sensory phenotypes. Quantitative sensory testing, a standardized method to evaluate sensory profiles in response to defined stimuli, assesses functional integrity of small and large nerve fiber afferents and central somatosensory pathways. It has revealed detailed insights into mechanisms of neuropathy, yet it remains unclear if pain directly affects sensory profiles. The main objective of this study was to investigate sensory profiles in patients with various neuropathic conditions, including polyneuropathy, mononeuropathy, and lesions to the central nervous system, in relation to self-reported presence or absence of pain and pain sensitivity using the Pain Sensitivity Questionnaire. A total of 443 patients (332 painful and 111 painless) and 112 healthy participants were investigated. Overall, loss of sensation was equally prevalent in patients with and without spontaneous pain. Pain thresholds were equally lowered in both patient groups, demonstrating that hyperalgesia and allodynia are just as present in patients not reporting any pain. Remarkably, this was similar for dynamic mechanical allodynia. Hypoalgesia was more pronounced in painful polyneuropathy, whereas hyperalgesia was more frequent in painful mononeuropathy (compared with painless conditions). Self-reported pain sensitivity was significantly higher in painful than in painless neuropathic conditions. Our results reveal the presence of hyperalgesia and allodynia in patients with central and peripheral lesions of the somatosensory system not reporting spontaneous pain. This shows that symptoms and signs of hypersensitivity may not necessarily coincide and that painful and painless neuropathic conditions may mechanistically blend into one another.
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22
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Pain catastrophizing in daughters of women with fibromyalgia: a case-control study. Braz J Anesthesiol 2021; 71:228-232. [PMID: 33934878 PMCID: PMC9373569 DOI: 10.1016/j.bjane.2020.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/18/2020] [Indexed: 11/22/2022] Open
Abstract
Fibromyalgia is a syndrome characterized by chronic pain related to the musculoskeletal system. Patients feel incapable and show catastrophic thoughts (exaggeration of the sensations) related to painful events. This study aimed to compare catastrophic thoughts of pain between daughters of women with fibromyalgia and daughters of women without fibromyalgia, no daughter having the syndrome. It was a case-control study in which 76 women were included: 38 daughters of women diagnosed with fibromyalgia (case group), and 38 daughters of women without fibromyalgia (control group). The Brazilian versions of the Profile of Chronic Pain: Screen, the Pittsburgh Sleep Quality Index, the Pain Catastrophizing Scale, Resilience Scale, Beck Depression Inventory-II, and the State-Trait Anxiety Inventory were used. Data were tabulated and analyzed using SPSS 20.0. Continuous variables were compared between the groups using the Mann-Whitney U test or Student’s t-test for independent samples. A significant difference was considered at p < 0.05. Regarding catastrophism, the case group had higher total catastrophism compared to the control group (p = 0.025). Daughters of patients with fibromyalgia showed higher rumination and magnification levels related to pain (p = 0.028 and p = 0.007, respectively) but did not show hopelessness. This study concludes that daughters of women with fibromyalgia are more likely to have symptoms of fibromyalgia due to their visualization of the syndrome. This indicates that emotional aspects may induce changes, and additional research on an individual basis is necessary.
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23
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Dinan JE, Hargitai IA, Watson N, Smith A, Schmidt JE. Pain catastrophising in the oro-facial pain population. J Oral Rehabil 2021; 48:643-653. [PMID: 33710632 DOI: 10.1111/joor.13166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/21/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pain catastrophising is a maladaptive cognitive response characterised by an exaggerated negative interpretation of pain experiences. It has been associated with greater disability and poorer outcomes in chronic pain, to include several specific oro-facial pain conditions. The goal of this study was to examine pain catastrophising at a military oro-facial pain specialty clinic. METHODS This retrospective chart review (RCR) examined information collected at initial examination from 699 new patients seen between September 2016 and August 2019 at the Orofacial Pain Center at the Naval Postgraduate Dental School (Bethesda, MD). Pain catastrophising, pain characteristics, psychosocial factors and sleep were assessed using standardised scales. Linear regression was used to evaluate associations of patient characteristics and pain intensity with pain catastrophising. Mediation analyses were done to characterise the extent to which the relationship between pain intensity and pain catastrophising may be explained by anxiety, depression and insomnia. RESULTS Higher pain intensity, depression, anxiety, insomnia and younger age were each associated with higher pain catastrophising (all p < .05). A primary diagnosis of neuropathic pain was the strongest independent predictor of higher pain catastrophising. The relationship between pain intensity and pain catastrophising was partially mediated by anxiety, depression and insomnia. CONCLUSIONS In this RCR of a population of oro-facial pain patients, those diagnosed with neuropathic pain were most likely to display high levels of pain catastrophising, a characteristic which is associated with poor long-term pain outcomes. This is the first study to show that, independent of other patient characteristics, those suffering from neuropathic pains displayed the highest levels of pain catastrophising. This highlights the importance of also addressing psychosocial factors in the treatment of neuropathic pain conditions, which are commonly treated using a predominantly biomedical approach. Additionally, anxiety, depression and insomnia each partially explains the relationship between pain intensity and pain catastrophising.
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Affiliation(s)
- John E Dinan
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Istvan A Hargitai
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Nora Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Alexander Smith
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - John E Schmidt
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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24
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Asquini G, Bianchi AE, Borromeo G, Locatelli M, Falla D. The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders. PLoS One 2021; 16:e0245999. [PMID: 33529226 PMCID: PMC7853459 DOI: 10.1371/journal.pone.0245999] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/12/2021] [Indexed: 12/22/2022] Open
Abstract
This study aimed to understand the impact of COVID-19 distress on psychological status, features of central sensitization and facial pain severity in people with temporomandibular disorders (TMDs). In this prospective cohort study, 45 adults (19 chronic, 26 acute/subacute TMD) were recruited prior to the COVID-19 outbreak. Baseline assessment took place before the outbreak while a follow-up was performed immediately after the lockdown period. Multiple variables were investigated including age, gender, perceived life quality, sleep quality, anxiety and depression, coping strategies, central sensitization, pain intensity, pain-related disability and oral behaviour. COVID Stress Scales (CSS) were applied at follow-up to measure the extent of COVID-related distress. CSS were significantly higher in those with chronic TMDs compared to those with acute/subacute TMDs (p<0.05). In people with chronic TMD, the variation in anxiety and depression from baseline to follow-up was significantly correlated with scores on the CSS (r = 0.72; p = 0.002). Variations of the central sensitization inventory (r = 0.57; p = 0.020) and graded chronic pain scale (r = 0.59; p = 0.017) were significantly correlated with scores on the CSS. These initial findings indicate that people with chronic TMD were more susceptible to COVID-19 distress with deterioration of psychological status, worsening features of central sensitization and increased chronic facial pain severity. These findings reinforce the role of stress as a possible amplifier of central sensitization, anxiety, depression, chronic pain and pain-related disability in people with TMDs. Trial Registration: ClinicalTrials.gov ID: NCT03990662.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Craniomandibular Physiotherapy Service, Italian Stomatologic Institute, Milan, Italy
| | | | - Giulia Borromeo
- Craniomandibular Physiotherapy Service, Italian Stomatologic Institute, Milan, Italy
| | | | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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Kazi A, West E, Rahman S, Kim S, Sima A, Schuman TA. Pain Catastrophizing and Quality of Life in Adults With Chronic Rhinosinusitis. Laryngoscope 2021; 131:1939-1945. [PMID: 33513282 DOI: 10.1002/lary.29405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Psychological comorbidity is common in patients with chronic rhinosinusitis (CRS) and is correlated with decreased overall and disease-specific quality of life (QoL). Prior research reported that anxiety and depression, as measured by the hospital anxiety and depression scale (HADS), are associated with worse CRS-specific QoL, as assessed via the Rhinosinusitis Disability Index (RSDI). Furthermore, patients prone to anxiety/depression may display an exaggerated response to real or anticipated discomfort; the pain catastrophizing scale (PCS) is a validated instrument designed to measure this phenomenon. This study is intended to explore the role of pain catastrophizing in relation to anxiety, depression, and disease-specific QoL in patients with facial pain attributed to CRS. STUDY DESIGN Prospective cohort study. METHODS Diagnosis of presumed CRS was based upon current American Academy of Otolaryngology - Head & Neck Surgery (AAO-HNS) guidelines; all participants reported facial pain as a component of their CRS symptomatology. RSDI, HADS, and PCS questionnaires were administered upon presentation prior to intervention, and objective measurements of sinonasal inflammation were obtained via nasal endoscopy and computed tomography (CT). RESULTS Seventy-five patients were enrolled in the study. Significant positive correlations were found between PCS and HADS, total RSDI, and RSDI emotional sub-scores (P < .05). The incidence of objective evidence of disease, as measured via nasal endoscopy and CT, was not significantly different in catastrophizing patients. CONCLUSIONS Pain catastrophizing correlates with anxiety/depression and worse disease-specific QoL in patients meeting symptomatic criteria for CRS. Otolaryngologists should be aware that catastrophic thinking can intensify a patient's perception of sinonasal symptoms, and clinicians may consider management of psychological comorbidity to optimize rhinologic outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 131:1939-1945, 2021.
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Affiliation(s)
- Aasif Kazi
- Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A
| | - Emma West
- Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A
| | - Shahryar Rahman
- Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A
| | - Sarah Kim
- Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A
| | - Adam Sima
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, U.S.A
| | - Theodore A Schuman
- Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University, Richmond, Virginia, U.S.A
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Facial Pain and Temporomandibular Joint Dysfunction Secondary to Acromegaly: Treatment with Manual Therapy, Neuromuscular Re-education - A Case Report. REHABILITATION ONCOLOGY 2021; 38:127-133. [PMID: 33447472 DOI: 10.1097/01.reo.0000000000000190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background and Purpose Acromegaly is a disorder typically caused by a benign pituitary adenoma resulting in hypersecretion of growth hormone. Common sequelae, including musculoskeletal changes and arthropathies can result in facial pain and temporomandibular disorder (TMD) that persist beyond primary treatment. Due to the unique etiology of facial pain and TMD in cases of acromegaly, the generalizability of established physical therapy (PT) literature for treatment of TMD cannot be assumed. The purpose of this case report was to illustrate an example of multimodal PT as a treatment strategy for facial pain and TMD secondary to acromegaly following treatment for benign pituitary macroadenoma. Case Description 48-year-old male patient with history significant for benign pituitary macroadenoma, presented with facial pain and TMD secondary to acromegaly. Patient-reported outcomes of pain, function, and quality of life were assessed utilizing the Gothenburg Trismus Questionnaire (GTQ) at baseline, eighth PT visit, and eight weeks following course of PT. Quantity and quality of jaw mobility were assessed at baseline and post-intervention using standard goniometric measurements and observation. A total of nine PT sessions were delivered over three months consisting of manual therapy, relaxation techniques, neuromuscular re-education, and therapeutic exercise. Outcomes After eight PT visits, patient's GTQ score improved from 81% to 67.6%, with a corresponding decrease in pain and improved symmetry of jaw mobility. Eight weeks following last PT visit, patient's GTQ score further decreased from 67.6% to 61.3%. Discussion Conservative management through multimodal PT may be effective in managing facial pain and TMD secondary to acromegaly following treatment for benign pituitary macroadenoma.
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Bhalang K, Steiger B, Lukic N, Zumbrunn Wojczyńska A, Hovijitra RS, Ettlin DA. The Pain-to-Well-Being Relationship in Patients Experiencing Chronic Orofacial Pain. Front Neurol 2020; 11:557415. [PMID: 33343482 PMCID: PMC7744627 DOI: 10.3389/fneur.2020.557415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/26/2020] [Indexed: 12/18/2022] Open
Abstract
Introduction: Orofacial pain features may negatively influence a person's well-being and vice versa. Some aspects of well-being can be measured with axis II instruments that assess patients' psychosocial and behavioral status. The aim of this study was to investigate associations between pain features and psychosocial variables as indicators of well-being. Materials and Methods: Seven hundred ninety-nine anonymized datasets collected using the Web-based Interdisciplinary Symptom Evaluation (WISE) of patients reporting to the Interdisciplinary Orofacial Pain Unit, University of Zurich, between March 19, 2017 and May 19, 2019, were analyzed. Pain features including intensity, number of locations, impact, and duration were evaluated. Psychometric measures assessed pain-related catastrophizing and disability, illness perception, distress, anxiety, depression, injustice experience, dysmorphic concerns, and insomnia. Results: Most patients were between 30 and 59 years old (58.3%), female (69.8%), working (66.0%), and experienced pain for more than 6 months (68.5%). Pain intensities were higher in women than men and higher in disabled than working patients. Scores indicating elevated stress and depression were also observed in disabled patients. The sample prevalence rates of clinically relevant axis II instrument scores were as follows: Graded Chronic Pain Scale for the Head (GCPS-H), 27%; Patient Health Questionnaire 4 (PHQ4), 21%; PHQ9, 21%; Pain Catastrophizing Scale (PCS), 20%; General Anxiety Disorder 7 (GAD7), 15%; Insomnia Severity Index (ISI), 15%; Injustice Experience Questionnaire (IEQ), 14%; GCPS for the Body (GCPS-B), 13%; PHQ for Stress (PHQstr), 6%; and Dysmorphic Concern Questionnaire (DCQ), 2%. Noteworthy results of correlation analysis of the clinically relevant axis II scores and pain measures were as follows: the PHQstr had moderate associations (0.34-0.43) with the sum of pain intensity at rest and during function, number of pain locations, and typical pain intensity. The IEQ scores were moderately associated with typical pain intensity at 0.39. The DCQ scores were moderately associated with pain extension at 0.41. Conclusions: Moderate correlations of certain pain and well-being measures were found in patients reporting clinically relevant stress, injustice experience, and dysmorphic concern, all of which reflect impaired well-being. PHQ4 is suitable for routine distress screening in the clinical setting.
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Affiliation(s)
- Kanokporn Bhalang
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Beat Steiger
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Aarau, Switzerland
| | - Nenad Lukic
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Ray S Hovijitra
- Dental Center, Bumrungrad International Hospital, Bangkok, Thailand
| | - Dominik A Ettlin
- Orofacial Pain Unit, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,São Leopoldo Mandic Institute and Research Center, São Paulo, Brazil.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
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Catastrophizing Has a Better Prediction for TMD Than Other Psychometric and Experimental Pain Variables. Pain Res Manag 2020; 2020:7893023. [PMID: 33273993 PMCID: PMC7676933 DOI: 10.1155/2020/7893023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/21/2020] [Accepted: 10/24/2020] [Indexed: 01/11/2023]
Abstract
Temporomandibular disorders (TMDs) are characterized by moderate to severe pain in the masticatory muscles and/or the temporomandibular joint (TMJ). The present study is a part of a multidisciplinary project, initiated by the Norwegian Ministry of Health. The main purpose of this study is to compare a cohort of TMD patients to healthy individuals regarding experimental pain, the degree of disability caused by living with pain and psychometric variables, and to investigate which of these variables is the best predictor for TMD patients. We hypothesised that TMD patients have more disability when living with pain and lower pain thresholds than healthy controls, and those psychometric variables are stronger predictors than pain thresholds provoked by experimental pain. Sixty TMD patients were matched by sex and age to sixty healthy individuals without TMD symptoms or other musculoskeletal symptoms in the head and neck region. All subjects completed a questionnaire that included psychometric characteristics, that is, a one- and two-item version of the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale (HADS), and the Roland Morris Scale (RMS), which measures disability when living with pain. They also underwent a clinical examination including the measurement of pain thresholds with electrical and pressure stimuli. The TMD patients had lower pain thresholds for experimental electrical and pressure stimuli compared with the controls (P < 0.05 and <0.001, respectively). They also scored higher than healthy individuals with disability living with pain (P < 0.001), anxiety (P < 0.001), depression (P < 0.001), and catastrophizing (P < 0.001). The results for anxiety, depression, and catastrophizing have been published earlier, and the reused data in this study are compared with RMS and pain thresholds. The conditional logistic regression model identified catastrophizing (OR = 2.42, CI 1.22–4.79) as a significant predictor of TMD patients. The results support this hypothesis and indicate that TMD patients have lower pain thresholds and more disability when living with pain compared to healthy individuals, where the strongest prediction for TMD was catastrophizing. Awareness of psychometric disabilities in TMD patients is of importance when considering the choice of treatment.
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Imbriglio TV, Moayedi M, Freeman BV, Tenenbaum HC, Thaut M, Cioffi I. Music Modulates Awake Bruxism in Chronic Painful Temporomandibular Disorders. Headache 2020; 60:2389-2405. [PMID: 32997813 DOI: 10.1111/head.13971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/15/2020] [Accepted: 08/16/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In this experimental study, we aimed to determine whether guided music listening (GML) - a music intervention based on models of mood mediation and attention modulation - modulates masticatory muscle activity and awake bruxism in subjects with chronic painful muscular temporomandibular disorders (TMD myalgia, mTMD), a condition causing a significant burden to patients, their families, and healthcare systems. BACKGROUND Awake bruxism - a stress behavior characterized by clenching of the teeth - is a strong contributor to chronic mTMD. GML modulates psychological stress and motor responses and could thus reduce muscle activity in chronic musculoskeletal conditions, including mTMD. METHODS We recorded the electromyographic (EMG) activity in the right masseter of 14 women with chronic (>6 months) mTMD (median [IQR] = 39.5.3 [24.3] years) and 15 pain-free women (median [IQR] = 30.0 [3.5] years) during a GML session, including 3 music (stressful, relaxing, and participants' favorite music) and a no-music (pink noise) control blocks, each lasting 15 minutes. We measured the motor effort of the right masseter relative to the participants' maximum voluntary contraction (MVC), the muscular effort to maintain mandibular posture (EMGposture ), and to produce spontaneous awake bruxism episodes (EMGbruxism ), and the duration and frequency of spontaneous awake bruxism episodes. We tested between-group and within-group (between blocks) differences, as well as the effect of the interaction group by experimental block on these outcome measures. RESULTS In both groups, EMGposture was significantly affected by the interaction group by experimental block (P < .001). Compared to pink noise [mean (95% CI); mTMD: 2.2 (1.6-2.8) %MVC; Controls: 1.1 (0.5-1.7) %MVC], EMGposture increased during the stressful music block [contrast estimate (95% CI); mTMD: +0.8 (0.7-0.8) %MVC; Controls: +0.3 (0.3-0.4) %MVC; both P < .001], and decreased during the relaxing [mTMD: -0.4 (-0.5 to -0.4) %MVC; Controls: -0.3 (-0.4 to -0.3) %MVC; both P < .001] and favorite [mTMD: -0.5 (-0.6 to -0.5) %MVC; Controls: -0.5 (-0.5 to -0.4) %MVC; both P < .001] music blocks. EMGposture was greater in mTMD individuals than controls during the favorite music [contrast estimate (95% CI): +1.1 (0.2-1.9) %MVC; P = .019] and the pink noise [+1.1 (0.2-2.0) %MVC; P = .014] blocks. EMGbruxism was significantly affected by the interaction group by experimental block (P < .001). In mTMD participants, compared to the pink noise block [mean (95% CI); 23.8 (16.0-31.6) %MVC], EMGbruxism increased during the stressful music block [contrast estimate (95% CI); +10.2 (8.6-11.8) %MVC], and decreased during the relaxing [-6.2 (-8.1 to -4.3) %MVC; P < .001] and favorite [-10.2 (-12.2 to -9.1) %MVC; P < .001] music blocks. These effects were not observed in the control group [mean (95% CI); pink noise: 19.3 (10.9-27.6); stressful: 21.2 (12.9-29.4) %MVC; relaxing: 21.6 (13.3-29.9) %MVC; favorite: 24.2 (15.8-32.7) %MVC; all P > .05]. EMGbruxism was significantly greater in mTMD participants than controls during the stressful music block [contrast estimate (95% CI): +12.9 (1.6-24.2) %MVC; P = .026). GML did not affect the duration or the frequency of awake bruxism in either group (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108). The frequency of awake bruxism episodes was greater in the mTMD group compared to controls only during the pink noise block (median [IQR], mTMD: 5 [15.3] episodes, range 0-62 episodes; Controls: 1 [3] episode, range 0-27 episodes; P = .046). No significant between-group differences were found in either the overall time spent engaging in awake bruxism (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108), or during each block (all P > .05). CONCLUSIONS In subjects with chronic mTMD, relaxing music and the individual's favorite music decreased the muscular effort during spontaneous awake bruxism episodes by 26% and 44% (relative changes), respectively. In contrast, stressful music increases it by about 43%. Because of its positive effects on awake bruxism, GML with selected music could be a promising and non-invasive component of a multimodal approach for the management of chronic mTMD.
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Affiliation(s)
- Tina Veronica Imbriglio
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Massieh Moayedi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Bruce Victor Freeman
- Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Howard Charles Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Thaut
- Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
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Tran J, Lou T, Nebiolo B, Castroflorio T, Tassi A, Cioffi I. Impact of clear aligner therapy on tooth pain and masticatory muscle soreness. J Oral Rehabil 2020; 47:1521-1529. [PMID: 32898936 DOI: 10.1111/joor.13088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical findings suggest that orthodontic treatment with clear aligners (clear aligner therapy/CAT) may cause masticatory muscle soreness in some patients. OBJECTIVE This multi-site prospective study investigated tooth pain and masticatory muscle soreness and tenderness in patients undergoing CAT and explored whether psychological traits affected these outcomes. METHODS Twenty-seven adults (22F, 5M; mean age ± SD=35.3 ± 17.6 years) about to start CAT were recruited at three clinics. During CAT, they reported on 100-mm visual analogue scales their tooth pain, masticatory muscle soreness and stress three times per day over 4 weeks (week 1 = baseline; week 2 = dummy aligner; week 3 = first active aligner; week 4 = second active aligner). Pressure pain thresholds (PPTs) were measured at the masseter and temporalis at baseline and after week 4. Mixed models were used to evaluate the outcome measures over time. RESULTS Clear aligner therapy caused mild tooth pain, which was greater with the passive than the first and second active aligners (both P < .001). Mild and clinically not relevant masticatory muscle soreness was produced by all aligners (all P < .05), with the first active aligner producing less soreness than the dummy aligner (P < .001). PPTs did not change significantly after 4 weeks. Both tooth pain and masticatory muscle soreness were affected by stress and trait anxiety, whilst muscle soreness was affected also by oral behaviours. CONCLUSIONS In the short term, CAT produces tooth pain and masticatory muscle soreness of limited significance. Frequent oral behaviours are related to increased masticatory muscle soreness during CAT. The medium- and long-term effects of CAT should be further explored.
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Affiliation(s)
- Johnny Tran
- Division of Graduate Orthodontics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Tiantong Lou
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Bianca Nebiolo
- Department of Orthodontics, Dental School, University of Turin, Turin, Italy
| | | | - Ali Tassi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,Centre for The Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
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Häggman-Henrikson B, Liv P, Ilgunas A, Visscher CM, Lobbezoo F, Durham J, Lövgren A. Increasing gender differences in the prevalence and chronification of orofacial pain in the population. Pain 2020; 161:1768-1775. [PMID: 32701837 PMCID: PMC7365674 DOI: 10.1097/j.pain.0000000000001872] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/12/2020] [Accepted: 03/12/2020] [Indexed: 12/17/2022]
Abstract
Although a fluctuating pattern of orofacial pain across the life span has been proposed, data on its natural course are lacking. The longitudinal course of orofacial pain in the general population was evaluated using data from routine dental check-ups at all Public Dental Health services in Västerbotten, Sweden. In a large population sample, 2 screening questions were used to identify individuals with pain once a week or more in the orofacial area. Incidence and longitudinal course of orofacial pain were evaluated using annual data for 2010 to 2017. To evaluate predictors for orofacial pain remaining over time, individuals who reported pain on at least 2 consecutive dental check-ups were considered persistent. A generalized estimating equation model was used to analyze the prevalence, accounting for repeated observations on the same individuals. In total, 180,308 individuals (equal gender distribution) were examined in 525,707 dental check-ups. More women than men reported orofacial pain (odds ratio 2.58, 95% confidence interval [CI] 2.48-2.68), and there was a significant increase in the prevalence of reported pain from 2010 to 2017 in both women and men. Longitudinal data for 135,800 individuals were available for incidence analysis. Women were at higher risk of both developing orofacial pain (incidence rate ratio 2.37; 95% CI 2.25-2.50) and reporting pain in consecutive check-ups (incidence rate ratio 2.56; 95% CI 2.29-2.87). In the northern Swedish population studied, the prevalence of orofacial pain increases over time and more so in women, thus indicating increasing differences in gender for orofacial pain.
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Affiliation(s)
- Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Aurelia Ilgunas
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
| | - Corine M. Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Justin Durham
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Newcastle, United Kingdom
| | - Anna Lövgren
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå , Umeå , Sweden
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Fichera G, Polizzi A, Scapellato S, Palazzo G, Indelicato F. Craniomandibular Disorders in Pregnant Women: An Epidemiological Survey. J Funct Morphol Kinesiol 2020; 5:E36. [PMID: 33467252 PMCID: PMC7739292 DOI: 10.3390/jfmk5020036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 11/16/2022] Open
Abstract
Temporomandibular joint (TMJ) disorder has been reported to be 1.5 to two times more common in women than men. Such a gender-based difference could be attributed to behavioral, hormonal, anatomical, and psychological characteristics. Physiological hormonal differences between genders could be one of the possible explanations for the higher incidence of temporomandibular disorder (TMD) in women. As the plasma level of certain female hormones increases during gestation, it could be assumed that there is a higher prevalence of dysfunctional signs and symptoms in pregnant women. We performed an epidemiological survey based on screening for TMD in a group of 108 pregnant women and found that 72% of young women reported significant signs of TMJ disorders, 9% of the young women reported mild signs of TMJ disorders, and 19% of the included subjects reported no signs or symptoms of TMD. The presence of estrogen receptors in the temporomandibular joint of female baboons could be the basis of an explanation for the increased prevalence of dysfunction in young women reported in the literature and the high feedback we have seen of joint noises in pregnant women. On the basis of the present findings, it could be assumed that gestation period could represent a risk factor for craniomandibular dysfunctions.
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Affiliation(s)
- Grazia Fichera
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy; (G.F.); (S.S.); (G.P.); (F.I.)
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy; (G.F.); (S.S.); (G.P.); (F.I.)
| | - Simone Scapellato
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy; (G.F.); (S.S.); (G.P.); (F.I.)
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, University of Messina, 98125 Messina, Italy
| | - Giuseppe Palazzo
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy; (G.F.); (S.S.); (G.P.); (F.I.)
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, 95124 Catania, Italy; (G.F.); (S.S.); (G.P.); (F.I.)
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33
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Kim HK, Kim ME. Phenotyping 1488 patients with painful temporomandibular disorders and its relevance to subjective sleep quality: A key step for stratified medicine. Cranio 2019; 39:491-501. [DOI: 10.1080/08869634.2019.1682750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Hye-Kyoung Kim
- Department of Orofacial Pain and Oral Medicine, College of Dentistry, Dankook University, Cheonan, South Korea
| | - Mee-Eun Kim
- Department of Orofacial Pain and Oral Medicine, College of Dentistry, Dankook University, Cheonan, South Korea
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