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Benli M, Huck O, Özcan M. Effect of low-level gallium aluminum arsenide laser therapy on the chewing performance and pain perception of patients with systemic lupus erythematosus: A randomized controlled clinical trial. Cranio 2024; 42:411-420. [PMID: 34455912 DOI: 10.1080/08869634.2021.1971888] [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: 10/20/2022]
Abstract
OBJECTIVE To evaluate the effect of low-level laser therapy (LLLT) on pain intensity (PI) and chewing performance (CP) in systemic lupus erythematosus (SLE) patients with myogenic temporomandibular disorder (TMD). METHODS Ninety-one patients were randomly allocated to three groups: Group L (intervention), Group P (placebo), and Group C (control). Outcomes were PI (assessed with visual analog scale (VAS)) and CP (assessed with the geometric mean diameter (GMD) of crushed test food). Measurements were performed at T0 (before the LLLT), T1 (immediately after the LLLT), and T2 (1-month follow-up). Data were analyzed using Generalized Linear Models, Kruskal-Wallis, and Friedman tests. RESULTS For T1 and T2, Group L demonstrated the lowest values for both GMD (6283.7 ± 257.2 µm; 6382.7 ± 303.7 µm) and VAS (5;6) (p < 0.001). CONCLUSION LLLT was an effective therapeutic approach in reducing pain and improving CP for one month in SLE patients with myogenic TMD.
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Affiliation(s)
- Merve Benli
- University of Pittsburgh, School of Dental Medicine, Department of Oral Biology, Pittsburgh, PA, USA
- Istanbul University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Olivier Huck
- Inserm, Umr 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculty of Medicine, Strasbourg, France
- University of Strasbourg, Faculty of Dentistry, Department of Periodontology, Strasbourg, France
| | - Mutlu Özcan
- University of Zurich, Dental Materials Unit, Center for Dental and Oral Medicine Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland
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Syrmou V, Grammatikopoulou MG, Bogdanos DP, Mitsimponas KT. Temporomandibular joint disorders in seronegative spondyloarthritis: what a rheumatologist needs to know? Reumatologia 2023; 61:375-388. [PMID: 37970123 PMCID: PMC10634408 DOI: 10.5114/reum/173078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/02/2023] [Indexed: 11/17/2023] Open
Abstract
Temporomandibular joint (TMJ) can be affected in the context of spondyloarthritis (SpA) with detrimental impact on individuals' quality of life. Intra-articular inflammation, synovitis, enthesitis, disc displacement and cervical vertebrae malalignment are some of the pathophysiological phenomena involved. Temporomandibular joint disorders (TMD) incidence appears to be higher in patients with ankylosing spondylitis and psoriatic arthritis, especially when clinical evaluation includes not only imaging but relevant history, TMJ examination and diagnostic criteria for TMD. The Visual Analogue Scale (VAS) pain score and Health Assessment Questionnaire Disability Index (HAQ) quality of life score could be useful tools. Panoramic radiographs and ultrasound can be used for screening but in symptomatic patients magnetic resonance imaging (MRI) is preferable. Conservative management and early pharmacological treatment can prevent permanent joint impairment. For refractory cases, early referral to Legislation for Oral and Maxillofacial Surgery (OMFS) specialists is indicated. The aim of this narrative review is to address the involvement of TMJ in SpA and to encourage clinicians to incorporate TMJ assessment in their physical examination and basic screening.
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Affiliation(s)
- Vasiliki Syrmou
- Department of Rheumatology and Clinical Immunology, Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
| | - Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Medical School, Faculty of Health Sciences, University of Thessaly, Larissa, Greece
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de Melo-Silva EMV, Valdez RA, da Barbosa-Silva IM, Chateaubriand MM, Duarte ALBP, Gueiros LA. Association between axial spondyloarthritis and temporomandibular disorders: A systematic review. Oral Dis 2023; 29:2592-2599. [PMID: 36578234 DOI: 10.1111/odi.14490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to assess the frequency of temporomandibular disorders (TMDs) in patients with axial spondyloarthritis (axSpA) compared with the healthy individuals. We systematically searched PubMed, Embase, Scopus, Web of Science, CINAHL, and Google Scholar databases from their inception until 2022, without language restriction. A standardized dataset was used to extract data from the observational studies. Patients were required to have axial spondyloarthritis and clinical and/or radiographic evidence of temporomandibular joint dysfunction. Meta-analysis was performed with a random effects model. A systematic review was registered under number CRD42020206283. We identified seven relevant studies, which provided data for 745 patients and 216 temporomandibular disorders events. The combined odds ratio (OR) showed that the risk of temporomandibular disorders in individuals with axial spondyloarthritis was higher than the control group (pooled OR = 5.26, 95% CI 2.50-11, 06; p < 0.02; I2 = 58%). Also, these individuals do not appear to refer possible temporomandibular joint symptoms to the rheumatologist or dentist. The results of this systematic review and meta-analysis suggest that patients with axial spondyloarthritis have an increased frequency of temporomandibular disorders. TMDs seem to be secondary to postural alterations rather than direct involvement of the temporomandibular joints (TMJs).
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Affiliation(s)
- Elma Mariana Verçosa de Melo-Silva
- Departamento de Clínica e Odontologia Preventiva & Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Remberto Argandoña Valdez
- Departamento de Clínica e Odontologia Preventiva & Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Izabella Maria da Barbosa-Silva
- Departamento de Clínica e Odontologia Preventiva & Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Marina Moura Chateaubriand
- Departamento de Clínica e Odontologia Preventiva & Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | | | - Luiz Alcino Gueiros
- Departamento de Clínica e Odontologia Preventiva & Oral Medicine Unit, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
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Hysa E, Lercara A, Cere A, Gotelli E, Gerli V, Paolino S, Pizzorni C, Sulli A, Smith V, Cutolo M. Temporomandibular disorders in immune-mediated rheumatic diseases of the adult: A systematic review. Semin Arthritis Rheum 2023; 61:152215. [PMID: 37167773 DOI: 10.1016/j.semarthrit.2023.152215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/24/2022] [Accepted: 04/26/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To systematically review the literature concerning temporomandibular disorders (TMDs) in immune-mediated rheumatic diseases (IMRDs) of the adult. The temporomandibular joint (TMJ) outcomes used in clinical studies, the prevalence of TMDs in IMRDs and the risk factors for their development were qualitatively synthetized. METHODS A literature search on PubMed Central, Embase and Cochrane Library databases was performed for studies including TMJ outcomes in IMRDs patients compared with healthy controls, other rheumatic diseases or in the assessed IMRDs patients after follow-up and treatment. Among the IMRDs of the adult, original articles investigating TMJ involvement in inflammatory polyarthritides and/or autoimmune connective tissue diseases were considered. The quality of the studies was scored using the Newcastle-Ottawa scale (NOS). RESULTS Of the 3259 screened abstracts, 56 papers were included in the systematic review. Most of the papers (77%) investigated TMDs in rheumatoid arthritis (RA) with a prevalence of signs and symptoms varying from 8% to 70%. The risk factors for TMDs development in RA were female sex, younger age, anti-citrulline peptide autoantibodies (ACPA) positivity, higher disease activity, cervical spine involvement, cardiovascular and neuropsychiatric comorbidities. Ten papers (18%) evaluated TMDs in spondylarthritides (SpA) reporting a prevalence of symptoms and signs in 12%-80% of patients with higher TMDs prevalence in patients with radiographic spine involvement, skin psoriasis and HLADRB1×01 positivity. Among autoimmune connective tissue diseases (CTDs), systemic sclerosis (SSc) displayed the highest evidence of TMDs patient-reported outcomes (PROs) and clinical findings (20-93%), followed by systemic lupus erythematosus (SLE) in 18-85%, primary Sjogren's syndrome (24-54%) and idiopathic inflammatory myopathies (4-26%). In SSc and SLE, TMDs were more frequent in patients with higher disease activity and duration, correlating with the extent of skin fibrosis in SSc and with renal involvement in SLE. CONCLUSION TMDs in IMRDs display a significant relevance in the rheumatological clinical practice even if often misdiagnosed. This burden is epidemiologically important in terms of PROs and clinical findings which correlate with disease activity in RA, SpA, SSc and SLE. The early recognition and multidisciplinary management of TMDs is warranted and should be aimed at hindering the TMJ structural damage maximizing the quality of life of patients.
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Affiliation(s)
- Elvis Hysa
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Adriano Lercara
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Andrea Cere
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Emanuele Gotelli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Veronica Gerli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Sabrina Paolino
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Carmen Pizzorni
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Alberto Sulli
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy
| | - Vanessa Smith
- Department of Internal Medicine, Department of Rheumatology, Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent University Hospital, Corneel Heymanslaan 10, Ghent 9000, Belgium
| | - Maurizio Cutolo
- Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine and Specialties, University of Genova, IRCCS San Martino Polyclinic Hospital Viale Benedetto XV, No 6, Genova 16132, Italy.
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Gębska M, Dalewski B, Pałka Ł, Kołodziej Ł. Surface electromyography evaluation of selected manual and physical therapy interventions in women with temporomandibular joint pain and limited mobility. Randomized controlled trial (RCT). Injury 2023:110906. [PMID: 37400325 DOI: 10.1016/j.injury.2023.110906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 07/05/2023]
Abstract
Non-invasive approach is gaining an increasing recognition in the TMD patients management. It is therefore reasonable to conduct RCTs evaluating the effectiveness of both physical and manual physiotherapy interventions. The aim of this study was to evaluate the short-term efficacy of selected physiotherapeutic interventions and their effect on the bioelectrical function of the masseter muscle in patients with pain and limited TMJ mobility. The study was conducted on a group of 186 women (T) with the Ib disorder diagnosed in DC/TMD. The control group consisted of 104 women without diagnosed TMDs. Diagnostic procedures were performed in both groups. The G1 group was randomly divided into 7 therapeutic groups in which the therapy was carried out for 10 days: magnetostimulation (T1), magnetoledotherapy (T2), magnetolaserotherapy (T3), manual therapy- positional release and therapeutic exercises (T4), manual therapy - massage and therapeutic exercises (T5), manual therapy - PIR and therapeutic exercises (T6), self therapy - therapeutic exercises (T7). In the T4 and T5 groups, the treatments led to complete resolution of pain after the 10th day of therapy and to the largest minimal clinically significant difference in the MMO and LM parameter. GEE model for PC1 values using treatment method and time point showed that T4, T5 and T6 treatments had the strongest effect on the parameters studied. Therefore, it may be concluded that SEMG testing is a helpful indicator to assess the therapeutic effectiveness of physiotherapeutic interventions. BACKGROUND Non-invasive approach is gaining an increasing recognition in the TMD patients management. It is therefore reasonable to conduct RCTs evaluating the effectiveness of both physical and manual physiotherapy interventions in a qualitative and quantitative manner. However, there were numerous controversies reported regarding the use of surface electromyography (SEMG) in Orofacial Pain patients. Therefore, we wanted to assess the effectiveness of physiotherapy interventions in TMD patients using SEMG. PURPOSE Evaluation of the short-term efficacy of selected physiotherapeutic interventions and their effect on the bioelectrical function of the masseter muscle in patients with pain and limited TMJ mobility. MATERIAL AND METHODS The study was conducted on a group of 186 women (T) with the Ib disorder diagnosed in DC/TMD (Ib - myofascial pain with restricted mobility). The control group consisted of 104 women without diagnosed TMDs (normal reference values for TMJ ROM and masseter muscle SEMG bioelectric activity). Diagnostic procedures were performed in both groups (SEMG of the masseter muscles at baseline and during exercise, measurement of TMJ mobility, assessment of pain intensity - NRS scale). The G1 group was randomly divided into 7 therapeutic groups in which the therapy was carried out for 10 days: magnetostimulation (T1), magnetoledotherapy (T2), magnetolaserotherapy (T3), manual therapy- positional release and therapeutic exercises (T4), manual therapy - massage and therapeutic exercises (T5), manual therapy - PIR and therapeutic exercises (T6), self-therapy - therapeutic exercises (T7). Each time after therapy, the intensity of pain and TMJ mobility were assessed. Sealed, opaque envelopes were used for randomization. After 5 and 10 days of therapy, bilateral SEMG signals of the masseter muscles were acquired. PC1 factor analysis was performed. A score of 99% in the PC1 parameter, demonstrates the clinical relevance of electromyography (MVC). RESULTS Synergism of physical factors will lead to a higher MID on the NRS scale. Evaluating the MID of the therapeutic interventions used showed a better therapeutic effect of manual interventions over physical and self-therapy. In the T4 and T5 groups, the treatments led to complete resolution of pain after the 10th day of therapy and to the largest minimal clinically significant difference in the MMO and LM parameter. GEE model for PC1 values using treatment method and time point showed that T4, T5 and T6 treatments had the strongest effect on the parameters studied. CONCLUSIONS 1. Exercise SEMG testing is a helpful indicator to assess the therapeutic effectiveness of physiotherapy interventions. 2. Manual therapy treatments are superior to physical treatments in their relaxation and analgesic efficacy and should therefore be prescribed as a first line non-invasive intervention for TMD pain patients.
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Affiliation(s)
- Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, Szczecin, Poland
| | | | - Łukasz Kołodziej
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, Szczecin, Poland
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de Holanda GA, de Holanda TA, Boscato N, Casarin M. Temporomandibular joint involvement in individuals with ankylosing spondylitis: A scoping review. Arch Oral Biol 2023; 146:105609. [PMID: 36565536 DOI: 10.1016/j.archoralbio.2022.105609] [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: 07/19/2022] [Revised: 11/22/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This scoping review aimed to identify the signs and symptoms of temporomandibular joint (TMJ) involvement in individuals with ankylosing spondylitis (AS). DESIGN Systematic literature searches were performed on PubMed, Embase, and Web of Science databases (up to April 2022). Studies with signs and symptoms of temporomandibular joint disorder (TMD) in adults with AS were included. TMJ outcomes were extracted and analyzed qualitatively. RESULTS From 527 potentially eligible studies, 22 were included. A total of 4309 individuals with AS were evaluated, aged between 18 and 80 years, being males approximately 65% of the sample. Signs and symptoms of pain, tenderness to palpation on TMJ and masticatory muscles, joint noises (i.e., clicking or crepitus), limited mouth opening, disc displacement, and radiographic changes were often observed. CONCLUSION The available evidence shows that different signs and symptoms of TMD co-occur with AS disease, with a higher prevalence of TMD observed in individuals with AS than in individuals without AS. Indeed, it seems that individuals suffering from AS disease have an increased risk of developing TMD.
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Affiliation(s)
| | | | - Noéli Boscato
- Graduate Program in Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
| | - Maísa Casarin
- Graduate Program in Dentistry, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil.
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Jalal RA, Ahmed KM, Saeed SM, Qaradaghi TA. Correlation of clinical findings of temporomandibular joint with serological results in rheumatoid arthritis patients. Clin Exp Dent Res 2022; 8:1270-1276. [PMID: 35767468 PMCID: PMC9562840 DOI: 10.1002/cre2.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives Patients and Methods Results
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Affiliation(s)
- Ranj A. Jalal
- Department of Oral Diagnosis, College of Dentistry University of Sulaimani Sulaimaniyah Iraq
| | - Khadija M. Ahmed
- Department of Oral Diagnosis, College of Dentistry University of Sulaimani Sulaimaniyah Iraq
| | - Shahla M. Saeed
- Department of Surgery University of Sulaimani Sulaimaniyah Iraq
| | - Taha A. Qaradaghi
- Bone Mineral Density and Osteoporosis Center, Ministry of Health Sulaimaniyah Internal Medicine Teaching Hospital Sulaimaniyah Iraq
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Mustafa MA, AL-Attas BA, Badr FF, Jadu FM, Wali SO, Bawazir YM. Prevalence and Severity of Temporomandibular Disorders in Rheumatoid Arthritis Patients. Cureus 2022; 14:e21276. [PMID: 35070578 PMCID: PMC8761059 DOI: 10.7759/cureus.21276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The temporomandibular joint (TMJ) is an important joint that plays major functions, including dental occlusion, mastication, and facial expressions. Different diseases can affect the TMJ, including chronic inflammatory arthritis. Rheumatoid arthritis (RA) is the most common inflammatory arthritis worldwide associated with TMJ dysfunction. In this study, we assess the prevalence of TMJ among RA patients based on the Fonseca Anamnestic Index. Methods Eighty-one patients with rheumatoid arthritis were interviewed by a trained physician to fulfill the Fonseca Anamnestic Index questionnaire. All participants underwent a medical file review to collect their sociodemographic data, RA duration, co-existing comorbidities, and different lab results. Result According to the Fonseca score, 29.6% had no temporomandibular disorder (TMD) among RA patients, while 39.5% had mild TMD. Only 6% had severe TMD. The female sex and increased body weight were associated with TMJ disease. Conclusion The majority of rheumatoid arthritis patients (70%) suffer from some degree of temporomandibular joint disorder.
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Gębska M, Dalewski B, Pałka Ł, Kołodziej Ł, Sobolewska E. The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic. Brain Sci 2021; 12:brainsci12010028. [PMID: 35053772 PMCID: PMC8773638 DOI: 10.3390/brainsci12010028] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 11/22/2022] Open
Abstract
Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.
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Affiliation(s)
- Magdalena Gębska
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Bartosz Dalewski
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
| | - Łukasz Pałka
- Private Dental Practice, 68-200 Zary, Poland
- Correspondence:
| | - Łukasz Kołodziej
- Department of Rehabilitation Musculoskeletal System, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.G.); (Ł.K.)
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.D.); (E.S.)
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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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Huang YF, Chang CT, Muo CH, Chiu KM, Tsai CH, Liu SP. Bidirectional relationship between temporomandibular disorder and ankylosing spondylitis: a population-based cohort study. Clin Oral Investig 2021; 25:6377-6384. [PMID: 33855657 DOI: 10.1007/s00784-021-03938-0] [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: 01/10/2021] [Accepted: 04/05/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This study aimed to determine the relation between temporomandibular disorder (TMD) and ankylosing spondylitis (AS) bidirectionally and ascertain the important comorbidities for AS occurrence in TMD patients. MATERIALS AND METHODS We conducted this population-based cohort study through Longitudinal Health Insurance Database, Taiwan. Study 1 investigated the risk of TMD in AS patients. Study 2 assessed the risk of AS in TMD patients. RESULTS In total, 3204 AS patients and 12,816 age-matched and gender-matched comparisons were enrolled in study 1. The TMD incidence in the AS cohort was 2.88-fold higher when compared with the comparisons (1.54 vs. 0.53 per 10,000 person-years). After adjusting for age, gender, and comorbidity, the AS cohort had a 2.66-fold (95% CI = 1.79-3.97) increased risk of TMD occurrence (P < 0.0001). The second study recruited 4998 TMD patients and 19,991 age-matched and gender-matched comparisons. Both TMD and comparison cohorts showed similar AS risk (HR = 1.49, 95% CI = 0.91-2.43, P = 0.1108) in the adjusted model. Study 2 identified a 3.66-fold increased risk of AS occurrence in TMD patients with comorbidity, including parapsoriasis, rheumatoid arthritis, osteoporosis, Cushing's syndrome, and climacteric arthritis (P < 0.012). CONCLUSIONS AS appears to significantly impact the occurrence of TMD. TMD might play a synergic role in AS development. CLINICAL RELEVANCE Clinicians have to be vigilant about the increased risk of TMD in AS patients and take care of AS disease activity and prognosis. The symptoms and signs of TMD could be a predictor of AS in patients with the aforementioned comorbidities.
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Affiliation(s)
- Yi-Fang Huang
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan.,School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan.,Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Chung-Ta Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan. .,Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist, New Taipei City, 22056, Taiwan. .,Graduate Institute of Medicine, Yuan Ze University, Taoyuan, 32003, Taiwan.
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan
| | - Kuan-Ming Chiu
- Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City, 22056, Taiwan.,Department of Nursing, Oriental Institute of Technology, New Taipei City, 22056, Taiwan.,Department of Electrical Engineering, Yuan Ze University, Taoyuan, 32003, Taiwan
| | - Chun-Hao Tsai
- Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan.,Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Shih-Ping Liu
- Program for Aging, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 40402, Taiwan. .,Center for Translational Medicine, China Medical University and Hospital, Taichung, 40402, Taiwan. .,Department of Social Work, Asia University, Taichung, 41354, Taiwan.
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12
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Covert L, Mater HV, Hechler BL. Comprehensive Management of Rheumatic Diseases Affecting the Temporomandibular Joint. Diagnostics (Basel) 2021; 11:diagnostics11030409. [PMID: 33673675 PMCID: PMC7997293 DOI: 10.3390/diagnostics11030409] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/18/2022] Open
Abstract
The temporomandibular joint (TMJ) is a synovial joint and thus is vulnerable to the afflictions that may affect other joints in the fields of rheumatology and orthopedics. Too often temporomandibular complaints are seen strictly as dental or orofacial concerns. Similarly, patients with known rheumatic disease may not have their TMJs included in routine screening and monitoring protocols. The purpose of this review is to highlight the rheumatic conditions likely to affect the TMJ and outline medical and surgical management in these patients with a focus on the need for continued patient reassessment and monitoring.
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Affiliation(s)
- Lauren Covert
- Department of Pediatrics, Division of Rheumatology, Duke University Hospitals, Durham, NC 27710, USA; (L.C.); (H.V.M.)
| | - Heather Van Mater
- Department of Pediatrics, Division of Rheumatology, Duke University Hospitals, Durham, NC 27710, USA; (L.C.); (H.V.M.)
| | - Benjamin L. Hechler
- Department of Surgery, Division of Plastic, Maxillofacial, and Oral Surgery, Duke University Hospitals, Durham, NC 27710, USA
- Department of Head and Neck Surgery and Communication Sciences, Duke University Hospitals, Durham, NC 27710, USA
- Correspondence:
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13
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Braido GVDV, Campi LB, Jordani PC, Fernandes G, GonÇalves DADG. Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents. J Appl Oral Sci 2020; 28:e20190608. [PMID: 32901693 PMCID: PMC7480668 DOI: 10.1590/1678-7757-2019-0608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 07/07/2020] [Indexed: 11/25/2022] Open
Abstract
Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification.
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Affiliation(s)
- Guilherme Vinícius do Vale Braido
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Leticia Bueno Campi
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Paula Cristina Jordani
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Giovana Fernandes
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
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14
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Kmeid E, Nacouzi M, Hallit S, Rohayem Z. Prevalence of temporomandibular joint disorder in the Lebanese population, and its association with depression, anxiety, and stress. Head Face Med 2020; 16:19. [PMID: 32887633 PMCID: PMC7650519 DOI: 10.1186/s13005-020-00234-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022] Open
Abstract
Background The objectives of this study were to study the prevalence of temporomandibular joint disorder (TMD) and its association with anxiety, depression, and stress among the general Lebanese population as well as in a sample of patients recruited from an otolaryngologist clinic. Methods A cross-sectional study was conducted between September 2018 and December 2019, which enrolled 459 participants from all districts of Lebanon (sample 1) and 37 patients from the otolaryngologist clinic at the Eye and Ear Hospital (sample 2). The temporomandibular disorder screening checklist was used to screen for temporomandibular joint disorder. The Fonseca’s anamnestic index was used to assess for temporomandibular joint disorder related signs and symptoms, as well as for symptoms severity. Results The results showed that 19.7% of the general Lebanese population had TMD, from which 55.9% were female. In contrast, 59.5% of patients in the sample recruited from the clinic were found to have TMD. Higher stress, anxiety, and depression scores were associated with higher temporomandibular disorder severity score (B = 0.23; B = 0.10 and B = 0.10 respectively). Patients in the sample recruited from the clinic had higher mean stress (20.75 vs 11.43), anxiety (12.46 vs 5.78), depression (13.24 vs 6.52), and temporomandibular disorder severity scores (59.5% vs 19.7%) than the general population. Conclusion Temporomandibular joint disorder appears to be associated significantly with depression, anxiety, and stress and remains largely underdiagnosed in the general population.
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Affiliation(s)
- Elio Kmeid
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Mansour Nacouzi
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Department of otorhinolaryngology, Eye and Ear Hospital, Naccache, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie- Liban, Beirut, Lebanon.
| | - Ziad Rohayem
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,Department of otorhinolaryngology, Eye and Ear Hospital, Naccache, Lebanon.
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15
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Correlation between TM joint disease and rheumatic diseases detected on bone scintigraphy and clinical factors. Sci Rep 2020; 10:4547. [PMID: 32161274 PMCID: PMC7066130 DOI: 10.1038/s41598-020-60804-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 02/17/2020] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to evaluate the effect of rheumatic disease as a risk factor for temporomandibular disease (TMD). A total of 143 outpatients reporting symptoms indicating rheumatic disease at their first visit to the rheumatology clinic were included. We evaluated the temporomandibular joint (TMJ) with scintigraphic images, and standard questionnaires were administered for the symptomatic assessment for all patients. The patients were classified into ‘healthy controls’ or as per their diagnosis into ‘osteoarthritis’, ‘axial spondyloarthritis’, ‘peripheral spondyloarthritis’, ‘rheumatoid arthritis’, or ‘other rheumatic diseases’ groups. The patients were also differentiated depending on the presence or absence of axial involvement. The relation between the rheumatic disease type and findings at the TMJ were evaluated using statistical analyses. Axial spondyloarthritis, peripheral spondyloarthritis, and rheumatic arthritis patients showed significantly higher scintigraphic uptake at the TMJ compared with those in the control and osteoarthritis groups (axial spondyloarthritis: 4.5, peripheral spondyloarthritis: 4.5, rheumatoid arthritis: 4.09, control: 3.5, osteoarthritis: 3.4, p < 0.0001). Compared with patients without axial involvement, patients with axial involvement also showed significantly higher TMJ scintigraphic uptake (axial involvement: 4.24, without axial involvement: 3.50, p < 0.0001) with elevated symptomatic rates in TMD (axial involvement: 17.82, without axial involvement: 9.97, p < 0.005).
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16
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Benli M, Batool F, Stutz C, Petit C, Jung S, Huck O. Orofacial manifestations and dental management of systemic lupus erythematosus: A review. Oral Dis 2020; 27:151-167. [PMID: 31886584 DOI: 10.1111/odi.13271] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/14/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease with numerous clinical manifestations. There is no consensus about the ideal oral management for this group of patients to date. This review aimed to describe the broad spectrum of orofacial and clinical manifestations and their therapeutic approaches. Studies concerning orofacial manifestations of SLE and dental treatment modalities were selected by a literature search (1978-2019) using Google Scholar, PubMed/MEDLINE electronic databases. The initial search strategy provided a total of 129 articles, and of these, 30 were included for qualitative synthesis. The reviewed studies revealed that SLE patients are more at risk of compromised oral and dental health exhibiting increased risk of periodontal diseases and temporomandibular joint disorders. The use of systemic drugs especially immunosuppressive and anticoagulants in SLE patients may also influence their oral management. Results emphasize the need to carry out, at an early stage of the disease, an appropriate oral management of these patients to improve oral health-related quality of life and to prevent the need of more invasive therapeutics. A multidisciplinary approach is needed for dental and medical management of such patients.
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Affiliation(s)
- Merve Benli
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Fareeha Batool
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Céline Stutz
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Petit
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sophie Jung
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,CNRS UPR 3572 "Immunologie, Immunopathologie et Chimie Thérapeutique (I2CT)", Institut de Biologie Moléculaire et Cellulaire (IBMC), Strasbourg, France
| | - Olivier Huck
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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17
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Crincoli V, Piancino MG, Iannone F, Errede M, Di Comite M. Temporomandibular Disorders and Oral Features in Systemic Lupus Erythematosus Patients: An Observational Study of Symptoms and Signs. Int J Med Sci 2020; 17:153-160. [PMID: 32038098 PMCID: PMC6990878 DOI: 10.7150/ijms.38914] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022] Open
Abstract
Aims: Systemic Lupus Erythematosus (SLE) is a connective tissue disease characterized by a wide range of pleomorphic pictures, including mucocutaneous, renal, musculoskeletal and neurological symptoms. It involves oral tissues, with hyposalivation, tooth decay, gingivitis, angular cheilitis, ulcers and glossitis. Temporomandibular disorders represent a heterogeneous group of inflammatory or degenerative diseases of the stomatognatic system, with algic and/or dysfunctional clinical features involving temporomandibular joint (TMJ) and related masticatory muscles. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in SLE patients (Lp) compared with a control group. Methods: Fifty-five patients (9 men and 46 women) with diagnosed Lupus were recruited in the study group. A randomly selected group of 55 patients, matched by sex and age, served as control group. The examination for TMD symptoms and signs was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination. Results: Lupus patients complained more frequently (95.8%) of oral and TMJ symptoms (dysgeusia, stomatodynia, masticatory muscle pain during function, neck and shoulder muscles pain and presence of tinnitus) but only xerostomia (χ2=4,1548 p=0,0415), temple headache (χ2=4,4542 p=0,035) and the sensation of a stuck jaw (Mid-p-test p=0,043) were significant. About signs, cheilitis (p=0,0284) oral ulcers (χ2=4,0104 p=0,045) and fissured tongue are significantly more frequent in study group. The salivary flow was significantly decreased in the study group respect to the control one (p<0.0001). As regard to the oral kinematics, restricted movements (RM) in protrusion and left lateral movement were significantly different between study group and controls. In particular, 85,2% of Lp showed limited protrusion versus 56,4% of controls (χ2= 10,91 p<0,001); 59,3% of Lp had also a limitation during left lateral movement versus 47,3% of controls (T=2,225 p=0,0282). About bruxism, only the indentations on the lateral edges of the tongue were found in Lp group (72,7%), with a significant difference respect to controls (χ2=7,37 p=0,007). Conclusions: While masticatory muscles have an overlapping behavior in both groups, the findings collected show a more severe TMJ kinematic impairment in Lp than in controls, with protrusion and left lateral movements significantly different. In addition, a remarkable reduction of salivary flow has been detected in Lp compared to controls. In conclusion, this autoimmune disease seems to play a role in oral manifestations and TMJ disorders, causing an increase in orofacial pain and an altered chewing function.
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Affiliation(s)
- Vito Crincoli
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Italy
| | | | - Florenzo Iannone
- Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Italy
| | - Mariella Errede
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Italy
| | - Mariasevera Di Comite
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Italy
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18
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Oral health and orofacial function in patients with rheumatoid arthritis. Rheumatol Int 2019; 40:445-453. [PMID: 31531708 DOI: 10.1007/s00296-019-04440-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/31/2019] [Indexed: 02/08/2023]
Abstract
The aim of the study was to describe the oral health and orofacial function of Mexican patients with rheumatoid arthritis (RA) and their association with clinical and radiological aspects of the disease. Patients with RA received a complete odontological exam, which also included a clinical and radiographic assessment of the temporomandibular joint (TMJ). The rheumatologic assessment included detailed profiling of the disease and serological and radiographic parameters. The study included 62 RA patients; the median (min-max) age was 51 (18-72) years old and 8.5 (1-39) years of disease duration. The 63.6% of the patients had DAS28 ≥ 3.2, and a median (min-max) of Sharp/van der Heijde score (SvdHS) of 41 (0-214). 98.3% of the patients presented caries, which were severe in 53.3% of the cases. The 73.8% of the patients were missing teeth due to caries, with a median (min-max) of 4 (0-32) teeth missing per patient. Oral hygiene was classified as bad in 49.1% of patients and only 15.3% of them had a healthy periodontium. The TMJ function was abnormal in 98.4% of the patients and 62.9% of them presented moderate or severe TMJ disorder (TMD). The radiographic damage of the TMJ correlated positively with the SvdHS. No correlations were found between disease activity or structural progression and orofacial variables, including periodontitis. There are severe oral and orofacial health problems in RA patients despite having medical attention for their disease. Multidisciplinary management remains an area of opportunity for both the medical specialists and the health system in our country.
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19
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Naujokat H, Sengebusch A, Möller B, Wieker H, Açil Y, Wiltfang J. Antigen-induced arthritis of the temporomandibular joint via repeated injections of bovine serum albumin in domestic pigs. J Craniomaxillofac Surg 2019; 47:932-939. [PMID: 30910433 DOI: 10.1016/j.jcms.2019.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/07/2019] [Accepted: 03/01/2019] [Indexed: 01/28/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease and the temporomandibular joint (TMJ) is affected in up to 50%, resulting in pain, limited mouth opening and dental malocclusion. The outcome of conservative and surgical therapies is unsatisfying in many cases. The purpose of this study was to establish a large animal model of antigen-induced arthritis (AIA) of the TMJ that enables the investigation of the pathogenesis of RA and the evaluation of new therapies. In five domestic pigs, systemic immunization was performed via consecutive intramuscular injections of bovine serum albumin (BSA). Then, AIA was induced via the application of BSA into the TMJ. Injection with saline served as the control. After ten weeks, the joints and adjacent tissues were harvested for histological analysis and cytokine quantification. The changes observed in the AIA specimens included severe synovial inflammation, cartilage-specific glycosaminoglycan content loss, and cartilage surface and discus alterations as well as the formation of chondrocyte clusters. Protein analyses of the synovia showed enhanced levels of IL-1β, IL-6, TNFα and VEGF. A porcine model of immunologic arthritis of the TMJ was successfully established. This model may be used in future studies to investigate the underlying pathogenesis of RA and new therapeutic strategies.
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Affiliation(s)
- Hendrik Naujokat
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany.
| | - André Sengebusch
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Björn Möller
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Henning Wieker
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Yahya Açil
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
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20
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González-Chávez SA, Pacheco-Tena C, Campos Torres RM, Quiñonez-Flores CM, Reyes-Cordero G, Caraveo Frescas TDJ. Temporomandibular and Odontological Abnormalities in Patients with Rheumatoid Arthritis. ACTA ACUST UNITED AC 2018; 16:262-271. [PMID: 30097330 DOI: 10.1016/j.reuma.2018.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/20/2018] [Accepted: 07/06/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination.
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Affiliation(s)
| | - César Pacheco-Tena
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México.
| | - Rosa María Campos Torres
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México; Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
| | | | - Greta Reyes-Cordero
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
| | - Teresita de Jesús Caraveo Frescas
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México; Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, Chihuahua, México
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21
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Gilheaney Ó, Zgaga L, Harpur I, Sheaf G, Kiefer L, Béchet S, Walshe M. The Prevalence of Oropharyngeal Dysphagia in Adults Presenting with Temporomandibular Disorders Associated with Rheumatoid Arthritis: A Systematic Review and Meta-analysis. Dysphagia 2017; 32:587-600. [PMID: 28508937 DOI: 10.1007/s00455-017-9808-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 05/10/2017] [Indexed: 01/03/2023]
Abstract
Temporomandibular disorders (TMDs) are the most frequent non-dental orofacial pain disorders and may be associated with rheumatoid arthritis (RA), resulting in oropharyngeal dysphagia (OD). However, clinicians' understanding of involvement with OD caused by RA-related TMDs is limited and the methodological quality of research in this field has been criticised. Therefore, the aim of this study was to systematically review the prevalence of oral preparatory and oral stage signs and symptoms of OD in adults presenting with TMDs associated with RA. A systematic review of the literature was completed. The following electronic databases were searched from inception to February 2016, with no date/language restriction: EMBASE, PubMed, CINAHL, Web of Science, Elsevier Scopus, Science Direct, AMED, The Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses A & I. Grey literature and reference lists of the included studies were also searched. Studies reporting the frequency of OD in adults presenting with TMD and RA were included. Study eligibility and quality were assessed by three independent reviewers. Methodological quality was assessed using the Down's and Black tool. The search yielded 19 eligible studies. Typical difficulties experienced by RA patients included impaired swallowing (24.63%), impaired masticatory ability (30.69%), masticatory pain (35.58%), and masticatory fatigue (21.26%). No eligible studies reported figures relating to the prevalence of weight loss. Eligible studies were deemed on average to be of moderate quality. Study limitations included the small number of studies which met the inclusion criteria and the limited amount of studies utilising objective assessments. Valid and reliable prospective research is urgently required to address the assessment and treatment of swallowing difficulties in RA as TMJ involvement may produce signs and symptoms of OD.
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Affiliation(s)
- Órla Gilheaney
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland.
| | - Lina Zgaga
- Department of Public Health and Primary Care, Trinity College Centre for Health Sciences, Tallaght Hospital, Dublin 24, Ireland
| | - Isolde Harpur
- Library of Trinity College Dublin, Trinity College Dublin, Dublin 2, Ireland
| | - Greg Sheaf
- Library of Trinity College Dublin, Trinity College Dublin, Dublin 2, Ireland
| | - Liss Kiefer
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland
| | - Sibylle Béchet
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, 7-9 South Leinster Street, Dublin 2, Ireland
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Zhang X, Chen F, Chen L, Li B, Xu S, Cui D, Yu L, Liu M, Shi X, Li Q, Li Y. Symptoms and signs of temporomandibular disorders in patients with knee osteoarthritis. Int Dent J 2017; 67:78-84. [DOI: 10.1111/idj.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Yıldızer Keriş E, Yaman SD, Demirağ MD, Haznedaroğlu Ş. Temporomandibular joint findings in patients with rheumatoid arthritis, ankylosing spondylitis, and primary Sjögren's syndrome. ACTA ACUST UNITED AC 2016; 8. [PMID: 27989011 DOI: 10.1111/jicd.12255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/22/2016] [Indexed: 01/22/2023]
Abstract
AIM The aim of the present study was to investigate the prevalence of temporomandibular joint (TMJ) symptoms in rheumatoid arthritis (RA), primary Sjögren's syndrome (pSS), and ankylosing spondylitis (AS) patients. METHODS The present study consisted of 79 individuals with various rheumatic disease (study group: 39 with RA, 17 with AS, 23 with pSS) and 79 age- and sex-matched healthy controls (control group). Subjective symptoms of the TMJ were recorded by means of a questionnaire. And stomatognathic examination was then performed. RESULTS The prevalence of subjective symptoms in patients with rheumatic disease (73.4%) were significantly higher than that of the controls (22.8%; P<.05). The most common objective symptoms were pain during lateral TMJ palpation (29.1% of patients overall, 8.9% of controls) and mandibular movements (19% of patients overall, 2.5% of controls), and muscle pain during palpation (38% of patients overall, 3.8% of controls). They were significantly higher in all of the rheumatic patients than the controls (P<.05). There was not a statistically-significant difference in the values for mandibular movements between the study and control groups (P>.05, Mann-Whitney U test). CONCLUSIONS TMJ symptoms were observed to be higher in the patients with RA, AS and pSS than the control group. Dentists and rheumatologists should be aware of TMJ symptoms in patients with rheumatic diseases.
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Affiliation(s)
| | | | | | - Şeminur Haznedaroğlu
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Ismail F, Eisenburger M, Lange K, Schneller T, Schwabe L, Strempel J, Stiesch M. Identification of psychological comorbidity in TMD-patients. Cranio 2016; 34:182-7. [DOI: 10.1179/2151090315y.0000000008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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