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de Souza KBR, Almeida Guerra LRD, da Silva Guerreiro ML, Casais-E-Silva LL, Aguiar MC. Nociceptive and histomorphometric evaluation of the effects of ozone therapy on the rat masseter muscle in a carrageenan model of myofascial pain. Arch Oral Biol 2024; 160:105893. [PMID: 38271891 DOI: 10.1016/j.archoralbio.2024.105893] [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: 10/11/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE This study evaluated the effects of intramuscular ozone therapy on nociception, inflammation, and tissue damage caused by the injection of carrageenan in the masseter muscle of rats. DESIGN Rat masseter muscles were injected with saline or carrageenan. Seventy-seven adult male rats were divided into six groups: Sal, saline; Car, carrageenan; Ibup + Sal, ibuprofen and saline; Ibup + Car, ibuprofen and carrageenan; O3 + Sal, ozone and saline; and O3 + Car, ozone and carrageenan. The mixture of 5% ozone and 95% oxygen (20 µg/mL) was administered three times in the course of a week. Nociceptive responses in the masseter muscles were measured using a head withdrawal threshold, determined by an electronic von Frey anesthesiometer. The animals were euthanized one or eight days after the carrageenan injection, and the masseters were submitted to histological and histomorphometric analyses. RESULTS Mechanical allodynia and inflammation levels were reduced in the Ibup + Car group compared to the other groups. Myonecrosis was similar among carrageenan-treated groups. Picrosirius red stained sections showed more collagen fibers and more regenerating myofibers in the O3 + Car group compared to the other groups. Eight days after carrageenan injection, the O3 + Car group showed neutrophils close to the regenerating myofibers. CONCLUSIONS Intramuscular ozone therapy did not alleviate mechanical allodynia, and it did not protect the masseter muscle against the deleterious effects produced by carrageenan, probably due to the mode of administration of this therapeutic agent.
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Affiliation(s)
- Kelvin Borges Rocha de Souza
- Laboratory of Orofacial Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | | | - Marcos Lázaro da Silva Guerreiro
- Laboratory of Venomous Animals and Herpetology, Department of Biological Sciences, State University of Feira de Santana, Feira de Santana, BA, Brazil
| | - Luciana Lyra Casais-E-Silva
- Department of Bioregulation, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil
| | - Marcio Cajazeira Aguiar
- Laboratory of Orofacial Biology, Institute of Health Sciences, Federal University of Bahia, Salvador, BA, Brazil.
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Figueiró C, Knorst JK, Fensterseifer CK, Folchini S, Milanesi JDM, Bernardon Silva T, Marquezan M. Changes in oral health-related quality of life after self-care treatment in patients with myofascial pain. Cranio 2024; 42:199-205. [PMID: 33928869 DOI: 10.1080/08869634.2021.1922229] [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: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the changes in oral health-related quality of life (OHRQoL) of patients with myofascial pain treated by means of self-care measures. METHODS Fifteen patients with myofascial pain had OHRQoL evaluated by the Oral Health Impact Profile (OHIP-TMD) questionnaire and were instructed for self-care measures verbally and with a printed guide in the first consultation (T0), after 30 days (T1) and 60 days (T2). Paired t-test was performed to evaluate changes through time. RESULTS OHIP-TMD scores were 29.3 (SD 10.2) at T0, 18.9 (SD 11.2) at T1, and 15.9 (SD 10.7) at T2. There was a reduction of scores related to the OHIP-TMD domains of functional limitation, physical pain, psychological and social inability and incapacity (T1 and T2), and psychological discomfort (T2). CONCLUSION Self-care measures had positive effects on the myofascial pain treatment, reducing physical pain generated by TMD and improving patients' OHRQoL.
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Affiliation(s)
- Cláudio Figueiró
- Restorative Dentistry Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Jéssica Klöckner Knorst
- Student, Postgraduation Program in Dental Sciences, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | | | - Stella Folchini
- Student, Postgraduation Program in Dental Sciences, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Jovana De Moura Milanesi
- Physiotherapist, External Collaborator, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Tatiana Bernardon Silva
- Restorative Dentistry Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Marquezan
- Stomatology Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
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Uzunçıbuk H, Marrapodi MM, Meto A, Ronsivalle V, Cicciù M, Minervini G. Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study. J Oral Rehabil 2024; 51:500-509. [PMID: 38041596 DOI: 10.1111/joor.13614] [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: 09/11/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms. METHODS This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests. RESULTS The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05). CONCLUSIONS Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.
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Affiliation(s)
- Hande Uzunçıbuk
- Department of Orthodontics, Dentistry Faculty, Trakya University, Edirne, Turkey
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Aida Meto
- Department of Dentistry, Faculty of Dental Sciences, University of Aldent, Tirana, Albania
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Yang C, Teng H, Shao B, Liu Z. Biomechanical study of temporomandibular joints of patients with temporomandibular disorders under incisal clenching: A finite element analysis. J Biomech 2024; 166:112065. [PMID: 38555778 DOI: 10.1016/j.jbiomech.2024.112065] [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: 09/25/2023] [Revised: 03/01/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Temporomandibular disorders (TMD) encompass a collection of pathologies. Within the multitude of etiological factors contributing to TMD, mechanical factors hold significant importance. The aim of this investigation was to assess the magnitude and distribution of stresses encountered by the temporomandibular joints (TMJs) during incisal clenching among TMD patients while also elucidating the mechanical pathogenesis underlying TMD. Ten asymptomatic subjects and ten TMD patients were recruited. The Control, Bilateral, and Unilateral groups were set. The contact stress, maximum principal stress, and minimum principal stresses of TMJ structures among the groups were compared. In addition, comparisons of the contact stress distribution among the groups were adopted. In the Control and Bilateral groups, the magnitudes of stresses (contact stress, maximum and minimum principal stresses) between the right and left sides showed no significant difference (P > 0.05). For unilateral TMD patients,the minimum principal stress on the condyle in the Uni-N group (the normal side) was significantly greater than thatin the Uni-T group (the TMD side)(P = 0.016, mean difference 9.99 MPa [95 %CI: 3.11 to 16.87]). Furthermore, stresses on the condyle and fossa of the patients were significantly greater than those of asymptomatic subjects (P < 0.05). The contact stress distributions were concentrated in the Control group while irregular in the TMD groups. In conclusion, asymmetrical contact stress distributions were observed in unilateral TMD, with excessive stresses on the healthy side. The protection of the healthy TMJ during treatment is recommended for patients with unilateral TMD.
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Affiliation(s)
- Chunxin Yang
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Haidong Teng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Bingmei Shao
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology/Sichuan University, Yibin Park, Yibin 644600, China.
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Torul D, Yılmaz MF, Örnek Akdoğan E, Omezli MM. Temporomandibular joint disorders and associated factors in a Turkish pediatric population. Oral Dis 2024. [PMID: 38287493 DOI: 10.1111/odi.14875] [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: 11/16/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To explore the presence and severity of temporomandibular disorders (TMD) signs and symptoms in a Turkish pediatric population, as well as their relationship to parafunctional behaviors, bruxism, malocclusion, anxiety, and sociodemographic traits. METHODS A cross-sectional study was conducted with patients between the ages of 5-15. Demographic variables, TMD signs and symptoms, parafunctional habits, bruxism, and malocclusion were evaluated by clinical examination. Fonseca Anamnestic Index (FAI) was used to determine the presence and severity of TMD. State-Trait Anxiety Scale for Children (STAI-C) was used to evaluate the anxiety. Student t, Mann-Whitney U, chi-square tests, and logistic regression were used for statistical analysis. RESULTS One hundred sixty-two participants (85 girls, 77 boys) with a mean age of 10.03 ± 1.88 years were included. The frequency of the participants who reported signs/symptoms of TMD was 19.7% according to FAI scores. Logistic regression analysis with the associated factors showed a significant relationship between the presence of the signs/symptoms of TMD and parafunctional habits (OR 4.24, 95% CI 1.64-10.93), and the presence of signs/symptoms of anxiety (OR 1.09, 95% CI 1.02-1.16). CONCLUSIONS Children and adolescents who exhibit parafunctional behaviors and anxiety had a higher likelihood of having TMD signs/symptoms of varying degrees of severity.
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Affiliation(s)
- Damla Torul
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
| | - Muhammed Furkan Yılmaz
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
| | | | - Mehmet Melih Omezli
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ordu University, Ordu, Turkey
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Melo V, Monteiro L, Orge C, Sales M, Melo J, Rodrigues B, Melo A. Prevalence of temporomandibular disorders in the Brazilian population: A systematic review and meta-analysis. Cranio 2023:1-8. [PMID: 37955100 DOI: 10.1080/08869634.2023.2276627] [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: 11/14/2023]
Abstract
This systematic review aimed to assess the prevalence of temporomandibular disorders (TMD) in the Brazilian population, with studies that used the RDC/TMD or DC/TMD as diagnostic tools. A total of 6365 people from 11 studies were included. Sample mean age ranged from 12 to 69.5 years. The pooled prevalence of TMD was 33.6% (95% CI 31.5-35.8; I2 = 37.2). Prevalence of TMD was higher in females (37.0%) than in males (29.3%). Our results indicate that TMD is a prevalent condition across Brazil's territories. The results from this meta-analysis can help calculate more accurate sample sizes for future studies.
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Affiliation(s)
- Vítor Melo
- School of Medicine, Universidade Salvador, Salvador, Brazil
| | - Larissa Monteiro
- Department of Pediatrics, Universidade Federal da Bahia, Salvador, Brazil
| | - Carolina Orge
- Masters Program in Medicine and Health, School of Medicine, Universidade Federal da Bahia, Salvador, Brazil
| | - Matheus Sales
- Department of Neurology and Epidemiology, Universidade Federal da Bahia, Salvador, Brazil
| | - Juliana Melo
- School of Odontology, Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | - Ailton Melo
- Department of Neurology and Mental Health, Universidade Federal da Bahia, Salvador, Brazil
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Alrizqi AH, Aleissa BM. Prevalence of Temporomandibular Disorders Between 2015-2021: A Literature Review. Cureus 2023; 15:e37028. [PMID: 37143640 PMCID: PMC10152905 DOI: 10.7759/cureus.37028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2023] [Indexed: 04/04/2023] Open
Abstract
The prevalence of temporomandibular disorder (TMD) is significantly high around the world. We conducted a literature review to determine the prevalence of TMD globally and in Saudi Arabia based on published studies. This review article collected 35 full-text articles after searching PubMed for TMD prevalence between 2015-2021. Assessing the prevalence of TMDs is important for several reasons, including providing an overview of the incidence of such disorders, educating the community, clarifying the gender and age group with the highest prevalence, establishing a program to prepare specialists to treat these disorders, and identifying the appropriate number of specialists by comparing TMD prevalence to Saudi Arabia's census. Out of 35 selected articles, thirty studies were done outside Saudi Arabia, and five were local. Less than 40% prevalence of TMD has been reported with associated factors such as gender, psychological status, and age. The female gender has shown a higher TMD rate than the male gender. Some authors have suggested conducting a temporomandibular joint (TMJ) assessment in the pediatric clinic. Moreover, TMD screening is an important tool for every patient visiting the dental clinic to assess TMJ status and treat TMD at early stages, especially in non-painful cases.
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Al-Moraissi EA, Christidis N, Ho YS. Publication performance and trends in temporomandibular disorders research: A bibliometric analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101273. [PMID: 36057419 DOI: 10.1016/j.jormas.2022.08.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are common, can be both painful and non-painful, and encompass various conditions affecting the temporomandibular joint, the masticatory muscles or both TMD. Therefore, the purpose of this bibliometric analysis was to synthetically analyze citation performance in TMD, to address a more innovative method including details of article title, author keyword, KeyWords Plus, and abstracts. MATERIAL AND METHODS Data used in this study were retrieved from the Clarivate Analytics Web of Science Core Collection, the online version of the Science Citation Index Expanded (SCI-EXPANDED) between 1992 and 2021. The distribution of key words in the article title and author‑selected keywords were used to evaluate research trends. RESULTS Of the 7,228 documents in SCI-EXPANDED, 6,138 documents met all inclusion criteria and were included in the final analysis, of which 4,945 were articles. The present bibliometric analysis of the articles published in the research filed of TMD revealed that orofacial pain, bruxism, chronic pain, and myofascial pain are the most commonly used keywords by the authors. Further, over the last 30 years 4,945 articles are published in the field of TMD, and the far most frequently cited study was published 8 years ago and handles the diagnostic criteria of TMD. The USA and Brazil were top two ranking productive countries of publication on TMD. The most productive journal was Journal of Oral Rehabilitation, followed by Cranio-The Journal of Craniomandibular & Sleep Practice and Journal of Oral & Facial Pain and Headache. The most productive authors were P. Svensson, R. Ohrbach, and F. Lobbezooas. The most productive institutes were Sao Paulo University (Brazil), Malmo University (Sweden), and Washington university (USA) CONCLUSION: Based on the outcome of this bibliometric study, the authors hope that both clinicians and researchers will have information to shape their future research focus, finding prominent institutions in their nearby area, or even to be stimulated to initiate new international or even multinational collaborations.
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Affiliation(s)
- Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge SE-141 04, Sweden
| | - Yuh-Shan Ho
- Trend Research Centre, Asia University, No. 500 Lioufeng Road, Wufeng, Taichung 41354, Taiwan.
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Nemati M, Tabrizi R, Rasooli F, Ghafari S. Is the Prevalence of Vitamin D deficiency in Patients with Temporomandibular Disorder Higher than Healthy Control Group? J Maxillofac Oral Surg 2022; 21:1205-1208. [PMID: 36896049 PMCID: PMC9989067 DOI: 10.1007/s12663-021-01522-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose Vitamin D plays an essential role in subchondral bone, cartilage, and periarticular muscle. This study aims to assess the prevalence of vitamin D deficiency in temporomandibular disorder (TMD) patients. Materials and methods This is a cross-sectional study. Subjects were assigned into two groups based on having signs and symptoms of TMD: Group 1: subjects had TMD, and group 2 healthy group (control group). The serum level of vitamin D was measured in the two groups. The independent t test was used to compare the serum level of vitamin D between the study and control groups. Results One hundred ten subjects were studied into two groups (55 subjects in each group). The mean serum level of vitamin D was 18.13 ± 6.38 ng/mL in the study group and 31.83 ± 7.00 ng/mL in the control group. Analysis of the data demonstrated a significant difference in the mean serum level of vitamin D between the study and control groups (p = 0.001). Conclusion It seems the serum level of vitamin D is lower in TMD patients than in the healthy control group.
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Affiliation(s)
- Majid Nemati
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Tabrizi
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faezeh Rasooli
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Ghafari
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Al‐Moraissi EA, Goddard G, Christidis N. Are acupuncture and dry needling effective in the management of masticatory muscle pain: A network meta‐analysis of randomised clinical trials. J Oral Rehabil 2022; 50:87-97. [PMID: 36314254 DOI: 10.1111/joor.13382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/05/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Several studies have shown that both acupuncture and dry needling are effective in the treatment of musculoskeletal pains. Therefore, the aim of this network meta-analysis (NMA) was to investigate the treatment outcome of acupuncture and dry-needling for masticatory muscle pain (TMD-M) and to compare with active and inactive placebo. MATERIAL AND METHOD An electronic search was performed to identify randomised controlled trials (RCTs) published until September 2019, comparing dry-needling, acupuncture, and inactive as well as active placebo in patients with TMD-M. Outcome variables were post-treatment pain intensity, pressure pain threshold (PPT), and maximum mouth opening (MMO). The quality of evidence was rated according to Cochrane's tool for assessing the risk of bias. Mean difference was used to analyse via frequentist NMA using STATA-software. RESULTS Both NMA and direct pairwise meta-analysis have shown that there was no difference between active treatment with either acupuncture or dry-needling when compared to active and inactive placebo in patients with TMD-M with respect to pain intensity, and PPT (p > .05). However, there was a significant increase in MMO following dry-needling when compared to the placebo (very low-quality evidence). CONCLUSION Despite the short-term positive effect of MMO by dry-needling, this NMA could not show any pain-reducing effect in patients with TMD-M by acupuncture or dry-needling when compared to an active or inactive placebo. Taken together, this NMA indicates that it is the placebo effect that accounts for the majority of the treatment effect of TMD-M, rather than a real therapeutic effect of acupuncture/dry-needling.
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Affiliation(s)
| | - Greg Goddard
- Emeritus Professor at University of California, San Francisco San Francisco California USA
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine Karolinska Institutet Huddinge Sweden
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Macrì M, Murmura G, Scarano A, Festa F. Prevalence of temporomandibular disorders and its association with malocclusion in children: A transversal study. Front Public Health 2022; 10:860833. [PMID: 36159244 PMCID: PMC9500209 DOI: 10.3389/fpubh.2022.860833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/21/2022] [Indexed: 01/21/2023] Open
Abstract
This study investigated the prevalence of temporomandibular disorders (TMDs) in a sample of children and adolescents and evaluated the correlation with occlusal variables. TMD signs and symptoms were recorded in 411 subjects (age range 7-15 years), divided into two groups: 214 subjects treated in Chieti (Italy) CG group and 197 in Murcia (Spain) MG group. Once the Angle dental class was identified, it was recorded if there were signs and symptoms of temporomandibular disorders (TMDs) and occlusal interferences. The percentages of signs and symptoms were compared to determine the differences among the groups for TMDs, bruxism, joint sounds, deviation during the opening, reduced opening/lateral/protrusive movements, malocclusions, and myofascial pain. There is no statistically significant difference between the two groups (χ2 = 1.057, p > 0.05). Subjects with Angle Class I (37.37%), deep bite (43.43%), and increased overjet (41.41%) showed a higher prevalence of TMD symptoms.
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Shinde N, Kanabar DJ, Miles LJ. Narrative review of the prevalence and distribution of acute pain in children in the self-care setting. PAEDIATRIC & NEONATAL PAIN 2022; 4:169-191. [PMID: 36618510 PMCID: PMC9798044 DOI: 10.1002/pne2.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.
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Affiliation(s)
- Nutan Shinde
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| | | | - Lisa J. Miles
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
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Fathy S, Abdelrhman IG, Aggour RL. Ultrasonographic evaluation of the masseter muscle in temporomandibular disorders patients with myofascial pain: A case-control observational study. Cranio 2022:1-7. [PMID: 35616982 DOI: 10.1080/08869634.2022.2080961] [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: 10/18/2022]
Abstract
OBJECTIVE To investigate ultrasonographic changes of masseter muscle (MM) in patients with myofascial pain disorder (MPD) and possible correlations with clinical features. METHODS The study included 20 MPD patients and 20 healthy volunteers. Masseter muscle thickness (MMT) and the echogenic pattern were ultrasonographically evaluated. The maximum interincisal opening (MIO), duration of symptoms, and pain level were evaluated for correlations with MMT. RESULTS At relaxation, MMT was greater in the test group (p < 0.05); however, the percentage of increase in MMT from relaxation to contraction was greater in controls (p < 0.05). In MPD patients, the echogenic pattern differed significantly from controls. In MPD patients, a strong positive correlation was found between MMT and pain level, while a moderate negative correlation was found between MMT and both the duration of symptoms and MIO. CONCLUSION Ultrasound is an adjunctive method for complementing the assessment of the MM condition in MPD patients.
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Affiliation(s)
- Shereen Fathy
- Department of Oral Medicine & Periodontology, Faculty of Dentistry, October 6 University, Giza, Egypt
| | | | - Reham Lotfy Aggour
- Department of Oral Medicine & Periodontology, Faculty of Dentistry, October 6 University, Giza, Egypt
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Temporomandibular joint innervation: Anatomical study and clinical implications. Ann Anat 2021; 240:151882. [PMID: 34906668 DOI: 10.1016/j.aanat.2021.151882] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Temporomandibular disorders and related pain are commonly seen in clinical practice. Due to its recurrent nature, they adversely affect a patient's social life. Current knowledge on the temporomandibular joint (TMJ) innervation is debatable and insufficient to ensure optimal treatment for the underlying pathology. This study aimed to elucidate the pathophysiology of temporomandibular pain by revealing the TMJ innervation topography, its variations, and its relationships with the surrounding anatomical structures. This will aid in creating a guide for temporomandibular, infratemporal, and preauricular interventions. METHODS A total of 20 cadaver half heads, 10 fresh frozen and 10 embalmed, were used. The TMJ nerves were dissected together with the surrounding anatomical structures. RESULTS We showed that the TMJ is mainly innervated by the auriculotemporal nerve posteriorly, the masseteric nerve anteriorly, the posterior deep temporal nerve anteromedially, and the TMJ branch originating directly from the mandibular nerve medially, and that there are variations in these innervation pathways. Additionally, we emphasized how these nerves might be affected in certain clinical conditions based on their anatomical relationships and pathophysiological mechanisms. To our knowledge, this is the first study showing the existence of a branch of the mandibular nerve directly innervating the TMJ. CONCLUSION In light of our findings, elucidating TMJ pain based on the anatomical characteristics of the region will allow precise treatment algorithms and better clinical outcomes in these patients. Based on this study, new clinical studies and interventions can be designed to reduce healthcare costs and alleviate the burden of temporomandibular disorders.
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Velly AM, Botros J, Bolla MM, Khan K, Teixeira Junior OA, Guimarães AS, Gornitsky M. Painful and non-painful comorbidities associated with short- and long-term painful temporomandibular disorders: A cross-sectional study among adolescents from Brazil, Canada, and France. J Oral Rehabil 2021; 49:273-282. [PMID: 34731502 DOI: 10.1111/joor.13280] [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: 03/21/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular disorder (TMD) pain is common among adolescents. The association between painful TMD and other comorbidities has been demonstrated. However, the difference between short-term (<6 months) and long-term (≥ 6 months) painful TMD is not yet clear. OBJECTIVE The aim of this study was to assess the association between comorbidities and short- and long-term painful TMD among adolescents. METHODS In this cross-sectional study, adolescents were recruited from Montreal (Canada), Nice (France), and Arceburgo (Brazil). Self-reported painful TMD, comorbidities, school absence, and analgesic intake were assessed using reliable instruments. Multivariable logistic regression analyses were conducted to assess the study aims. RESULTS The prevalence of short- and long-term painful TMD was estimated at 22.29% and 9.93%, respectively. The number of comorbidities was associated with short- (OR = 1.71, 95%CI = 1.53-1.90) and long-term painful TMD (OR = 1.79, 95%CI = 1.55-2.08) compared to controls. Frequent headaches (ORshort-term = 4.39, 95%CI = 3.23-5.98, ORlong-term = 3.69, 95%CI = 2.45-5.57) and back pain (ORshort-term = 1.46, 95%CI=1.06-2.03, ORlong-term = 1.69, 95%CI = 1.11-2.59) were associated with both painful TMD groups. Frequent neck pain (OR = 2.23, 95%CI = 1.53-3.26) and allergies were only associated with short-term painful TMD (OR = 1.54, 95%CI = 1.13-2.10). Frequent stomach pain was related to long-term (OR = 2.01, 95%CI = 1.35-3.26), and it was the only comorbidity significantly more frequent among the long than short-term TMD (OR = 1.82, 95%CI: 1.14-2.90). These analyses were adjusted by sex, age, and city. CONCLUSION In this multi-center study, both short- and long-term painful TMD are associated with frequent headaches and back pain, whereas frequent neck pain and allergies are related to only short-term, and frequent stomach pain with long-term painful TMD.
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Affiliation(s)
- Ana Miriam Velly
- Dental Department, SMBD - Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Montreal, QC, Canada
| | - Jack Botros
- Dental Department, SMBD - Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Michèle Muller Bolla
- Centre Hospitalier Universitaire de Nice, Nice, France.,Department of Pediatric Dentistry, Faculty of Dentistry, Côte d'Azur University, France.,Laboratory URB2i, University Paris Descartes, Paris, France
| | - Khurram Khan
- Dental Department, SMBD - Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | | | | | - Mervyn Gornitsky
- Dental Department, SMBD - Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Montreal, QC, Canada
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A Novel Injection Technique to the Lateral Pterygoid Muscle for Temporomandibular Disorders: A Cadaveric Study. Plast Reconstr Surg 2021; 148:785e-790e. [PMID: 34705786 DOI: 10.1097/prs.0000000000008493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lateral pterygoid muscle activity is associated with the pathological mechanisms of some temporomandibular disorders. The authors aimed to define and demonstrate a novel, practical, and safe technique for botulinum toxin type A injection to the lateral pterygoid muscle based on their findings. Their secondary aims were to standardize the injection pattern according to the variations of the lateral pterygoid muscle and its surrounding anatomical structures, and to establish its advantages over intraoral injection. METHODS Twenty cadaver heads were dissected. The lateral pterygoid muscle and its surrounding structures were investigated for anatomical variations. Based on these findings, a standardized extraoral injection protocol was defined and compared with the intraoral technique for accuracy and safety. RESULTS The average depth of the lateral pterygoid plate from the skin surface was 49.9 ± 2.2 mm, and the mean width of the lateral pterygoid plate was 10.5 ± 3.9 mm. The extraoral injection approach based on the location of the maxillary tuberosity, tragus, and lateral pterygoid plate was consistent in all dissections for the accuracy of the intramuscular injection. In the intraoral approach, standardization of the entry point of the needle through the oral mucosa is difficult, which makes adjustment of the depth of the injection challenging while increasing the risk of neurovascular injury. CONCLUSIONS The clinical significance of the lateral pterygoid muscle makes it worthwhile to implement minimally invasive treatments before considering more invasive options. The authors define a safe, accurate, and reliable approach with ease of administration in patients with temporomandibular disorders.
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Golanska P, Saczuk K, Domarecka M, Kuć J, Lukomska-Szymanska M. Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7807. [PMID: 34360099 PMCID: PMC8345811 DOI: 10.3390/ijerph18157807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.
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Affiliation(s)
- Paulina Golanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Klara Saczuk
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Monika Domarecka
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 24 A M. Sklodowskiej-Curie St., 15-276 Bialystok, Poland;
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
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Srivastava KC, Shrivastava D, Khan ZA, Nagarajappa AK, Mousa MA, Hamza MO, Al-Johani K, Alam MK. Evaluation of temporomandibular disorders among dental students of Saudi Arabia using Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): a cross-sectional study. BMC Oral Health 2021; 21:211. [PMID: 33902543 PMCID: PMC8077893 DOI: 10.1186/s12903-021-01578-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/15/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Temporomandibular disorders (TMD) are a broad category of conditions arising from the various components of the temporomandibular joint complex. Bio-psychosocial model is the most accepted theory describing the etiopathogenesis of TMD. Dental students are vulnerable to psychological disorders, including anxiety, depression, and stress. Hence, the aim of the current study was to evaluate the prevalence and possible risk factors of TMD among dental students of various academic levels and explore the association of TMDs with demographic, academic, and psychosocial parameters. METHODS A total of 246 students of a Saudi Arabia dental school were chosen for the study. After getting consent, all students were examined according to the Diagnostic Criteria for Temporomandibular Disorders, including Axis I and II components. RESULTS The overall cross-sectional prevalence of TMD was found to be 36.99%. Pain arising from the jaw, temple, and the peri-auricular area were the most commonly reported symptoms and elicited signs during examination. Among the pain-related TMD, myalgia was the commonest diagnosed condition, whereas disc displacement with reduction was found prevalent in the intra-articular disorder category. Female (OR = 1.94; P = 0.004), married (OR = 1.74; P = 0.04), and students in clinical academic levels (OR = 1.65; P = 0.03) were found to have significantly increased risk of TMD. Among the psychosocial parameters, anxiety (OR = 1.55; P = 0.04) and parafunctional behaviours (OR = 2.10; P < 0.001) were shown to increase the risk of developing TMD. Students with any TMD reported to have significantly higher pain intensity levels (OR = 1.68; P = 0.01) and jaw functional limitations (OR = 1.45; P = 0.008). CONCLUSION Dental students, especially in clinical levels were shown to pose a higher risk of developing TMD, hence strategies such as academic counselling and objective evaluation via rubrics should be planned to modify the administration of the curriculum, training methods and evaluation process.
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Affiliation(s)
- Kumar Chandan Srivastava
- Oral Medicine and Radiology, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia.
| | - Deepti Shrivastava
- Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Zafar Ali Khan
- Oral Surgery, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Anil Kumar Nagarajappa
- Oral Medicine and Radiology, Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Mohammed Assayed Mousa
- Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - May Othman Hamza
- Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Khalid Al-Johani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Khursheed Alam
- Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
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Restrepo C, Ortiz AM, Henao AC, Manrique R. Association between psychological factors and temporomandibular disorders in adolescents of rural and urban zones. BMC Oral Health 2021; 21:140. [PMID: 33743662 PMCID: PMC7981971 DOI: 10.1186/s12903-021-01485-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/04/2021] [Indexed: 12/26/2022] Open
Abstract
Background Temporomandibular disorders (TMD) are related to psychological factors. Adolescence is one of the stages in life with more psychosocial vulnerability, which is dissimilar in rural and urban zones. Thus, the aim of this investigation was to evaluate the association between psychological factors (symptoms of anxiety, depression and somatization) and TMD in adolescents between 12 and 15 years, belonging to urban and rural zones of Colombia. Methods 180 subjects aged 12–15 years (mean 13.8, SD 1.2), enrolled in public schools in the rural (n = 90) and urban (n = 90) zones were included. All subjects were evaluated using the DC/TMD instrument; the Axis I was applied for the clinical examination and the Axis II for the psychological evaluation. Data were analyzed by means of T-student, Mann–Whitney, Kruskall–Wallis tests, Pearson Chi square and multiple-variable analysis with logistic regression. Results Forty percent of the included subjects presented some type of TMD. TMD related to pain were the most common (25.5% of the studied adolescents), being myalgia the most common (20% of the adolescents in urban zone and 31.1% of the adolescents in the rural zone). There was no difference between the TMD present in males and females, but there were differences in the symptoms of Anxiety, and Somatization (p < 0.05). TMD and psychological factors were more prevalent in children with 13 years of age. A statistically significant association between TMD and symptoms of Anxiety (Pearson Chi squared 25.57, p = 0.04), depression (Pearson Chi squared 33.28, p = 0.03) and somatization (Pearson Chi squared 25.79, p = 0.04) was found in subjects from rural zones. No associations between psychological aspects and TMD were found in subjects from urban zones, but overall all psychological factors significantly influenced TMD. Conclusion This study indicates Myalgia to be the most prevalent TMD in studied Colombian adolescents. Pain-related TMDs are associated with psychological factors in the adolescent population of rural Colombia. Symptoms of anxiety, depression and somatization were found to be associated to TMD, even when the frequency was not necessarily severe.
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Affiliation(s)
- Claudia Restrepo
- CES-LPH Research Group, Universidad CES, Calle 10 A No. 22-04, Medellín, Colombia.
| | - Ana Maria Ortiz
- CES-LPH Research Group, Universidad CES, Calle 10 A No. 22-04, Medellín, Colombia
| | - Ana Carolina Henao
- CES-LPH Research Group, Universidad CES, Calle 10 A No. 22-04, Medellín, Colombia
| | - Ruben Manrique
- CES-LPH Research Group, Universidad CES, Calle 10 A No. 22-04, Medellín, Colombia
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20
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Miranda LS, Graciosa MD, Puel AN, Raulino de Oliveira L, Sonza A. Masticatory muscles electrical activity, stress and posture in preadolescents and adolescents with and without temporomandibular dysfunction. Int J Pediatr Otorhinolaryngol 2021; 141:110562. [PMID: 33360408 DOI: 10.1016/j.ijporl.2020.110562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To verify the difference between the masticatory muscles' electrical activity, stress signals and the posture of preadolescents and adolescents with and without temporomandibular dysfunction (TMD). METHODS 24 preadolescents and adolescents aged between 11 and 18 years old were divided into two groups, TMD group (TMDG) and control group (CG). All subjects were submitted to anthropometric measurements, psychological stress analysis, temporomandibular joint clinical evaluation and TMD verification; postural evaluation and masseter and temporal muscles electrical activity analysis during chewing. For statistical analysis, the Student's t-test or Mann-Whitney U test were used according to data distribution. RESULTS There was a significant difference between the groups for the electrical activity of the right temporal muscles (7.43% ± 2.92 vs. 11.71% ± 5.37) and left (7.70% ± 4.04 vs.11.44% ± 4.03) in the inactive period of chewing between CG and TMDG, respectively. There was no difference in stress or posture variables between groups. CONCLUSIONS During the inactive period of chewing, there was greater activation of the temporal muscles in the TMDG. Female gender was prevalent in TMDG. The study participants showed signs of stress, regardless of the group. The posture and TMD relationship still need to be studied.
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Affiliation(s)
- Letícia Souza Miranda
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
| | - Maylli Daiani Graciosa
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
| | - Alexia Nadine Puel
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
| | - Luiza Raulino de Oliveira
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
| | - Anelise Sonza
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil; Post-graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358- Coqueiros, Florianópolis, SC, 88080-350, Brazil.
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Thirunavukarasu AJ, Ferro A, Sardesai A, Biyani G, Dubb SS, Brassett C, Hamilton DL. Temporomandibular joint anatomy: Ultrasonographic appearances and sexual dimorphism. Clin Anat 2021; 34:1043-1049. [PMID: 33421181 DOI: 10.1002/ca.23719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/15/2020] [Accepted: 01/04/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Temporomandibular joint (TMJ) dysfunction is common, with a greater prevalence in females. While magnetic resonance imaging (MRI) is commonly used for clinical investigation, ultrasonography represents a potential alternative in some clinical scenarios. We designed a protocol for ultrasonographic evaluation of the TMJ and assessed its reliability. Presentation was compared between the sexes to establish whether an anatomical dichotomy underlies the female preponderance of TMJ dysfunction. MATERIALS AND METHODS Ultrasound imaging of the TMJ was carried out in the longitudinal and oblique planes. Standard images were produced using model skulls and healthy volunteers. Measurements were made between the temporal bone, mandibular condyle, joint capsule and overlying skin, as well as of condylar translation during mouth opening. Both joints were scanned in 50 healthy volunteers. Measurements were repeated to evaluate reliability. A novel classification system was used to assess lateral condylar morphology. RESULTS The protocol facilitated reliable visualization of key anatomical features of the TMJ (average intraclass correlation coefficient = 0.75, p ¯ = 5.4E-03). Distribution of condylar morphology differed between the sexes. The capsular-cutaneous distance ('joint depth') and condylar-temporal bone distance ('interarticular distance') were significantly greater in males than in females. CONCLUSIONS Ultrasonography provides reliable views of the TMJ in two planes: longitudinal and oblique. Observed sexual dimorphism in TMJ anatomy might be associated with the female preponderance of dysfunction. With a standardized scanning protocol, ultrasound could provide a rapid, cost-effective alternative to MRI as a point-of-care imaging tool in TMJ clinics.
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Affiliation(s)
- Arun J Thirunavukarasu
- Corpus Christi College, University of Cambridge, Cambridge, United Kingdom
- Human Anatomy Centre, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Ashley Ferro
- Human Anatomy Centre, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Anand Sardesai
- Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Ghansham Biyani
- Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Sukhpreet Singh Dubb
- Department of Oral and Maxillofacial Surgery, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Cecilia Brassett
- Human Anatomy Centre, Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Duncan L Hamilton
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, United Kingdom
- University of Sunderland School of Medicine, Sunderland, United Kingdom
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Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, Januzzi E, de Souza BDM. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:441-453. [PMID: 33409693 DOI: 10.1007/s00784-020-03710-w] [Citation(s) in RCA: 232] [Impact Index Per Article: 77.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the prevalence of temporomandibular joint disorders (TMJD) among the general population. MATERIALS AND METHODS Five main electronic databases and three grey literature were searched to identify observational studies in which TMJD was diagnosed using the research diagnostic criteria (RDC/TMD) or diagnostic criteria (DC/TMD). The studies were blindly selected by two reviewers based on eligibility criteria. Risk of bias (RoB) was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and the "R" Statistics software was used to perform meta-analyses. RESULTS From 2741 articles, 21 were included. Ten studies were judged at low RoB, seven at moderate, and four at high. The TMJD investigated were as follows: arthralgia, disk displacement (DDs) with reduction (DDwR), DDwR with intermittent locking, DDs without reduction (DDwoR) with limited opening, DDwoR without limited opening, degenerative joint disease (DJD), osteoarthritis, osteoarthrosis, and subluxation. The main results from prevalence overall meta-analyses for adults/elderly are as follows: TMJD (31.1%), DDs (19.1%), and DJD (9.8%). Furthermore, for children/adolescents are as follows: TMJD (11.3%), DDs (8.3%), and DJD (0.4%). Considering the individual diagnosis meta-analyses, the most prevalent TMJD is DDwR for adults/elderly (25.9%) and children/adolescents (7.4%). CONCLUSIONS The overall prevalence of TMJD was approximately 31% for adults/elderly and 11% for children/adolescents, and the most prevalent TMJD was DDwR. CLINICAL RELEVANCE Knowledge about the frequency of TMJD can encourage dentists to consider appropriate strategies for early and correct diagnosis and, if need be, correct management.
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Affiliation(s)
- Lígia Figueiredo Valesan
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n - Trindade, Florianópolis, SC, 88040-900, Brazil.
| | - Cecília Doebber Da-Cas
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n - Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Jéssica Conti Réus
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n - Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Ana Cristina Scremin Denardin
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n - Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Roberto Ramos Garanhani
- Department of Dentistry, University of South Santa Catarina (UNISUL), Av. Pedra Branca, 25 - Cidade Universitária, Palhoça, SC, 88137-272, Brazil
| | - Daniel Bonotto
- Department of Dentistry, Federal University of Paraná (UFPR), Av. XV de Novembro, 1299 - Centro, Curitiba, PR, 80060-000, Brazil
| | - Eduardo Januzzi
- Orofacial Pain Center, Hospital Mater Dei (HMD), Av. Gonçalves Dias, 2700 - Santo Agostinho, Belo Horizonte, MG, 30190-094, Brazil
| | - Beatriz Dulcineia Mendes de Souza
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, s/n - Trindade, Florianópolis, SC, 88040-900, Brazil
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Almashraqi AA, Barngkgei I, Halboub ES, Al-Maweri SA, Al-Wesabi MA, Al-Kamel A, Alhammadi MS, Alamir AH. Cone beam computed tomography findings in the temporomandibular joints of chronic qat chewers: Radiographic bone density and trabecular microstructural analyses. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 132:465-474. [PMID: 33478931 DOI: 10.1016/j.oooo.2020.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/05/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This cross-sectional comparative study investigated the effects of qat chewing habit on the radiographic bone density (RBD) and trabecular microstructure of temporomandibular joint condyles using cone beam computed tomography (CBCT). STUDY DESIGN In total, 85 systemically healthy Yemeni males were included and divided into qat chewers (QCs; n = 41); and non-qat chewers (NQCs; n = 44). The participants responded to a structured questionnaire and underwent standardized clinical examination and CBCT scanning of the temporomandibular joint. Measurements of RBD and trabecular microstructure (trabecular thickness, trabecular separation, bone volume fraction, and fractal dimension) were performed. Statistical significance was established at P ≤ .05. RESULTS No statistically significant differences were found between QCs and NQCs in RBD or trabecular microstructure. The mean standard deviations and maximum values of trabecular separation on the nonchewing side for QCs were significantly lower compared to the corresponding values for NQCs (0.60 and 2.68 for QCs vs 0.72 and 3.05 for NQCs; P = .025 and .05, respectively). A comparison between chewing and nonchewing sides in QCs revealed no significant differences. CONCLUSIONS Qat chewing habit induces insignificant changes in condylar RBD and trabecular microstructure as detected by CBCT. Further studies using advanced radiographic techniques are warranted.
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Affiliation(s)
- Abeer A Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Oral Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Al-Wataniya Private University, Hama, Syria
| | - Esam S Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen.
| | - Sadeq A Al-Maweri
- Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges for Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen
| | - Mohammed A Al-Wesabi
- Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sana'a,Yemen
| | - Ahlam Al-Kamel
- Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sana'a,Yemen
| | - Maged S Alhammadi
- Department of Preventive Dental Sciences, Division of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia; Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Abdulwahab H Alamir
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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24
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Rauch A, Körner A, Kiess W, Hirsch C, Schierz O. Relationship between Age-Dependent Body Constitution and Temporomandibular Joint Sounds in Adolescents. J Clin Med 2020; 9:jcm9123927. [PMID: 33287339 PMCID: PMC7761726 DOI: 10.3390/jcm9123927] [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: 11/05/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
To date, risk factors for temporomandibular joint (TMJ) sounds are still not completely understood, and anatomical factors are suspected to influence their occurrence. This study aimed to evaluate the impact of body constitution on temporomandibular joint sounds of adolescents. 10- to 18-year-old participants of the LIFE Child Study were examined for TMJ sounds, and physical parameters such as body height, body weight, and general laxity of joints were measured. Odds ratios (OR) for associations of TMJ sounds and standard deviation scores (SDS) of body height and body weight were calculated by using binary logistic regression, including cofactors such as age and number of hypermobile joints. The OR for TMJ sounds and SDS of body height was 1.28 (95% confidence interval (CI) 1.06; 1.56) in females when the age-adjusted height value was above 0. SDS of body weight indicated significant ORs for TMJ sounds in males with values of 0.81 (95% CI 0.70; 0.94). No correlation was detected for SDS values and TMJ crepitus. Tall female adolescents seem to be more prone to TMJ clicking sounds, while their occurrence seems less likely in male adolescents with higher body weight.
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Affiliation(s)
- Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
- Correspondence:
| | - Antje Körner
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany; (A.K.); (W.K.)
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Liebigstr. 20a, 04103 Leipzig, Germany
| | - Wieland Kiess
- LIFE—Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany; (A.K.); (W.K.)
- Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Liebigstr. 20a, 04103 Leipzig, Germany
- Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Philipp-Rosenthal-Str. 27, 04103 Leipzig, Germany
| | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
| | - Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany;
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25
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Pelai EB, Foltran-Mescollotto F, de Castro-Carletti EM, de Moraes M, Rodrigues-Bigaton D. Comparison of the pattern of activation of the masticatory muscles among individuals with and without TMD: A systematic review. Cranio 2020; 41:102-111. [PMID: 33073743 DOI: 10.1080/08869634.2020.1831836] [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: 10/23/2022]
Abstract
OBJECTIVE To verify the characteristics of the electromyographic signal of masticatory muscles in individuals with TMD and asymptomatic individuals. METHODS A systematic review was carried out, selecting cross-sectional studies with at least one electromyographic parameter (FM; iEMG; RMS) of the masticatory muscles (anterior temporal, bilateral masseter, and suprahyoid muscles) of individuals with TMD compared to asymptomatic individuals. RESULTS This review identified 1656 titles, of which 30 articles were included in the final analysis. It was observed that the data referring to the pattern of activation of masticatory muscles in the rest, isometry, and isotonic conditions of individuals with TMD are heterogeneous. This fact may be related to variability in the methods and analyses applied in the studies. CONCLUSION Data referring to the pattern of activation of masticatory muscles in the rest and isometry conditions and in the mastication cycle of individuals with TMD and asymptomatic individuals are diverse.
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Affiliation(s)
- Elisa Bizetti Pelai
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Fabiana Foltran-Mescollotto
- Graduate Program in Human Movement Sciences, Methodist University of Piracicaba - UNIMEP, Piracicaba, Brazil
| | | | - Marcio de Moraes
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
| | - Delaine Rodrigues-Bigaton
- Post-Graduate Program in Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, Brazil
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26
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Filho JC, Vedovello SAS, Venezian GC, Vedovello Filho M, Degan VV. Women’s oral health-related quality of life as a risk factor for TMD symptoms. A case-control study. Cranio 2020; 41:139-143. [PMID: 33063638 DOI: 10.1080/08869634.2020.1833159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To investigate the association between temporomandibular disorder (TMD) symptoms and women's oral health-related quality of life (OHRQoL).Methods: An observational case-control study was performed with 765 adult women aged 21.5 years on average. Oral Health Impact Profile (OHIP-14) assessed OHRQoL and determined the selection of cases and controls matched by age and marital status at a ratio of 1:4 (153 cases: 612 controls). American Academy of Orofacial Pain's self-explanatory questionnaire assessed the TMD symptoms. The TMD symptoms' impact on OHRQoL was analyzed, estimating the odds ratio with a 95% confidence interval. RESULTS Of the women, 86.9% in the case group, and 69.6% in the control group presented some TMD symptoms (p< 0.05). Women with an impacted OHRQoL are 2.95 (95% CI:1.79-4.86) times more likely to report some TMD symptoms (p< 0.05). DISCUSSION Women with a negative impact on OHRQoL are more likely to report TMD symptoms.
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Affiliation(s)
- Jairton Costa Filho
- Department of Orthodontics, Araras Dental School, University Center of Hermínio Ometto Foundation-FHO, Araras, SP, Brazil
| | | | - Giovana Cherubini Venezian
- Department of Orthodontics, Araras Dental School, University Center of Hermínio Ometto Foundation-FHO, Araras, SP, Brazil
| | - Mário Vedovello Filho
- Department of Orthodontics, Araras Dental School, University Center of Hermínio Ometto Foundation-FHO, Araras, SP, Brazil
| | - Viviane Veroni Degan
- Department of Orthodontics, Araras Dental School, University Center of Hermínio Ometto Foundation-FHO, Araras, SP, Brazil
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27
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Fischer J, Skeie MS, Rosendahl K, Tylleskär K, Lie S, Shi XQ, Gil EG, Cetrelli L, Halbig J, von Wangenheim Marti L, Rygg M, Frid P, Stoustrup P, Rosèn A. Prevalence of temporomandibular disorder in children and adolescents with juvenile idiopathic arthritis - a Norwegian cross- sectional multicentre study. BMC Oral Health 2020; 20:282. [PMID: 33050890 PMCID: PMC7557069 DOI: 10.1186/s12903-020-01234-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/25/2020] [Indexed: 12/30/2022] Open
Abstract
Background Children and adolescents with juvenile idiopathic arthritis (JIA) may suffer pain from temporomandibular disorder (TMD). Still, routines for the assessment of temporomandibular joint (TMJ) pain in health and dental care are lacking. The aims of this study were to examine the prevalence of TMD in children and adolescents with JIA compared to their healthy peers and to investigate potential associations between JIA and TMD. Methods This comparative cross-sectional study is part of a longitudinal multicentre study performed during 2015–2020, including 228 children and adolescents aged 4–16 years with a diagnosis of JIA according to the ILAR criteria. This particular substudy draws on a subset of data from the first study visit, including assessments of TMD as part of a broader oral health examination. Children and adolescents with JIA were matched with healthy controls according to gender, age, and centre site. Five calibrated examiners performed the clinical oral examinations according to a standardised protocol, including shortened versions of the diagnostic criteria for TMD (DC/TMD) and the TMJaw Recommendations for Clinical TMJ Assessment in Patients Diagnosed with JIA. Symptoms were recorded and followed by a clinical examination assessing the masticatory muscles and TMJs. Results In our cohort of 221 participants with JIA and 221 healthy controls, 88 (39.8%) participants with JIA and 25 (11.3%) healthy controls presented with TMD based on symptoms and clinical signs. Painful TMD during the last 30 days was reported in 59 (26.7%) participants with JIA vs. 10 (5.0%) of the healthy controls (p < 0.001). Vertical unassisted jaw movement was lower in participants with JIA than in controls, with means of 46.2 mm vs. 49.0 mm, respectively (p < 0.001). Among participants with JIA, a higher proportion of those using synthetic disease-modifying antirheumatic-drugs and biologic disease-modifying antirheumatic-drugs presented with painful masticatory muscles and TMJs at palpation. Conclusion Symptoms and clinical signs of TMD were seen in approximately half of the JIA patients compared to about one fourth of their healthy peers. Painful palpation to masticatory muscles and decreased vertical unassisted jaw movement were more frequent in participants with JIA than among healthy controls and should be part of both medical and dental routine examinations in patients with JIA.
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Affiliation(s)
- J Fischer
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway.
| | - M S Skeie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway.,Center for Oral Health Services and Research of Middle-Norway (TkMidt), Trondheim, Norway
| | - K Rosendahl
- Department of Radiology, University Hospital of North Norway, Tromsø, Norway.,UiT the Arctic University of North Norway, Tromsø, Norway
| | - K Tylleskär
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - S Lie
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - X-Q Shi
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway.,Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - E Grut Gil
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - L Cetrelli
- Center for Oral Health Services and Research of Middle-Norway (TkMidt), Trondheim, Norway
| | - J Halbig
- Public Dental Service Competence Centre of Northern-Norway (TkNN), Tromsø, Norway
| | - L von Wangenheim Marti
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway
| | - M Rygg
- Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olavs Hospital, Trondheim, Norway
| | - P Frid
- Public Dental Service Competence Centre of Northern-Norway (TkNN), Tromsø, Norway.,Department of Otorhinolaryngology, Division of Oral and Maxillofacial Surgery, University Hospital North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - P Stoustrup
- Section of Orthodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark
| | - A Rosèn
- Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Årstadveien 19, N-5009, Bergen, Norway.,Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
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28
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Almashraqi AA, Halboub ES, Al-Maweri SA, Barngkgei I, Al-Wesabi MA, Al-Kamel A, Alhammadi MS, Alamir AH. Cone beam computed tomography findings in temporomandibular joint of chronic qat chewers: Dimensional and osteoarthritic changes. J Oral Rehabil 2020; 47:1538-1549. [PMID: 32955738 DOI: 10.1111/joor.13092] [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: 06/21/2020] [Revised: 08/19/2020] [Accepted: 09/06/2020] [Indexed: 12/11/2022]
Abstract
The social habit of chewing qat (also known as khat) is widely practised in East Africa and the Arabian Peninsula. It has been linked with various oro-facial conditions, including temporomandibular joint disorders (TMD). This cross-sectional, comparative study sought to investigate the effects of qat chewing on temporomandibular joint (TMJ), using cone beam computed tomography (CBCT). A total of 85 Yemeni males were included. The participants were divided into two groups: Qat chewers (QC; n = 41) and non-qat chewers (NQC; n = 44). Relevant data were obtained using a structured questionnaire and standardised clinical examination. Additionally, CBCT images of the TMJs were obtained, and then, osteoarthritic changes and TMJ dimensions were analysed. SPSS 21 was used for statistical analyses, with a significant level was set at 0.05. Compared to NQC, a significantly higher proportion of QC presented with clinical signs of TMDs. The qualitative CBCT findings revealed significantly higher osteoarthritic changes in QC than in NQC: osteophyte (51.2% vs 22.7%; P = .008), subcortical sclerosis (48.8% vs 27.3%; P = .047), articular surface flattening (46.3% vs 6.8%; P = .009) and subcortical cysts (43.9% vs 4.5%; P < .001). However, CBCT quantitative findings (condylar dimensions) did not show significant differences between the two groups. The chewing side of the QC group showed slightly more changes compared to the non-chewing side. The results demonstrate that qat chewing has detrimental effects on TMJ manifested mainly as osteoarthritic changes. Further large-scale studies are recommended.
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Affiliation(s)
- Abeer A Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Oral Radiology, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Esam S Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen
| | - Sadeq A Al-Maweri
- Department of Oral Medicine, Oral Pathology and Oral Radiology, Faculty of Dentistry, Sana'a University, Yemen.,Department of Oral Medicine and Diagnostic Sciences, AlFarabi Colleges for Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Al-Wataniya Private University, Hama, Syria
| | - Mohammed A Al-Wesabi
- Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sana'a, Yemen
| | - Ahlam Al-Kamel
- Department of Preventive and Biomedical Science, Faculty of Dentistry, University of Science and Technology, Sana'a, Yemen
| | - Maged S Alhammadi
- Department of Preventive Dental Sciences, Division of Orthodontics and Dentofacial Orthopedics, College of Dentistry, Jazan University, Jazan, Saudi Arabia.,Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen
| | - Abdulwahab H Alamir
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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29
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Kalatakis-Dos-Santos AE, Fidelis-de-Paula-Gomes CA, Bassi-Dibai D, Gonçalves MC, Martins-de-Sousa PH, Pires FDO, Almeida MQG, Dibai-Filho AV. Correlation Between Habitual Physical Activity and Central Sensitization, Pain Intensity, Kinesiophobia, Catastrophizing, and the Severity of Myogenous Temporomandibular Disorder. J Chiropr Med 2020; 18:299-304. [PMID: 32952475 DOI: 10.1016/j.jcm.2019.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 11/18/2022] Open
Abstract
Objective We sought to correlate habitual physical activity with central sensitization, pain intensity, kinesiophobia, catastrophizing, and the severity of chronic myogenous temporomandibular disorder (TMD). Methods This was an observational study. Fifty-five individuals, male and female, aged 18 to 45 years, with pain for at least 3 months (chronic) related to myogenous TMD were included in the study. Myogenous TMD was evaluated by means of the Numerical Rating Scale, Catastrophic Thoughts on Pain Scale, Tampa Scale for Kinesiophobia, Fonseca Anamnestic Index, Central Sensitization Inventory, and habitual physical activity by means of the Baecke Questionnaire (BQ). The Spearman correlation coefficient (r s) was applied to verify the association of the BQ score with the pain variables. Results No significant correlations (P > .05) were observed in the total or mean BQ scores (both r s = -0.17 to -0.04), nor in the analyses performed on the occupational (r s = -0.03 to 0.14), sport (r s = -0.16 to 0.01), and leisure domains (r s = -0.16 to -0.02). Conclusion Habitual physical activity as measured by the BQ is not associated with pain intensity, catastrophizing, kinesiophobia, central sensitization, or the severity of chronic myogenous TMD.
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Affiliation(s)
| | | | - Daniela Bassi-Dibai
- Postgraduate Program in Programs Management and Health Services, Ceuma University, São Luís, MA, Brazil
| | | | | | | | | | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Federal University of Maranhão, São Luís, MA, Brazil
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30
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Chang PH, Chen YJ, Chang KV, Wu WT, Özçakar L. Ultrasound measurements of superficial and deep masticatory muscles in various postures: reliability and influencers. Sci Rep 2020; 10:14357. [PMID: 32873849 PMCID: PMC7463001 DOI: 10.1038/s41598-020-71378-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022] Open
Abstract
Masticatory muscle thickness provides objective measurements of the oral motor function, which may change in patients with oral myofascial pain. In this study, we aimed to establish a reliable ultrasound (US) protocol for imaging the superficial and deep masticatory muscles and to identify the potential influencers of the measurements. Forty-eight healthy participants without orofacial pain were enrolled. The intra-and inter-rater reliabilities of US measurements for masseter, temporalis, and lateral pterygoid muscles were assessed. Intraclass correlation coefficients for all muscles were greater than 0.6. The generalised estimating equation was used to analyse the impact of age, gender, laterality, and body mass index on the measurements, whereby age and body mass index were likely to be associated with an increase in masticatory muscle thickness. The thickness tended to be lesser in females. Laterality seemed to exert minimal influence on masticatory muscle thickness. Our study shows acceptable reliability of US in the evaluation of superficial and deep masticatory muscle thickness. Future studies are warranted to validate the usefulness of US imaging in patients with oral myofascial pain syndrome.
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Affiliation(s)
- Pei-Hsuan Chang
- Department of Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Yunn-Jy Chen
- Department of Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan, ROC
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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31
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Zarate MA, Frusso RD, Reeves KD, Cheng AL, Rabago D. Dextrose Prolotherapy Versus Lidocaine Injection for Temporomandibular Dysfunction: A Pragmatic Randomized Controlled Trial. J Altern Complement Med 2020; 26:1064-1073. [PMID: 32780636 DOI: 10.1089/acm.2020.0207] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective: Several intraarticular injections, including dextrose and lidocaine, are reported to reduce pain and dysfunction in temporomandibular dysfunction (TMD) and increase maximal jaw opening; our goal was to determine whether dextrose/lidocaine outperforms sterile water/lidocaine for TMD. Design: Pragmatic randomized controlled trial. Setting: Outpatient clinic. Subjects: Chronic (≥3 months) of moderate-to-severe (≥6/10) jaw or facial pain meeting research-specific TMD criteria. Intervention: Blinded intraarticular dextrose prolotherapy (DPT) (20% dextrose/0.2% lidocaine) versus intraarticular lidocaine (0.2% lidocaine in sterile water) at 0, 1, and 2 months. Participants were then unblinded and offered DPT by request for 9 additional months. Main outcome measures: Primary: Numerical Rating Scale (0-10 points) score for facial pain and jaw dysfunction; percentage achieving ≥50% improvement in pain and dysfunction (0, 3, and 12 months). Secondary: Maximal interincisal opening (MIO; 0 and 3 months). Intention-to-treat analysis was by joint using mixed-model regression. Results: Randomization of 29 participants (25 female, 47 ± 17 years, 43 joints) produced similar groups. Three-month pain and dysfunction improvements were similar, but more DPT-treated joints improved by ≥50% in pain (17/22 vs. 6/21; p = 0.028). The MIO improved in both groups (5.6 ± 5.8 mm vs. 5.1 ± 7.0 mm; p = 0.70). From 3 to 12 months, minimal DPT was received by original DPT and lidocaine recipients, 0.5 ± 0.9 and 0.6 ± 1.5 injections, respectively, with only 2 out of 21 joints in the original lidocaine group receiving more than 1 dextrose injection after 3 months. Twelve-month analysis revealed that joints in the original DPT group improved more in jaw pain (4.8 ± 2.4 points vs. 2.6 ± 2.9 points; p = 0.026) and jaw dysfunction (5.3 ± 2.6 points vs. 2.7 ± 2.3 points; p = 0.013). More DPT than lidocaine-treated joints improved by ≥50% in both pain (19/22 vs. 5/21; p = 0.003) and dysfunction (17/22 vs. 7/21; p = 0.040). There were no adverse events; satisfaction was high. Conclusions: Intraarticular DPT resulted in clinically important and statistically significant improvement in pain and dysfunction at 12 months compared to lidocaine injection (ClinicalTrials.gov identifier NCT01617356).
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Affiliation(s)
- Miguel Angel Zarate
- Private Practice Family Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ricardo Daniel Frusso
- Private Practice Family Medicine, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - An-Lin Cheng
- Department of Biomedical and Health Informatics, University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - David Rabago
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
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32
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De Stefano AA, Guercio-Mónaco E, Uzcátegui A, Boboc AM, Barbato E, Galluccio G. Temporomandibular disorders in Venezuelan and Italian adolescents. Cranio 2020; 40:517-523. [DOI: 10.1080/08869634.2020.1801013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Adriana A. De Stefano
- Department of Orthodontics, Faculty of Dentistry, University Central of Venezuela, Caracas, Venezuela
| | - Elisabetta Guercio-Mónaco
- Department of Orthodontics, Faculty of Dentistry, University Central of Venezuela, Caracas, Venezuela
| | - Albany Uzcátegui
- Facultad de Odontología, Universidad Central de Venezuela, Orthodontic Private Practice, Caracas, Venezuela
| | - Ana Maria Boboc
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Ersilia Barbato
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
- Director of Orthognatodontic Unit, Umberto I Hospital, Roma, Italy
| | - Gabriella Galluccio
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
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Küchler EC, Meger MN, Ayumi Omori M, Gerber JT, Carneiro Martins Neto E, Silva Machado NCD, Cavalcante RC, Teixeira LR, Stuani MB, Nelson Filho P, da Costa DJ, Souza JFD, Brancher JA, León JE, Scariot R. Association between oestrogen receptors and female temporomandibular disorders. Acta Odontol Scand 2020; 78:181-188. [PMID: 31646926 DOI: 10.1080/00016357.2019.1675904] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To evaluate if temporomandibular disorders (TMDs) are associated with genetic polymorphisms in ESR1 and ESR2, which are genes encoding oestrogen receptor alpha (ERα) and beta (ERβ). Also, we included an animal model to check if ERα and ERβ are expressed in the temporomandibular joint (TMJ) during adolescence.Materials and methods: A total of 139 teenagers and 93 adults were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs). The DNA was collected and the markers ESR1 and ERS2 were genotyped. Additionally, immunohistochemistry was performed in TMJ tissues from female Wistar rats during puberty. All data were submitted to statistical analysis with confidence interval of 95%.Results: Teenagers presented more disc displacement and arthralgia than adults (p < .05). The genetic polymorphism rs1256049 in ESR2 was associated with disc displacement (p = .040; OR = 10.50/95%CI 1.17-98.74) and arthralgia (p = .036; OR = 7.20/95%CI 1.10-46.88) in adults. The ERα and ERβ are expressed in rat TMJ tissues.Conclusions: We provide evidence that ESR2 is associated with TMD and could be a genetic marker for this condition in adult women. Furthermore, oestrogens receptors are presented in TMJ of adolescent female rats.
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Affiliation(s)
- Erika Calvano Küchler
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Marjorie Ayumi Omori
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Jennifer Tsi Gerber
- Department of Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Brazil
| | | | | | | | - Lucas Ribeiro Teixeira
- Department of Oral Biology, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Maria Bernadete Stuani
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Paulo Nelson Filho
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Delson João da Costa
- Department of Oral and Maxillofacial Surgery, Universidade Federal Do Paraná, Curitiba, Brazil
| | | | - João Armando Brancher
- Department of Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Brazil
| | - Jorge Esquiche León
- Department of Oral Pathology, Ribeirão Preto Dental School, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Rafaela Scariot
- Department of Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Brazil
- Department of Oral and Maxillofacial Surgery, Universidade Federal Do Paraná, Curitiba, Brazil
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Restrepo CC, Suarez N, Moratto N, Manrique R. Content and construct validity of the Diagnostic Criteria for Temporomandibular Disorders Axis I for children. J Oral Rehabil 2020; 47:809-819. [PMID: 32118309 DOI: 10.1111/joor.12957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/10/2020] [Accepted: 02/25/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To perform the content and construct validation of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, for children 7-11 years old. MATERIALS AND METHODS A Delphi process was used to perform the content validity of the DC/TMD Axis I. One hundred eighty-nine 7- to 11-year-old children were assessed with the adapted instrument. Confirmatory factor analysis (CFA) was used to investigate construct validity of the DC/TMD for children. A baseline one-factor model was compared against a two-factor (Model 2) and a seven-factor (Model 3) models based on the original DC/TMD. Root mean squared error of approximation (RMSEA), comparative fit index (CFI), chi-square, change in chi-square and Cronbach's α were used to analyse the data. All analyses were performed in STATA© version 13.0. RESULTS Items of the DC/TMD were reduced, "history time" was changed to 2 weeks, pain intensity was assessed through a face scale, and language was adapted to be better understood by children. The amount of muscle pressure was maintained as in the original DC/TMD Axis I. The CFA led to a two- and a seven-factor model, with good fit. The internal consistency of Model 2 was .91 and of Model 3, .94. CONCLUSION The results of this study provide evidence to support a seven-factor representation of the DC/TMD Axis I for 7- to 11-year-old children, as well as a two-factor structure. Such findings will begin to provide researchers with confidence in the properties of this instrument when considering its inclusion in clinical research.
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Affiliation(s)
| | - Natasha Suarez
- CES-LPH Research Group, Universidad CES, Medellin, Colombia
| | - Nadia Moratto
- Psychology Faculty, Universidad CES, Medellín, Colombia
| | - Rubén Manrique
- CES-LPH Research Group, Universidad CES, Medellin, Colombia
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Polat ME, Yanik S, Odabasi O. Retrospective evaluation of the duration of arthrocentesis in the treatment of temporomandibular joint diseases. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:201-205. [PMID: 32109596 DOI: 10.1016/j.jormas.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated the duration of arthrocentesis in treatment of patients with different diagnoses of temporomandibular disorders. METHODS This retrospective study evaluated the duration of arthrocentesis used for 65 patients who were diagnosed with osteoarthritis (OA), disc displacement with reduction (DDWR), or disc displacement without reduction (DDWoR), in accordance with the Research Diagnostic Criteria for Temporomandibular Disorders protocol. RESULTS Mean operation times were 423.79 (± 66.77) seconds in OA patients, 459.92 (± 56.67) seconds in DDWR patients, and 609.00 (± 106.88) seconds in DDWoR patients; these significantly differed among groups (P < 0.001). In addition, post hoc analyses revealed statistically significant differences in mean operation times between DDWoR and OA (P<0.05) and DDWoR and DDWR (P<0.05). CONCLUSION The appropriate duration of arthrocentesis may vary among joint disorders, and the duration of arthrocentesis in DDWoR treatment is longer than that in DDWR and OA treatments. In addition there was no relationship between the age or gender and operation time of the patients. Changes in anatomic structures due to temporomandibular diseases are presumed to influence the duration of arthrocentesis treatment.
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Affiliation(s)
- M E Polat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey.
| | - S Yanik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Harran University, 63300 Sanlıurfa, Turkey.
| | - O Odabasi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yildirim Beyazit University, 06010 Ankara, Turkey.
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Rauch A, Schierz O, Körner A, Kiess W, Hirsch C. Prevalence of anamnestic symptoms and clinical signs of temporomandibular disorders in adolescents-Results of the epidemiologic LIFE Child Study. J Oral Rehabil 2019; 47:425-431. [PMID: 31841219 DOI: 10.1111/joor.12926] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/16/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prevalence values for symptoms and signs of temporomandibular disorders (TMD) in adolescents vary within the literature due to differences in set-ups of examination protocols. OBJECTIVES The objective was to present prevalence values for symptoms and signs of TMD in German adolescents that were observed within a standardised examination. Prevalence values comparing gender or pubertal status should be investigated. METHODS A cross-sectional sample of the LIFE Child Study aged 10 to 18 was examined. A questionnaire gathering anamnestic symptoms of TMD was completed, and an examination according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was performed by trained dentists. Pubertal status according to Tanner stages was documented. Descriptive statistics, Mann-Whitney U and Wilcoxon signed-rank tests were performed. RESULTS A total of 1.116 participants (mean age 12.9 years, 51.4% female) were consecutively recruited. Most prevalent anamnestic symptoms were headaches (55.7%) and temporomandibular joint (TMJ) sounds (17.6%). The major clinical sign was TMJ sounds (31.9%). Both the examination of muscles or TMJs showed that pain to palpation was statistically significantly higher than familiar pain (P < .001). Gender comparisons revealed higher prevalence values and an increase in TMD symptoms and signs during pubertal development in females. CONCLUSION The prevalence of self-reported headaches, as well as anamnestic and clinical TMJ sounds, was high in German adolescents. Prevalence values for pain to palpation and familiar pain obtained relevant differences. Considering the DC/TMD, females are more affected by TMD signs and symptoms that increase during pubertal development, than male adolescents.
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Affiliation(s)
- Angelika Rauch
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Oliver Schierz
- Department of Prosthodontics and Materials Science, University of Leipzig, Leipzig, Germany
| | - Antje Körner
- LIFE -Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany
| | - Wieland Kiess
- LIFE -Leipzig Research Center for Civilization Diseases, University of Leipzig, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), University of Leipzig, Leipzig, Germany.,Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
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Khan K, Muller-Bolla M, Anacleto Teixeira Junior O, Gornitsky M, Guimarães AS, Velly AM. Comorbid conditions associated with painful temporomandibular disorders in adolescents from Brazil, Canada and France: A cross-sectional study. J Oral Rehabil 2019; 47:417-424. [PMID: 31834958 DOI: 10.1111/joor.12923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 11/13/2019] [Accepted: 11/29/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Painful temporomandibular disorder (TMD) is common among adolescents. Presence of painful comorbidities may worsen painful TMD and impact treatment effectiveness. OBJECTIVE The aim of this study was to assess the association between painful TMD and comorbidities. METHODOLOGY In this cross-sectional study, adolescents were recruited in Montreal (Canada), Nice (France) and Arceburgo (Brazil). Reliable instruments were used to assess painful TMD and comorbidities. Multivariable logistic and linear regression analyses were conducted to assess the study aims. RESULTS The prevalence of self-reported painful TMD was estimated at 31.6%; Arceburgo (31.6%), Montreal (23.4%) and Nice (31.8%). Painful TMD was more common among girls than boys (OR = 1.96). Painful TMD was associated with a higher number of comorbidities (OR = 1.77); Arceburgo (OR = 1.81), Montreal (OR = 1.80) and Nice (OR = 1.72). A stronger association was found between painful TMD and headaches (OR = 4.09) and a weaker one with stomach pain (OR = 1.40). Allergies were also related to painful TMD (OR = 1.43). CONCLUSION Painful TMD was associated with comorbidities. Headaches were consistently associated with painful TMD. Other associations were modified by sex and/or covariates related to the cities where participants were recruited.
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Affiliation(s)
- Khurram Khan
- Dental Department, Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Michèle Muller-Bolla
- Centre Hospitalier Universitaire de Nice, Nice, France.,Department of Pediatric Dentistry, Faculty of Dentistry, Nice, France.,Laboratory URB2i, University Paris Descartes, Paris, France
| | | | - Mervyn Gornitsky
- Dental Department, Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Montreal, QC, Canada
| | | | - Ana Miriam Velly
- Dental Department, Jewish General Hospital, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Montreal, QC, Canada
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Soto-Llanos L, Rodríguez-Manjarrés C, Triana-Escobar FE, Duque-Borrero ÁMM. Signos y síntomas asociados a trastornos temporomandibulares en niños y adolescentes. Cali, Colombia. DUAZARY 2019. [DOI: 10.21676/2389783x.2968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Los trastornos temporomandibulares (TTM) en pacientes pediátricos se han estudiado poco. Realizar un diagnóstico oportuno, hace que exista mayor interés por parte de los investigadores para orientar a los odontólogos. El objetivo del estudio fue identificar la presencia de trastornos temporomandibulares registrados en las historias clínicas de pacientes atendidos en la clínica de Odontopediatría de la Universidad del Valle. Se realizó un estudio observacional descriptivo y transversal para evaluar presencia de trastornos temporomandibulares en pacientes, en edades entre 4 a 14 años, que asistieron a las clínicas de Odontopediatría de la Universidad del Valle (Cali-Colombia), durante 2013 y 2016. Se revisaron, 712 historias; 56% de sexo masculino y 44% de sexo femenino. El 18,11% reportaron la presencia de al menos. Los signos y síntomas asociados con los TTM, los más frecuentes fueron el click bilateral (36,4%), la desviación y deflexión mandibular (27,1%) y dolor a la palpación (24,0%). La subluxación (1,6%) y el chasquido articular en apertura (0,8%) fueron los de menor presencia. Se concluyó que los trastornos de la ATM cada vez son mayores, es importante, realizar investigaciones que involucren los factores de riesgo y/o desencadenantes, la intervención oportuna y el manejo multidisciplinario de esta alteración.
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Joy TE, Kiran M S, R R, Jasmin Sl S, Babu Kurra S. Evaluation of vertical facial height reduction and severity of temporomandibular joint disorders using Shimbashi number and cephalometric analysis. Cranio 2019; 39:287-293. [PMID: 31271115 DOI: 10.1080/08869634.2019.1631944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: This study was designed to evaluate the correlation between vertical dimension at occlusion (VDO) and various grades of temporomandibular disorders (TMDs) versus controls.Methods: Clinically measured Shimbashi number and radiographic cemento-enamel junction (CEJ-CEJ) measurements on 120 TMD patients and 40 controls were evaluated. Radiographic lateral cephalometric skull images of the patients were subjected to cephalometric analysis. The relationship between Shimbashi number, the cephalometric values, and its correlation with the degree of TMD were evaluated and statistically analyzed.Results: Shimbashi number and radiographic CEJ-CEJ values in the TMD patients were significantly lower than those in the controls. TMD severity appeared to increase with the increase in interincisal angle and the decrease in both Shimbashi number and radiographic CEJ-CEJ value.Conclusion: These findings indicate that radiographic evaluation of cephalograms is a reliable indicator of presence and degree of TMD, and the severity of TMD increases with the degree of reduction in VDO.
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Affiliation(s)
- Tatu E Joy
- Department of Medicine and Radiology, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari Dist., Tamilnadu, India
| | - Shashi Kiran M
- Department of Medicine and Radiology, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari Dist., Tamilnadu, India
| | - Rahul R
- Department of Medicine and Radiology, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari Dist., Tamilnadu, India
| | - Sajitha Jasmin Sl
- Department of Medicine and Radiology, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari Dist., Tamilnadu, India
| | - Sarath Babu Kurra
- Department of Pharmacology, SR Medical College Research Center, Akhathumuri, Verkala, Kerala, India
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Xie C, Lin M, Yang H, Ren A. Prevalence of temporomandibular disorders and its clinical signs in Chinese students, 1979–2017: A systematic review and meta‐analysis. Oral Dis 2019; 25:1697-1706. [DOI: 10.1111/odi.13016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Congman Xie
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Min Lin
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Hongmei Yang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
| | - Aishu Ren
- College of Stomatology Chongqing Medical University Chongqing China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences Chongqing China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Chongqing China
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de Melo Júnior PC, Aroucha JMCNL, Arnaud M, Lima MGDS, Gomes SGF, Ximenes R, Rosenblatt A, Caldas ADF. Prevalence of TMD and level of chronic pain in a group of Brazilian adolescents. PLoS One 2019; 14:e0205874. [PMID: 30735506 PMCID: PMC6368276 DOI: 10.1371/journal.pone.0205874] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Accepted: 01/22/2019] [Indexed: 11/18/2022] Open
Abstract
AIMS To determine the prevalence of temporomandibular disorders and associated factors in an adolescent sample from Recife, Brazil. MATERIALS AND METHODS A cross-sectional study was conducted with 1342 adolescents aged 10-17 years. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was used by calibrated examiners to evaluate the presence and levels of chronic pain. To evaluate the socioeconomic conditions, the subjects answered the Brazilian Economic Classification Criteria (CCEB) questionnaire. Data were analyzed by means of binary logistic regression in SPSS. RESULTS The results showed that 33.2% of the subjects had TMD irrespective of age (p = 0.153) or economic class (p = 0.653). Statistically significant associations were found between TMD and female gender (p = 0.017), headache/migraine in the past six months (p<0.001), chronic pain (p<0.001) and chronic pain level (p<0.001). In the final model, logistic regression showed that the level of chronic pain and the headache/migraine in the past six months were related to the presence of TMD. CONCLUSIONS The prevalence of TMD was considered high (33.2%) and adolescents with chronic pain and headache in the past six months were more likely to have TMD. CLINICAL RELEVANCE The data contribute to the understanding of TMD among adolescents and to the development of preventive measures and polices to identify the dysfunction promptly.
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Affiliation(s)
- Paulo Correia de Melo Júnior
- Postgraduate Program in Dentistry, Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | | | - Manuela Arnaud
- Postgraduate Program in Dentistry, Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Maria Goretti de Souza Lima
- Postgraduate Program in Dentistry, Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | | | - Rosana Ximenes
- Department of Neuropsychiatry, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Aronita Rosenblatt
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Arnaldo de França Caldas
- Department of Pediatric Dentistry, School of Dentistry, University of Pernambuco, Camaragibe, Pernambuco, Brazil
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Bueno CH, Pereira DD, Pattussi MP, Grossi PK, Grossi ML. Gender differences in temporomandibular disorders in adult populational studies: A systematic review and meta-analysis. J Oral Rehabil 2018; 45:720-729. [PMID: 29851110 DOI: 10.1111/joor.12661] [Citation(s) in RCA: 196] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 01/17/2023]
Abstract
The objective of this study was to systematically evaluate gender differences in the prevalence of TMD. A systematic review was performed in PubMed, EMBASE, Web of Science and LILACS in duplicate by two independent reviewers. The inclusion criteria were cross-sectional studies that reported the prevalence of TMD for men and women and that used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I group diagnostic criteria:(group I = muscle disorders; group II = disc displacements; group III = arthralgias/arthritis/arthrosis).To be eligible for inclusion, studies must include adult individuals (>18 years) from a non-clinical population (ie without pre-diagnosis of TMD); in other words, from population-based studies. There were no restrictions on the year and language of publication. The quality of the articles was assessed by an adapted version of the Newcastle-Ottawa Scale(NOS), and the publication bias was assessed by a funnel plot graph. Data were quantitatively analysed by meta-analysis using odds ratio (OR) as the measure effect. The electronic search retrieved a total of 6104 articles, of which 112 articles were selected for full-text reading according to the eligibility criteria. By means of manual search, one study was retrieved. Five articles were selected for meta-analysis with a combined sample of 2518 subjects. Women had higher prevalence of TMD in all RDC/TMD diagnostic groups. The meta-analysis yielded the following results: (a) OR = 2.24 for global TMD (groups I, II and III combined), (b) OR = 2.09 for group I, (c) OR = 1.6 for group II and (d) OR = 2.08 for group III. The importance of gender in the development of TMD has been demonstrated, with a two times greater risk of women to develop it as compared to men.
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Affiliation(s)
- C H Bueno
- Post-Graduate Program in Dentistry (Prosthodontics), Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - D D Pereira
- Post-Graduate Program in Dentistry (Prosthodontics), Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - M P Pattussi
- Post-Graduate Program in Public Health, Vale do Rio dos Sinos University (UNISINOS), São Leopoldo, Brazil
| | - P K Grossi
- Post-Graduate Program in Social Work, School of Humanities, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - M L Grossi
- Post-Graduate Program in Dentistry (Prosthodontics), Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Fehrenbach J, Gomes da Silva BS, Pradebon Brondani L. A associação da disfunção temporomandibular à dor orofacial e cefaleia. JOURNAL OF ORAL INVESTIGATIONS 2018. [DOI: 10.18256/2238-510x.2018.v7i2.2511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A articulação temporomandibular (ATM) possibilita a mastigação, deglutição e a fonética, faz parte do sistema estomatognático, e é capaz de múltiplos movimentos. A DTM (disfunção temporomandibular) representa certas condições musculares e articulares na região crânio orofacial que podem causar problemas nos músculos da mastigação e na ATM e suas estruturas associadas, sendo a cefaleia e a dor orofacial alguns dos principais sintomas relatados pelos pacientes. Objetivo: analisar a relação da DTM à dor orofacial e cefaleia através de uma revisão narrativa. Métodos: para a realização deste estudo, foram feitas buscas nas bases de dados Scielo e Pubmed, utilizando as palavras chave: Dor Orofacial, Disfunção Temporomandibular, Articulação Temporomandibular, Dor de Cabeça e Cefaleia. Conclusão: a partir dos artigos analisados na presente revisão foi possível concluir que existe relação entre dor na região orofacial e cefaleia com a DTM, porém ainda não é claro o mecanismo dessa correlação, sendo necessários mais estudos para elucidar esse quadro clínico.
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Natu VP, Yap AUJ, Su MH, Irfan Ali NM, Ansari A. Temporomandibular disorder symptoms and their association with quality of life, emotional states and sleep quality in South-East Asian youths. J Oral Rehabil 2018; 45:756-763. [DOI: 10.1111/joor.12692] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/02/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Vaishali P. Natu
- School of Health Sciences; Nanyang Polytechnic; Singapore City Singapore
| | - Adrian U-J. Yap
- Department of Dentistry; Ng Teng Fong General Hospital; National University Health System; Singapore City Singapore
- Faculty of Dentistry; National University of Singapore; Singapore City Singapore
| | - Marilyn Huiting Su
- Allied Health Division; Singapore General Hospital; Singapore City Singapore
| | | | - Anshad Ansari
- School of Health Sciences; Nanyang Polytechnic; Singapore City Singapore
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Abstract
PURPOSE OF REVIEW Elucidate temporomandibular joint (TMJ) development and pathophysiology relative to regeneration, degeneration, and adaption. RECENT FINDINGS The pharyngeal arch produces a highly conserved stomatognathic system that supports airway and masticatory function. An induced subperiosteal layer of fibrocartilage cushions TMJ functional and parafunctional loads. If the fibrocartilage disc is present, a fractured mandibular condyle (MC) regenerates near the eminence of the fossa via a blastema emanating from the medial periosteal surface of the ramus. TMJ degenerative joint disease (DJD) is a relatively painless osteoarthrosis, resulting in extensive sclerosis, disc destruction, and lytic lesions. Facial form and symmetry may be affected, but the residual bone is vital because distraction continues to lengthen the MC with anabolic bone modeling. Extensive TMJ adaptive, healing, and regenerative potential maintains optimal, life support functions over a lifetime. Unique aspects of TMJ development, function, and pathophysiology may be useful for innovative management of other joints.
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Affiliation(s)
- W Eugene Roberts
- School of Dentistry, Department of Orthodontics and Oral Facial Genetics, Indiana University-Purdue University (IUPUI), Indianapolis, IN, USA.
- Department of Orthodontics, Loma Linda University, Loma Linda, CA, USA.
- Advanced Dental Education, St. Louis University, St. Louis, MO, USA.
| | - David L Stocum
- School of Science, Department of Biology, Indiana University-Purdue University (IUPUI), Indianapolis, IN, USA
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de Paiva Bertoli FM, Bruzamolin CD, de Almeida Kranz GO, Losso EM, Brancher JA, de Souza JF. Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study. J Oral Rehabil 2018; 45:747-755. [PMID: 29972708 DOI: 10.1111/joor.12684] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/15/2018] [Accepted: 06/30/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Temporomandibular Disorders (TMD) is a multifactorial condition, which could be associated to occlusal and psychological factors, such as anxiety. OBJECTIVE Investigate if anxiety and malocclusion are associated with the prevalence of TMD in adolescents. METHODS To ensure a population-based representative sample, 934 adolescents aged 10 to 14 years old from Curitiba-PR, Brazil were randomly selected and examined according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and malocclusion by a single-calibrated examiner (Kappa > 0.80). Anxiety was assessed according to trait anxiety (STAI-T), categorised as high, moderate and low levels. For occlusal exam, it was considered: Angel's molar relationship, anterior and posterior crossbite, excessive overjet, open and deep bite. The associations were analysed by the crude and adjusted prevalence ration (RPa ) of TMJ, calculated by a Poisson multivariate regression with robust variance (α = 0.05). RESULTS The prevalence of at least one type of malocclusion was found in 52.3%. Anxiety was found in high level (12.2%), moderate (70.4%) and low (17.5%). Presence of high anxiety was significantly associated with the prevalence of TMD symptoms (RPa = 4.06, P < 0.001), as well as the prevalence of myofascial pain (RPa = 24.78; P < 0.001) and prevalence of disc displacement with reduction (RPa = 11.08, P < 0.001). Adolescents Class II had higher prevalence of myofascial pain (Class II RPa = 1.73; P < 0.015) than adolescents Class I. Adolescents Class III presented higher prevalence of myofascial pain (PRa 2.53; P = 0.004) than adolescents Class I. CONCLUSION Anxiety is strongly associated with TMD in adolescents. Presence of Class II or III is associated with higher prevalence of myofascial pain in adolescentsPLESAE check and approve the edit made in the article title.
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Alkhudhairy MW, Al Ramel F, Al Jader G, Al Saegh L, Al Hadad A, Alalwan T, Al Shaikh D, Al Bandar M. A Self-Reported Association between Temporomandibular Joint Disorders, Headaches, and Stress. J Int Soc Prev Community Dent 2018; 8:371-380. [PMID: 30123773 PMCID: PMC6071353 DOI: 10.4103/jispcd.jispcd_177_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/30/2018] [Indexed: 12/15/2022] Open
Abstract
AIMS AND OBJECTIVES Temporomandibular joint disorder (TMD) is an umbrella term for a number of conditions in the area of the joint, temple, and masticatory system. Many of those with TMD also suffer from headaches and anxiety. The aims and objectives of this study were to determine if there exists an association between the Diagnostic Criteria of TMD (DC/TMD) symptom questionnaire and report of headaches as well as stress. MATERIALS AND METHODS A cross-sectional study was implemented via the use of the DC/TMD symptom questionnaire and the perceived stress scale (PSS). This was distributed conveniently among dental students in a multi-dental school setting in Riyadh, Saudi Arabia, and was completed by 152 dental students. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05. RESULTS Those who ticked yes for pain on the TMD pain screener for pain with chewing hard or tough food, pain on mouth opening and lateral excursion, and pain with jaw habits as parafunction were at an odds risk from twice to thrice as likely to experience headaches. Similarly, those with poor coping skills on the PSS were more likely to have headaches (P = 0.002). Likewise, positive answers on the screener and symptom questionnaire were relevant with higher stress scores on the PSS. CONCLUSION This study clarifies and reiterates the intertwined power of both stress and headaches; the former being a role player in TMD progression and the latter its product. TMD is unfortunately on the rise; it should not be brushed off as a nuisance. A multidisciplinary approach in diagnosis and treatment of both TMD and headaches by a team of orofacial pain specialist, neurologist, psychiatrist and/or psychologist, and physical therapists to untangle the deceiving presentation of both conditions would not only provide a more favorable prognosis but also improve cost and time expenditures.
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Affiliation(s)
- May Wathiq Alkhudhairy
- Department of Diagnostic Sciences and Oral Maxillofacial Surgery, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Fatima Al Ramel
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Ghufran Al Jader
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Layla Al Saegh
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Areej Al Hadad
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Tumadhir Alalwan
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Dhuha Al Shaikh
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Malak Al Bandar
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
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