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Yule PL, Durham J, Playford H, Moufti MA, Steele J, Steen N, Wassell RW, Ohrbach R. OHIP
‐
TMD
s: a patient‐reported outcome measure for temporomandibular disorders. Community Dent Oral Epidemiol 2015; 43:461-70. [DOI: 10.1111/cdoe.12171] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 04/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Pamela L. Yule
- Restorative Department Newcastle Dental Hospital Newcastle upon Tyne UK
| | - Justin Durham
- Centre for Oral Health Research and Institute of Health and Society Newcastle University Newcastle upon Tyne UK
| | - Hannah Playford
- School of Dental Sciences Newcastle University Newcastle upon Tyne UK
| | - Mohammed Adel Moufti
- Restorative and Aesthetic Dentistry School of Dentistry University of Manchester Manchester UK
| | - Jimmy Steele
- Centre for Oral Health Research & School of Dental Sciences Newcastle University Newcastle upon Tyne UK
| | - Nick Steen
- Institute of Health and Society Newcastle University Newcastle upon Tyne UK
| | - Robert W. Wassell
- Centre for Oral Health Research & School of Dental Sciences Newcastle University Newcastle upon Tyne UK
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences SUNY – Buffalo School of Dentistry Buffalo NY USA
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152
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Silvola AS, Tolvanen M, Rusanen J, Sipilä K, Lahti S, Pirttiniemi P. Do changes in oral health-related quality-of-life, facial pain and temporomandibular disorders correlate after treatment of severe malocclusion? Acta Odontol Scand 2015; 74:44-50. [PMID: 25936383 DOI: 10.3109/00016357.2015.1040063] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The aim was to evaluate the relationships of changes in facial pain, temporomandibular disorders (TMDs) and oral health-related quality-of-life (OHRQoL) in adults who underwent orthodontic or orthodontic/surgical treatment. METHODS Sixty-four patients (46 women, 18 men, range 18-64 years) with severe malocclusion and functional problems were treated in Oulu University Hospital. Of these, 44 underwent orthodontic-surgical and 20 orthodontic treatment. Data were collected with questionnaires and clinical stomatognathic examinations before and on average 3 years after treatment. The OHRQoL was measured with OHIP-14 (The Oral Health Impact Profile), the intensity of facial pain with the Visual Analogue Scale (VAS) and the severity of TMD with the Helkimo's anamnestic (Ai) and clinical (Di) dysfunction indices. RESULTS A significant improvement was found in facial pain, signs and symptoms of TMD and OHRQoL after the treatment (p < 0.05). The decrease in VAS was associated with improvement in OHIP-14 severity (r = 0.296, p = 0.019). The correlations between changes in OHIP-14 severity and Ai and Di were not statistically significant. CONCLUSION Treatment of severe malocclusion seemed to improve OHRQoL via decreased facial pain. Decreased facial pain was associated especially with improved OHRQoL dimensions of physical pain, physical disability and social disability.
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Affiliation(s)
- Anna-Sofia Silvola
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
| | - Mimmi Tolvanen
- b 2 Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku, Finland
| | - Jaana Rusanen
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
| | - Kirsi Sipilä
- c 3 Institute of Dentistry, University of Eastern Finland , Kuopio, Finland
- d 4 Kuopio University Hospital , Kuopio, Finland
| | - Satu Lahti
- b 2 Department of Community Dentistry, Institute of Dentistry, University of Turku , Turku, Finland
| | - Pertti Pirttiniemi
- a 1 Department of Orthodontics, Oral Health Sciences, Faculty of Medicine, University of Oulu, MRC, Oulu University Hospital , Oulu, Finland
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153
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Johnston K, Bird L, Bright P. Temporomandibular joint effusion and its relationship with perceived disability assessed using musculoskeletal ultrasound and a patient-reported disability index. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2015; 23:90-6. [PMID: 27433242 DOI: 10.1177/1742271x14568608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The relationship between effusion of the temporomandibular joint (TMJ) and patient-reported disability is poorly researched. This pilot study explored the link between TMJ inflammation as measured by ultrasound and patient disability assessed by the Steigerwald Maher TMD Disability Index (SMTDI). The study design used a prospective correlational approach involving a sample with TMJ dysfunction (TMD). Twenty-four patients were recruited from the European School of Osteopathy and a Kent dental practice. Participants completed the SMTDI to determine the level of TMD (symptomatic score >20). A SonoSite SLA "Hockey Stick" [13-6 MHz] musculo-skeletal transducer was placed over the TMJ in a transverse direction and effusion was calculated indirectly by measuring capsular width. An upper left quadrant protocol was used throughout. A regression analysis was run with participants' gender, age and capsular width as predictor variables modelled against reported SMTDI. Larger capsular widths were found to be significant predictors of SMTDI scores (r = 0.803, p < 0.0001). The patient profile matched with the previous studies and the TMD sufferer population, indicating external validity. Results suggest that the SMTDI could be integrated into practice life as a quick, accessible and easy tool to monitor patients' progress and assess levels of inflammation, without the need for repetitive imaging. The study design proved reproducible and a larger scale study is indicated.
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Affiliation(s)
- Katie Johnston
- European School of Osteopathy, University of Greenwich, Maidstone, Kent, UK
| | - Lance Bird
- European School of Osteopathy, University of Greenwich, Maidstone, Kent, UK
| | - Phillip Bright
- European School of Osteopathy, University of Greenwich, Maidstone, Kent, UK
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154
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Silva PFDC, Biasotto-Gonzalez DA, Motta LJ, Silva SM, Ferrari RAM, Fernandes KPS, Bussadori SK. Impact in oral health and the prevalence of temporomandibular disorder in individuals with Parkinson's disease. J Phys Ther Sci 2015; 27:887-91. [PMID: 25931752 PMCID: PMC4395736 DOI: 10.1589/jpts.27.887] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 11/07/2014] [Indexed: 12/14/2022] Open
Abstract
The aims of the present study were to investigate the prevalence of temporomandibular
disorder (TMD) in a group of patients with Parkinson’s disease (PD), and to analyze oral
health according to the severity of the disease. [Methods] Signs and symptoms of TMD were
evaluated using the Research Diagnostic Criteria for Temporomandibular Disorders, and oral
health impact was measured using the Oral Health Impact Profile. The unpaired Student’s
t-test was used to compare groups with and without TMD. Pearson’s correlation coefficients
were calculated to determine correlations between the level of functional independence and
oral health impact. Fisher’s exact test was used to test the association between TMD and
the severity of symptoms of PD. [Results] Fifty-nine individuals with PD were analyzed.
The prevalence of TMD was 20.33%. No statistically significant associations were found
between TMD and the severity of PD. Oral health impact was considered weak, but a
statistically significant difference between groups with and without TMD was found for
psychological disability (p = 0.003). No significant correlation was found between the
level of functional independence and oral health impact. [Conclusion] The prevalence of
TMD among patients with Parkinson’s disease was 20.33%. A statistically significant
difference between groups with and without TMD was found regarding the psychological
disability domain.
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155
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Durham J, Steele JG, Breckons M, Story W, Vale L. DEEP Study: does EQ-5D-5L measure the impacts of persistent oro-facial pain? J Oral Rehabil 2015; 42:643-50. [PMID: 25818477 DOI: 10.1111/joor.12296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2015] [Indexed: 11/27/2022]
Abstract
The EQ-5D-5L is a generic quality of life (QOL) measure widely used throughout the world, which has the advantage that it allows health-state preferences to be elicited. The aim of this study was to examine whether: a) variation in the standardised reference period for EQ-5D-5L from 'today' to 'the last month' had a minimal clinically meaningful difference; (b) EQ-5D-5L had convergent validity with a multidimensional pain measure in quantifying the impacts of pain. As part of a larger study into the effectiveness and efficiency of care pathways for persistent orofacial pain (POFP) (http://research.ncl.ac.uk/deepstudy), participants with POFP (n = 100) completed two versions of the EQ-5D-5L at the same time with different reference periods ('today' vs. 'last month'). Participants also completed the first section of the West Haven-Yale Multidimensional Pain Inventory (v3) to assess convergent validity. Two-tailed nonparametric inferential statistics, intra-class correlation coefficients (ICC), and within-subject change scores were used to compare the two EQ-5D-5L versions. Convergent validity was assessed using Spearman's rho correlation coefficients. Health-state valuations were significantly different (P < 0.01), and there was good similarity between the two versions' ICC 0.86 (95% CI 0.79-0.91). The within-subject mean change was 0.03 (95% CI 0.01-0.06). For convergent validity, all relationships were significant (P < 0.05) and in the expected directions. EQ-5D-5L demonstrates sufficient convergent validity to be used with POFP, and a change in the standard reference period may be unnecessary if a multidimensional pain measure is also used.
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Affiliation(s)
- J Durham
- Centre for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, NE2 4BW, UK.,Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - J G Steele
- Centre for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, NE2 4BW, UK.,Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - M Breckons
- Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK
| | - W Story
- Centre for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, NE2 4BW, UK
| | - L Vale
- Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK
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156
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Yekkalam N, Wänman A. Associations between craniomandibular disorders, sociodemographic factors and self-perceived general and oral health in an adult population. Acta Odontol Scand 2014; 72:1054-65. [PMID: 25220523 DOI: 10.3109/00016357.2014.949843] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the relationships between pain in the craniomandibular region and jaw dysfunction, respectively, to sociodemographic factors and self-perceived general and oral health in a middle-aged and elderly population in Västerbotten County, Sweden. MATERIALS AND METHODS Six hundred individuals, 35-, 50-, 65- and 75 years old, from inland and 600 individuals from coastal areas were randomly selected in 2002. Of these, 987 individuals completed a questionnaire and 779 participated in a clinical examination. Thirty-five- and 50-year-olds together constituted a middle-aged group and the rest an elderly group. RESULTS Among the middle-aged, craniomandibular pain was associated with impaired general health status, signs of temporomandibular disorder (TMD) pain were associated with female gender and living alone, jaw dysfunction symptoms were associated with university degree and chewing with caution; and signs of TMD dysfunction were associated with female gender and living in the more densely populated coastal region. Among the elderly, craniomandibular pain was more common among those living in the inland region, craniomandibular pain and signs of TMD pain were associated with impaired general health status, jaw dysfunction symptoms were associated with higher education level and self-perceived impaired general health and oral health; and signs of TMD dysfunction were associated with female gender and living in the coastal region. Dental status was not associated with craniomandibular pain. CONCLUSIONS Socioeconomic factors and impaired general state of health were related to signs and symptoms indicative of CMD. These factors may influence demand for treatment among the affected.
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Affiliation(s)
- Negin Yekkalam
- Department of Clinical Oral Physiology, Umeå University , Umeå , Sweden
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157
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Ahola K, Saarinen A, Kuuliala A, Leirisalo-Repo M, Murtomaa H, Meurman JH. Impact of rheumatic diseases on oral health and quality of life. Oral Dis 2014; 21:342-8. [PMID: 25158802 DOI: 10.1111/odi.12285] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/15/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We investigated the effects of rheumatic diseases on oral symptoms, health habits, and quality of life in subjects with and without rheumatic diseases. The hypothesis was that patients with rheumatic diseases have more oral symptoms impairing their quality of life than healthy controls. METHODS A questionnaire was mailed to a random sample of 1500 members of the Finnish Rheumatism Association, including those with and without rheumatic diseases. We focused on symptoms of the mouth and temporomandibular area, and health habits. Oral Health Impact Profile (OHIP14) was used to evaluate the oral health-related quality of life. We analyzed differences between subjects with and without rheumatic diseases, controlled for age, gender, smoking, and non-rheumatic chronic diseases. RESULTS Completed questionnaires were received from 995 participants (response rate 66%). Of them, 564 reported rheumatic disease, 431 were used as controls. The patients reported significantly more all orofacial symptoms than controls. Severe dry mouth was reported by 19.6% of patients and 2.9% of controls (P < 0.001), and temporomandibular joint symptoms by 59.2% and 27.2% (P < 0.001), respectively. In the OHIP-14 questionnaire, the mean total score was significantly higher in patients (8.80 ± 11.15) than in controls (3.93 ± 6.60; P < 0.001). CONCLUSION The study hypothesis was confirmed by showing that the patients with rheumatic diseases reported oral discomfort and reduced quality of life more often when compared with controls.
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Affiliation(s)
- K Ahola
- Institute of Dentistry, University of Helsinki, Helsinki, Finland
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158
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Su N, Yang X, Liu Y, Huang Y, Shi Z. Evaluation of arthrocentesis with hyaluronic acid injection plus oral glucosamine hydrochloride for temporomandibular joint osteoarthritis in oral-health-related quality of life. J Craniomaxillofac Surg 2014; 42:846-51. [DOI: 10.1016/j.jcms.2013.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 09/24/2013] [Accepted: 12/17/2013] [Indexed: 01/25/2023] Open
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159
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Spontaneous neural activity alterations in temporomandibular disorders: a cross-sectional and longitudinal resting-state functional magnetic resonance imaging study. Neuroscience 2014; 278:1-10. [PMID: 25110816 DOI: 10.1016/j.neuroscience.2014.07.067] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/31/2014] [Accepted: 07/31/2014] [Indexed: 02/05/2023]
Abstract
The involvement of the central nervous system in the pathophysiology of temporomandibular disorders (TMD) has been noticed. TMD patients have been shown dysfunction of motor performance and reduced cognitive ability in neuropsychological tests. The aim of this study is to explore the spontaneous neural activity in TMD patients with centric relation (CR)-maximum intercuspation (MI) discrepancy before and after stabilization splint treatment. Twenty-three patients and twenty controls underwent clinical evaluations, including CR-MI discrepancy, Helkimo indices and chronic pain, and resting state functional magnetic resonance imaging scans at baseline. Eleven patients repeated the evaluations and scanning after the initial wearing (T1) and 3months of wearing (T2) of the stabilization splint. The fractional amplitude of low-frequency fluctuation (fALFF) was calculated to compare the neural functions. At baseline, the patients showed decreased fALFF in the left precentral gyrus, supplementary motor area, middle frontal gyrus and right orbitofrontal cortex compared with the controls (P<0.05, AlphaSim corrected). Negative correlations were found between the fALFF in the left precentral gyrus and vertical CR-MI discrepancy of bilateral temporomandibular joints of patients (P<0.05, two-tailed). At T2, the symptoms and signs of the patients were improved, and a stable condylar position on the CR was recovered, with increased fALFF in the left precentral gyrus and left posterior insula compared with pretreatment. The fALFF decrease in the patients before treatment was no longer evident at T2 compared with the controls. The results suggested that TMD patients with CR-MI discrepancy showed significantly decreased brain activity in their frontal cortexes. The stabilization splint elicited functional recovery in these cortical areas. These findings provided insight into the cortical neuroplastic processes underlying TMD with CR-MI discrepancy and the therapeutic mechanisms of stabilization splint.
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160
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Yekkalam N, Wänman A. Prevalence of signs and symptoms indicative of temporomandibular disorders and headaches in 35-, 50-, 65- and 75-year-olds living in Västerbotten, Sweden. Acta Odontol Scand 2014; 72:458-65. [PMID: 24417523 DOI: 10.3109/00016357.2013.860620] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to analyze and compare prevalence of signs and frequently occurring symptoms indicative of temporomandibular disorder (TMD) and headaches in 35-, 50-, 65- and 75-year-old men and women in Västerbotten County, Sweden. MATERIALS AND METHODS From a total target population of 11 324 subjects living in Västerbotten County in the year 2002, 300 individuals in each age group were randomly selected. Of these, 998 (82% response rate) answered and returned a postal questionnaire and 779 (65% response rate) individuals accepted a clinical examination. RESULTS The prevalence of frequent TMD symptoms peaked among 50-year-old women and then declined. Women at this age reported significantly higher prevalence compared to men for all TMD symptoms except temporomandibular joint locking. In the 65- and 75-year-olds, the prevalence was practically equal between men and women as well as between these ages. Frequent headaches showed the highest prevalence among 35- and 50-year-old women, with a statistically significant difference between men and women of 50 years of age (p < 0.05). Fifty-year-old women had statistically significantly higher prevalence of muscle pain to palpation (p < 0.001), temporomandibular joint sounds (p < 0.01) and impaired maximal jaw opening capacity (p < 0.01), compared to 50-year-old men. CONCLUSIONS The different symptoms indicative of TMD and headaches showed a similar pattern, with higher prevalence among the 35- and 50-year-old, as compared to the 65- and 75-year-old, participants. The pattern may be related to biological, psychosocial or generation-related factors.
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Affiliation(s)
- Negin Yekkalam
- Department of Clinical Oral Physiology, University of Umeå , Umeå , Sweden
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161
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Lodetti G, Marano G, Fontana P, Tartaglia GM, Maria de Felício C, Biganzoli E, Sforza C. Surface electromyography and magnetic resonance imaging of the masticatory muscles in patients with arthrogenous temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:248-56. [DOI: 10.1016/j.oooo.2014.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/06/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
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162
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Cioffi I, Perrotta S, Ammendola L, Cimino R, Vollaro S, Paduano S, Michelotti A. Social impairment of individuals suffering from different types of chronic orofacial pain. Prog Orthod 2014; 15:27. [PMID: 24935241 PMCID: PMC4047491 DOI: 10.1186/s40510-014-0027-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 01/16/2014] [Indexed: 11/13/2022] Open
Abstract
Background The daily life of patients suffering from orofacial pain is considerably impaired as compared to healthy subjects. The aim of this study was to investigate the influence of different categories of orofacial pain on the habitual life of adult individuals. Methods Seven hundred eighty-one individuals with orofacial pain were recruited from an initial sample of 1,058 patients. All the individuals were allocated to groups according to their diagnosis: myofascial pain (group A, 676 subjects, 525 females and 151 males; mean age ± SD = 35.2 ± 12.6), migraine (group B, 39 subjects, 29 females and 10 males; mean age ± SD 36.0 ± 10.7), and both myofascial pain and migraine (group C, 66 subjects, 56 females and 10 males, mean age ± SD = 35.6 ± 10.8). Characteristic pain intensity (CPI), disability days (DD), disability score (DS), and graded chronic pain intensity (GCPS) were calculated according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis II. Depression and somatization (nonspecific physical symptoms) scores were also calculated. Results A significant association between groups and GCPS categories was found (p < 0.0001). Post hoc tests showed a significant difference between groups A and B and between A and C, but not between B and C. In group A, the most frequent GCPS score was grade II. The most frequent GCPS score in groups B and C was grade III, indicating a moderate limiting impairment. This score was more frequent in group B (41%) than in the other groups (group A = 20.6%, group C = 34.8%). GCPS grade IV was more frequent in group C (19.7%) than in the other groups. Group C had significantly higher scores for nonspecific physical symptoms than group A (p < 0.05). Conclusions Myofascial pain and migraine sensibly affect the common daily life of adult individuals. The comorbidity of both conditions determines a major impairment.
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Affiliation(s)
- Iacopo Cioffi
- Department of Neuroscience, University of Naples Federico II, Napoli 80131, Italy.
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163
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Florakis A, Fotinea SE, Yapijakis C. Subconscious temporomandibular dysfunction therapy: A new therapeutic approach for temporomandibular disorders. World J Stomatol 2014; 3:10-18. [DOI: 10.5321/wjs.v3.i1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 09/17/2013] [Accepted: 11/21/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate a new therapeutic approach that may permanently address excessive involuntary muscle activity which causes temporomandibular disorders (TMD).
METHODS: A cohort of 69 TMD patients (33 men and 36 women, age range 14-71 years) was treated with Subconscious Temporomandibular Dysfunction (STeDy) therapy. A thick awareness splint assisted patients to gradually recognize the interdependence between psychological pressure and subconscious muscle activity. The STeDy therapy lasted for one year and involved three stages: (1) data collection including medical history, clinical examination and psychological evaluation; (2) application of the awareness splint and consultation on a monthly basis; and (3) final evaluation.
RESULTS: About 10% of patients (3 men and 4 women) quit the STeDy therapy within the first 3-6 mo due to severe health problems or psychosocial reasons. Based on the absence of objective and subjective clinical symptoms as well as on radiographic findings, the temporomandibular dysfunction treatment was successful in all remaining 62 patients that completed the year-long therapy. Symptoms, including recurrent headache, morning fatigue, clicking sound or painful temporomandibular joint disorders, were eliminated in all patients within the first six months. By completion of the STeDy therapy, all patients had learned to recognize stressful conditions and cognitively avoided displaying excessive bruxism or other subconscious activity of the stomatognathic muscles. A follow-up after at least one year indicated the permanent nature of the cognitive treatment in all patients, illustrating the fact that subconscious muscle activity due to stress plays a principal role in the great majority of TMD, at least in adults.
CONCLUSION: The STeDy therapy successfully and permanently resolved TMD problems of all patients that completed the year-long treatment.
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164
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Emerson Kavchak AJ, Mischke JJ, Lulofs-MacPherson K, Vendrely AM. The psychometric properties of self-report outcome measures in temporomandibular dysfunction. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x13y.0000000126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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165
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Häggman-Henrikson B, Rezvani M, List T. Prevalence of whiplash trauma in TMD patients: a systematic review. J Oral Rehabil 2013; 41:59-68. [DOI: 10.1111/joor.12123] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- B. Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology; Umeå University; Umeå Sweden
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - M. Rezvani
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
| | - T. List
- Department of Orofacial Pain and Jaw Function; Malmö University; Malmö Sweden
- Department of Rehabilitation Medicine; Skåne University Hospital; Lund Sweden
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166
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Schmid-Schwap M, Bristela M, Pittschieler E, Skolka A, Szomolanyi P, Weber M, Piehslinger E, Trattnig S. Biochemical analysis of the articular disc of the temporomandibular joint with magnetic resonance T2 mapping: a feasibility study. Clin Oral Investig 2013; 18:1865-71. [PMID: 24306680 DOI: 10.1007/s00784-013-1154-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Symptoms of temporomandibular joint (TMJ) dysfunction can seriously compromise patients' quality of life. The aim of our study was to use magnetic resonance imaging (MRI) T2 mapping of the articular disc to determine whether T2 mapping of the TMJ disc is feasible in routine clinical imaging and to assess the normal T2 relaxation time distribution within the TMJ. METHODS Included were ten asymptomatic volunteers without pain, any mouth-opening limitations, or any clicking phenomena. MR imaging was performed on a 3-T MR scanner using a flexible, dedicated, eight-channel multielement coil. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually. RESULTS The mean values for ROIs ranged between 22.4 and 28.8 ms, and the mean for all ROIs was 26.0 ± 5.0 ms. Intraclass correlation (ICC) for interobserver variability was 0.698, and ICC for intraobserver variability was 0.861. There was no statistically significant difference between raters (p = 0.091) or sides (p = 0.810). CONCLUSION The T2 mapping technique enables ultrastructural analysis of the composition of TMJ disc. This biochemical technique is feasible in vivo, as shown in our study, when a high-field (3 T) MR and a dedicated TMJ coil are used. CLINICAL RELEVANCE T2 mapping as a biochemical technique, together with morphological MRI, may help to gain more insights into the physiology and into the pathophysiology of the articular disc in the TMJ noninvasively and in vivo.
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Affiliation(s)
- Martina Schmid-Schwap
- Department of Prosthodontics, Bernhard Gottlieb University of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria,
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167
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Al-Ahmad HT, Al-Bitar ZB. The effect of temporomandibular disorders on condition-specific quality of life in patients with dentofacial deformities. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:293-301. [PMID: 24528790 DOI: 10.1016/j.oooo.2013.11.493] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/23/2013] [Accepted: 11/03/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study investigated the effect of temporomandibular disorders on quality of life (QOL) of patients with dentofacial deformities. STUDY DESIGN A case-control study was performed involving 3 age- and gender-matched groups: 38 preoperative participants, 38 postoperative participants, and 39 control participants. Temporomandibular joints were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD axis I), and QOL was assessed using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Short-Form Health Survey (SF-36). RESULTS Significantly lower OQLQ scores were found in postoperative patients with one or more RDC/TMD findings; the domains in which these occurred were mental health, dentofacial esthetics, and awareness of dentofacial esthetics for patients with myofascial pain; social aspects and awareness of dentofacial esthetics for patients with disk displacement with reduction; and all domains for patients with arthritis (all P < .05). CONCLUSIONS Despite the variable effect of orthognathic treatment on TMDs, the presence of TMDs in patients after treatment can have a negative effect on their QOL.
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Affiliation(s)
- Hazem T Al-Ahmad
- Associate Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, University of Jordan, Amman, Jordan.
| | - Zaid B Al-Bitar
- Associate Professor, Orthodontics Department, Faculty of Dentistry, University of Jordan, Amman, Jordan
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168
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Nascimento GC, Rizzi E, Gerlach RF, Leite-Panissi CRA. Expression of MMP-2 and MMP-9 in the rat trigeminal ganglion during the development of temporomandibular joint inflammation. Braz J Med Biol Res 2013; 46:956-967. [PMID: 24270905 PMCID: PMC3854335 DOI: 10.1590/1414-431x20133138] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Indexed: 11/21/2022] Open
Abstract
Orofacial pain is a prevalent symptom in modern society. Some musculoskeletal orofacial pain is caused by temporomandibular disorders (TMDs). This condition has a multi-factorial etiology, including emotional factors and alteration of the masticator muscle and temporomandibular joints (TMJs). TMJ inflammation is considered to be a cause of pain in patients with TMD. Extracellular proteolytic enzymes, specifically the matrix metalloproteinases (MMPs), have been shown to modulate inflammation and pain. The purpose of this investigation was to determine whether the expression and level of gelatinolytic activity of MMP-2 and MMP-9 in the trigeminal ganglion are altered during different stages of temporomandibular inflammation, as determined by gelatin zymography. This study also evaluated whether mechanical allodynia and orofacial hyperalgesia, induced by the injection of complete Freund's adjuvant into the TMJ capsule, were altered by an MMP inhibitor (doxycycline, DOX). TMJ inflammation was measured by plasma extravasation in the periarticular tissue (Evans blue test) and infiltration of polymorphonuclear neutrophils into the synovial fluid (myeloperoxidase enzyme quantification). MMP expression in the trigeminal ganglion was shown to vary during the phases of the inflammatory process. MMP-9 regulated the early phase and MMP-2 participated in the late phase of this process. Furthermore, increases in plasma extravasation in periarticular tissue and myeloperoxidase activity in the joint tissue, which occurred throughout the inflammation process, were diminished by treatment with DOX, a nonspecific MMP inhibitor. Additionally, the increases of mechanical allodynia and orofacial hyperalgesia were attenuated by the same treatment.
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Affiliation(s)
- G C Nascimento
- Universidade de São Paulo, Programa de Pós-Graduação em Psicobiologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Ribeirão PretoSP, Brasil
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169
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Cavalcante ALC, Siqueira RMP, Araujo JCB, Gondim DV, Ribeiro RA, Quetz JS, Havt A, Lima AAM, Vale ML. Role of NMDA receptors in the trigeminal pathway, and the modulatory effect of magnesium in a model of rat temporomandibular joint arthritis. Eur J Oral Sci 2013; 121:573-83. [DOI: 10.1111/eos.12093] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2013] [Indexed: 01/12/2023]
Affiliation(s)
- André L. C. Cavalcante
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
| | - Rafaelly M. P. Siqueira
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
| | - Joana C. B. Araujo
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
| | - Delane V. Gondim
- Department of Morphology; Federal University of Ceará; Fortaleza Brazil
| | - Ronaldo A. Ribeiro
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
| | - Josiane S. Quetz
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Alexandre Havt
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Aldo A. M. Lima
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Institute of Biomedicine for Brazilian Semi-Arid & Clinical Research Unit; Federal University of Ceara; Fortaleza Brazil
| | - Mariana L. Vale
- Medical Sciences Post-Graduation Program; Department of Clinical Medicine; Federal University of Ceará; Fortaleza Brazil
- Pharmacology Post-graduation Program; Department of Physiology and Pharmacology; Federal University of Ceará; Fortaleza Brazil
- Department of Morphology; Federal University of Ceará; Fortaleza Brazil
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170
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Kojima A, Ekuni D, Mizutani S, Furuta M, Irie K, Azuma T, Tomofuji T, Iwasaki Y, Morita M. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University. BMC Oral Health 2013; 13:62. [PMID: 24195632 PMCID: PMC4228361 DOI: 10.1186/1472-6831-13-62] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Abstract
Background Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. Methods This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. Results In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. Conclusion Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.
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Affiliation(s)
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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171
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Zakrzewska JM. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth 2013; 111:95-104. [PMID: 23794651 DOI: 10.1093/bja/aet125] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A structure for accurate diagnosis is proposed beginning with a very careful history. The commonest acute causes of pain are dental and these are well managed by dentists. Chronic facial pain can be unilateral or bilateral and continuous or episodic. The commonest non-dental pains are temporomandibular disorders (TMDs), especially musculoskeletal involving the muscles of mastication either unilaterally or bilaterally; they may be associated with other chronic pains. A very wide range of treatments are used but early diagnosis, reassurance and some simple physiotherapy is often effective in those with good coping strategies. Dentists will often make splints to wear at night. Neuropathic pain is usually unilateral and of the episodic type; the most easily recognized is trigeminal neuralgia. This severe electric shock like pain, provoked by light touch, responds best to carbamazepine, and neurosurgery in poorly controlled patients. Trauma, either major or because of dental procedures, results in neuropathic pain and these are then managed as for any other neuropathic pain. Red flags include giant cell arteritis which much be distinguished from temporomandibular disorders (TMD), especially in >50 yr olds, and cancer which can present as a progressive neuropathic pain. Burning mouth syndrome is rarely recognized as a neuropathic pain as it occurs principally in peri-menopausal women and is thought to be psychological. Chronic facial pain patients are best managed by a multidisciplinary team.
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Affiliation(s)
- J M Zakrzewska
- Facial Pain Unit, Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital, UCLH NHS Foundation Trust, 256 Grays Inn Road, London WC1X 8LD, UK.
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de Siqueira SRDT, Vilela TT, Florindo AA. Prevalence of headache and orofacial pain in adults and elders in a Brazilian community: an epidemiological study. Gerodontology 2013; 32:123-31. [DOI: 10.1111/ger.12063] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 12/01/2022]
Affiliation(s)
| | - Talissa Tavares Vilela
- Gerontology; School of Arts, Science and Humanities; University of Sao Paulo; Sao Paulo Brazil
| | - Alex Antonio Florindo
- Physical Activity; School of Arts, Science and Humanities; University of Sao Paulo; Sao Paulo Brazil
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173
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Zakrzewska JM. Multi-dimensionality of chronic pain of the oral cavity and face. J Headache Pain 2013; 14:37. [PMID: 23617409 PMCID: PMC3642003 DOI: 10.1186/1129-2377-14-37] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 04/09/2013] [Indexed: 11/10/2022] Open
Abstract
Orofacial pain in its broadest definition can affect up to 7% of the population. Its diagnosis and initial management falls between dentists and doctors and in the secondary care sector among pain physicians, headache neurologists and oral physicians. Chronic facial pain is a long term condition and like all other chronic pain is associated with numerous co-morbidities and treatment outcomes are often related to the presenting co-morbidities such as depression, anxiety, catastrophising and presence of other chronic pain which must be addressed as part of management . The majority of orofacial pain is continuous so a history of episodic pain narrows down the differentials. There are specific oral conditions that rarely present extra orally such as atypical odontalgia and burning mouth syndrome whereas others will present in both areas. Musculoskeletal pain related to the muscles of mastication is very common and may also be associated with disc problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are specific diagnosis with defined care pathways. Other trigeminal neuropathic pain which can be associated with neuropathy is caused most frequently by trauma but secondary causes such as malignancy, infection and auto-immune causes need to be considered. Management is along the lines of other neuropathic pain using accepted pharmacotherapy with psychological support. If no other diagnostic criteria are fulfilled than a diagnosis of chronic or persistent idiopathic facial pain is made and often a combination of antidepressants and cognitive behaviour therapy is effective. Facial pain patients should be managed by a multidisciplinary team.
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Affiliation(s)
- Joanna M Zakrzewska
- Facial pain unit, Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital, UCLH NHS Foundation Trust, 256 Gray's Inn Road, London, WC1X 8LD, UK.
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174
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Conti PCR, Pinto-Fiamengui LMS, Cunha CO, Conti ACDCF. Orofacial pain and temporomandibular disorders: the impact on oral health and quality of life. Braz Oral Res 2013; 26 Suppl 1:120-3. [PMID: 23318754 DOI: 10.1590/s1806-83242012000700018] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 10/10/2012] [Indexed: 05/27/2023] Open
Abstract
Many conditions may cause painful symptoms in orofacial structures. Among the chronic conditions that affect this area, temporomandibular disorders are the most common. Temporomandibular Disorder is a collective term that includes a number of clinical complaints involving the masticatory muscles, the Temporomandibular Joint and associated structures. In some cases, these complaints can be associated with depression, catastrophizing behavior and impact on quality of life. The present study aims to explain the relationship between Temporomandibular Disorders and pain chronification and their relation to a variety of psychosocial and behavioral comorbid conditions. The mechanisms of pain conduction and suggestions for management are also addressed.
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175
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Slade GD. Oral health-related quality of life is important for patients, but what about populations? Community Dent Oral Epidemiol 2013; 40 Suppl 2:39-43. [PMID: 22998303 DOI: 10.1111/j.1600-0528.2012.00718.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To review population-based research into oral health-related quality of life. METHODS Narrative review of selected publications. RESULTS In the 1970s, there were two incentives to assess nonclinical aspects of health: (i) a desire to understand the impacts of disease on individuals' quality of life; and (ii) a search for population-level measures that might better quantify the impact of health care systems on populations. Dental researchers responded to those incentives, creating dozens of questionnaires that assess individuals' ratings of subjective oral health and quality of life. This has been a boon for clinical dental research, for example, by showing marked improvements in subjective oral health in patients receiving implant-supported dentures. Also, health surveys show poorer subjective oral health among disadvantaged population groups. However, the same measures show only modest benefits of general dental care. Furthermore, several population surveys show that today's young adults, who grew up with widespread exposure to preventive dental programs, have poorer subjective oral health than earlier generations that experienced unprecedented levels of oral disease. Yet to materialize is the hope that 'socio-dental indicators' of subjective oral health might provide a meaningful metric to demonstrate population-level benefits of dental care. A fundamental limitation is that population health is a contextual measure, not merely the aggregated health status of individuals within the population. CONCLUSION While researchers have successfully broken with clinical dogma by assessing subjective dimensions of individuals' oral health, they have failed to explicitly ask people to assess the oral health of the community in which they live.
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Affiliation(s)
- Gary D Slade
- Department of Dental Ecology, University of North Carolina, Chapel Hill, NC, USA.
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Linsen SS, Reich RH, Teschke M. Pressure Pain Threshold and Oral Health-Related Quality of Life Implications of Patients With Alloplastic Temporomandibular Joint Replacement—A Prospective Study. J Oral Maxillofac Surg 2012; 70:2531-42. [DOI: 10.1016/j.joms.2012.06.193] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 06/28/2012] [Accepted: 06/29/2012] [Indexed: 11/24/2022]
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Spalj S, Peric D, Mlacovic Zrinski M, Bulj M, Plancak D. Predictive value of dental readiness and psychological dimensions for oral health-related quality of life in Croatian soldiers: a cross-sectional study. Croat Med J 2012; 53:461-9. [PMID: 23100208 PMCID: PMC3490457 DOI: 10.3325/cmj.2012.53.461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Aim To determine the predictive value of dental readiness and psychological dimensions for oral health-related quality of life (OHRQoL) in Croatian soldiers. Methods The sample consisted of 402 consecutive soldiers aged 21 to 54 years classified into the following groups according to dental readiness: Class 1 – not requiring dental treatment (N = 54), Class 2 – unlikely to need emergency treatment within 12 months (N = 205), and Class 3 – very likely to need treatment within 12 months (N = 143). OHRQoL was assessed by the Oral Health Impact Profile and psychological dimensions by the Brief Symptom Inventory and Dental Anxiety Scale. Results Multivariate analysis showed that Class 3 soldiers had higher frequency of psychological discomfort, psychological disability, and physical pain and handicap than Class 1 soldiers (P = 0.019). Multiple linear regression showed that longer military experience, higher level of dental anxiety, and dental unreadiness were significant predictors of lower OHRQoL (P < 0.050) but accounted for low variability. None of the single psychological symptomatic dimensions was a significant predictor of OHRQoL. Conclusion Although this study found a moderate association between OHRQoL and clinical, military, demographic, and psychological variables, the significant predictors could be used as a basis for further research of clinical and psychosocial factors of OHRQoL.
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Affiliation(s)
- Stjepan Spalj
- Department of Dental Medicine, School of Medicine, University of Rijeka, Kresimirova 40, Rijeka, Croatia.
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Affiliation(s)
- G.D. Slade
- Department of Dental Ecology, UNC School of Dentistry, CB#7455, Chapel Hill, NC 27599-7455, USA
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Miettinen O, Lahti S, Sipilä K. Psychosocial aspects of temporomandibular disorders and oral health-related quality-of-life. Acta Odontol Scand 2012; 70:331-6. [PMID: 22300221 PMCID: PMC3793272 DOI: 10.3109/00016357.2011.654241] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 10/07/2011] [Accepted: 11/24/2011] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the association between psychosocial aspects of temporomandibular disorders (TMD) and oral health-related quality-of-life (OHRQoL) and, secondly, to investigate the gender differences in these associations using patient and non-patient groups. MATERIALS AND METHODS The sample of the study consisted of 79 patients with TMD and 70 non-patients. The data was collected by Finnish versions of the RDC/TMD Axis II profile and Oral Health Impact Profile (OHIP-14) questionnaires. The associations between Axis II profile sub-scales and OHIP prevalence were evaluated using chi-square tests, as stratified by group status (TMD patients and non-patient controls) and by gender. The association between OHIP prevalence and Axis II profile sub-scales were evaluated using logistic regression analysis, adjusted by age, gender and group. RESULTS OHIP prevalence (those reporting at least one problem) was 90.9% in the patient group and 33.3% in the non-patient group (p < 0.001, chi-squared test). OHIP prevalence was higher among those scoring higher on all RDC/TMD Axis II profile sub-scales, i.e. graded chronic pain status, depression and non-specific physical symptoms with pain items included and with pain items excluded. The associations were significant in the non-patient group. Women showed statistically significant associations of OHIP prevalence with all Axis II sub-scales. Among men, OHIP prevalence associated with GCPS and somatization. The logistic regression analysis showed that OHIP prevalence associated significantly with somatization and depression. CONCLUSIONS TMD associate with OHRQoL through multiple ways, linked with depression and somatization. These findings emphasize the importance of early and effective treatment of TMD.
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Affiliation(s)
| | - Satu Lahti
- Institute of Dentistry, University of Oulu, Finland
- Oral and Maxillofacial Department, Oulu University Hospital, Oulu, Finland
- Institute of Dentistry, University of Turku, Finland
| | - Kirsi Sipilä
- Institute of Dentistry, University of Oulu, Finland
- Institute of Dentistry, University of Eastern Finland, Finland, and Oral and Maxillofacial Department, Kuopio University Hospital, Finland
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181
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2011; 106:224-65. [DOI: 10.1016/s0022-3913(11)60127-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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van der Meulen MJ, John MT, Naeije M, Lobbezoo F. Developing abbreviated OHIP versions for use with TMD patients. J Oral Rehabil 2011; 39:18-27. [PMID: 21827525 DOI: 10.1111/j.1365-2842.2011.02242.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to evaluate the psychometric characteristics of three versions of the Dutch Oral Health Impact Profile (OHIP-NL), for clinical use with temporomandibular disorder (TMD) patients. To that end, two abbreviated OHIP versions (OHIP-NL14 and OHIP-NL5) were developed by respectively selecting 14 and five items from the officially translated and culturally adapted original 49-item OHIP-NL questionnaire. A total of 245 consecutive patients, referred by their dentist to the TMD clinic of the Academic Centre for Dentistry Amsterdam (77% women; mean age ± s.d. = 41·0 ± 14·9 years), completed the Research Diagnostic Criteria for TMD (RDC/TMD) axis II questionnaire and the OHIP-NL. Reliability and validity of all three OHIP versions were compared, and their associations with four psychological axis II variables, indicating the level of impairment of patients with TMD, were examined. According to guidelines for clinical application, internal consistency scores were sufficient for OHIP-NL and OHIP-NL14, but insufficient for OHIP-NL5. Test-retest reliability (n = 64) was excellent for OHIP-NL and OHIP-NL14 and fair to good for OHIP-NL5. For all three versions, there was evidence for score validity: associations between OHIP summary scores on the one hand and validation variables and other RDC/TMD axis II variables on the other hand met the expectations and were statistically significant (P < 0·001). In conclusion, the OHIP-NL and OHIP-NL14 both performed comparatively well and better than the OHIP-NL5. When the length of the questionnaire (i.e. the time needed for its completion) is an issue, the OHIP-14 would therefore be the preferred version.
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Affiliation(s)
- M J van der Meulen
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, Research Institute MOVE, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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Rusanen J, Silvola AS, Tolvanen M, Pirttiniemi P, Lahti S, Sipila K. Pathways between temporomandibular disorders, occlusal characteristics, facial pain, and oral health-related quality of life among patients with severe malocclusion. Eur J Orthod 2011; 34:512-7. [DOI: 10.1093/ejo/cjr071] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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DURHAM J, STEELE JG, WASSELL RW, EXLEY C, MEECHAN JG, ALLEN PF, MOUFTI MA. Creating a patient-based condition-specific outcome measure for Temporomandibular Disorders (TMDs): Oral Health Impact Profile for TMDs (OHIP-TMDs). J Oral Rehabil 2011; 38:871-83. [DOI: 10.1111/j.1365-2842.2011.02233.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Barbosa TS, Leme MS, Castelo PM, Gavião MBD. Evaluating oral health-related quality of life measure for children and preadolescents with temporomandibular disorder. Health Qual Life Outcomes 2011; 9:32. [PMID: 21569403 PMCID: PMC3115836 DOI: 10.1186/1477-7525-9-32] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 05/12/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral health-related quality of life (OHRQoL) in children and adolescents with signs and symptoms of temporomandibular disorder (TMD) has not yet been measured. This study aimed to evaluate the validity and reliability of OHRQoL measure for use in children and preadolescents with signs and symptoms of TMD. METHODS Five hundred and forty-seven students aged 8-14 years were recruited from public schools in Piracicaba, Brazil. Self-perceptions of QoL were measured using the Brazilian Portuguese versions of Child Perceptions Questionnaires (CPQ)8-10 (n = 247) and CPQ11-14 (n = 300). A single examiner, trained and calibrated for diagnosis according to the Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD), examined the participants. A self-report questionnaire assessed subjective symptoms of TMD. Intraexaminer reliability was assessed for the RDC/TMD clinical examinations using Cohen's Kappa (κ) and intraclass correlation coefficient (ICC). Criterion validity was calculated using the Spearman's correlation, construct validity using the Spearman's correlation and the Mann-Whitney test, and the magnitude of the difference between groups using effect size (ES). Reliability was determined using Cronbach's alpha, alpha if the item was deleted and corrected item-total correlation. RESULTS Intraexaminer reliability values ranged from regular (κ = 0.30) to excellent (κ = 0.96) for the categorical variables and from moderate (ICC = 0.49) to substantial (ICC = 0.74) for the continuous variables. Criterion validity was supported by significant associations between both CPQ scores and pain-related questions for the TMD groups. Mean CPQ8-10 scores were slightly higher for TMD children than control children (ES = 0.43). Preadolescents with TMD had moderately higher scores than the control ones (ES = 0.62; p < 0.0001). Significant correlation between the CPQ scores and global oral health, as well as overall well-being ratings (p < 0.001) occurred, supporting the construct validity. The Cronbach's alphas were 0.93 for CPQ8-10 and 0.94 for CPQ11-14. For the overall CPQ8-10 and CPQ11-14 scales, the corrected item-total correlation coefficients ranged from 0.39-0.76 and from 0.28-0.73, respectively. The alpha coefficients did not increase when any of the items were deleted in either CPQ samples. CONCLUSIONS The questionnaires are valid and reliable for use in children and preadolescents with signs and symptoms of temporomandibular disorder.
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Affiliation(s)
- Taís S Barbosa
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba/SP, Brazil
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Moufti MA, Wassell RW, Meechan JG, Allen PF, John MT, Steele JG. The Oral Health Impact Profile: ranking of items for temporomandibular disorders. Eur J Oral Sci 2011; 119:169-74. [DOI: 10.1111/j.1600-0722.2011.00809.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
It is the aim of this paper to give a few examples of dogmas related to prosthodontics and oral implants and to discuss the controversial role of occlusion in the aetiology of temporomandibular disorders. New knowledge is developing at a rapidly increasing rate in dentistry, as in other areas of society. Our lecturers at university taught us many useful things. But, as time goes by, what is still relevant? Some methods are so well established that they deserve to be called dogmas. It is implied that a dogma is not supported by strong evidence, even though it has existed and been practised for a long time. In the era of evidence-based dentistry it is appropriate to scrutinize such issues. A review of the current literature indicates that conflicting opinions exist concerning a number of common procedures in clinical dentistry, mainly due to a scarcity of good studies with unambiguous results. There is therefore a need for more high-quality clinical research in attempting to reach the goal of evidence-based clinical practice. The dental community should take an active part in this process.
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Affiliation(s)
- Gunnar E Carlsson
- Department of Prosthetic Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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188
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Nilsson AM, Dahlström L. Perceived symptoms of psychological distress and salivary cortisol levels in young women with muscular or disk-related temporomandibular disorders. Acta Odontol Scand 2010; 68:284-8. [PMID: 20500119 DOI: 10.3109/00016357.2010.494620] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess any differences in psychological and endocrine variables between homogeneous core groups of young women with well-defined muscle- or disk-related temporomandibular disorders (TMDs) and matched controls. MATERIAL AND METHODS Fifteen women, aged 18-24 years, fulfilling the TMD Research Diagnostic Criteria I a/b (but not II or III) and 15 fulfilling the II a/b and III criteria were consecutively selected from referrals to an orofacial pain/TMD clinic. Thirty consecutive healthy age-matched women attending yearly routine check-ups at a general dental clinic served as controls. All 60 subjects answered a questionnaire, the Profile of Fatigue Related Symptoms (PFRS), and salivary samples on waking were collected for analysis of cortisol levels. RESULTS Symptom duration and pain levels were similar irrespective of muscle- or disk-related symptoms. Both diagnostic groups obtained scores that were similar and significantly higher than those of controls in all four scales of the PFRS: fatigue, emotional distress, cognitive difficulties and somatic symptoms. Salivary cortisol levels on waking did not differ between patients and controls. CONCLUSIONS Patients with TMDs, irrespective of diagnosis, appeared to be more psychologically distressed than controls evaluated psychometrically, which is in line with earlier findings. A corresponding difference was not reflected in a single measurement of morning salivary cortisol. A more comprehensive evaluation of endocrine variables is probably necessary to reveal whether any differences actually exist in this respect.
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Affiliation(s)
- Anne-Marie Nilsson
- Department of Prosthetic Dentistry, Specialist Center Uddevalla Hospital, Uddevalla, Sweden.
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