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AlSahman L, AlBagieh H, AlSahman R. Is There a Relationship between Salivary Cortisol and Temporomandibular Disorder: A Systematic Review. Diagnostics (Basel) 2024; 14:1435. [PMID: 39001325 PMCID: PMC11241310 DOI: 10.3390/diagnostics14131435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/29/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. METHOD Six databases-PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library-were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was "Do salivary cortisol levels correlate with TMD in individuals aged 18-40?" The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. RESULT A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case-control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. CONCLUSIONS The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding.
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Affiliation(s)
- Lujain AlSahman
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Hamad AlBagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Roba AlSahman
- Faculty of Dentistry, Royal College of Surgeons, D02YN77 Dublin, Ireland;
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Colonna A, Guarda-Nardini L, Ferrari M, Manfredini D. COVID-19 pandemic and the psyche, bruxism, temporomandibular disorders triangle. Cranio 2024; 42:429-434. [PMID: 34652252 DOI: 10.1080/08869634.2021.1989768] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the effect of the Coronavirus pandemic on the report of psychological status, bruxism, and TMD symptoms. METHODS An online survey was drafted to report the presence of psychological status, bruxism activities, and reported symptoms of TMDs perceived during the COVID-19 pandemic in a population of 506 individuals. RESULTS Mental health is not positive during the Coronavirus pandemic: almost half the subjects reported an increase in bruxism behaviors, while up to one-third reported an increase in their symptoms involving the TMJ and jaw muscles. Specifically, 36% and 32.2% of participants reported increased pain in the TMJ and facial muscles, respectively, and almost 50% of the subjects also reported more frequent migraines and/or headaches. CONCLUSION Increased psychosocial distress during the COVID-19 pandemic can increase the frequency of TMD symptoms and bruxism behaviors, which, in turn, constitute a triangle of mutually interacting factors with the psychological and emotional status.
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Affiliation(s)
- Anna Colonna
- School of Dentistry, University of Siena, Siena, Italy
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Guarda-Nardini
- Section of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy
| | - Marco Ferrari
- School of Dentistry, University of Siena, Siena, Italy
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Dutra Dias H, Botelho AL, Bortoloti R, Dos Reis AC. Neuroscience contributes to the understanding of the neurobiology of temporomandibular disorders associated with stress and anxiety. Cranio 2024; 42:439-444. [PMID: 34515609 DOI: 10.1080/08869634.2021.1977901] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This review proposes a neurobiological model for temporomandibular disorders (TMD) associated with stress and anxiety. METHODS An electronic search was performed in the PubMed, Embase, and Web of Science databases. Articles published up to 2020 were selected. The search terms were the following: temporomandibular disorders, anxiety, stress, neurobiology of stress and anxiety, and orofacial pain. RESULTS In total, there were 100 studies, which presented a total of 10 different analyses. The results were described, demonstrating the type of analysis that was performed on each item analyzed for a better understanding of the context. CONCLUSION The conclusion is that the interactions between the masticatory system, temporomandibular joints (TMJs), and stomatognathic apparatus with "stress neuromatrix," "pain neuromatrix," "limbic system," and "neuroimmunoendocrine system" would produce the range of changes observed in neural connectivity and the diversity of symptoms presented in TMD.
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Affiliation(s)
- Haroldo Dutra Dias
- Department of Psychology, Faculty of Philosophy and Human Sciences, Federal University of Minas Gerais (Ufmg), Belo Horizonte, Brazil
| | - André Luís Botelho
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (Usp), Ribeirão Preto, Brazil
| | - Renato Bortoloti
- Department of Psychology, Faculty of Philosophy and Human Sciences, Federal University of Minas Gerais (Ufmg), Belo Horizonte, Brazil
| | - Andréa Cândido Dos Reis
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo (Usp), Ribeirão Preto, Brazil
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Ekici Ö, Arıkan Söylemez ES. The association of T102C (rs6313) polymorphism in the 5-HT2A receptor gene with temporomandibular disorders and anxiety in a group of Turkish population. Cranio 2024:1-9. [PMID: 38899594 DOI: 10.1080/08869634.2024.2369729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE To investigate the relationship between T102C (rs6313) polymorphism in the 5-hydroxytryptamine receptor-2A (5HTR2A) gene and temporomandibular disorder (TMD) and anxiety. METHODS This observational case-control study included 80 patients and 70 healthy controls. TMD was diagnosed using the criteria for TMD (DC/TMD). Anxiety was assessed with the Beck anxiety scale. A genotyping study of HTRR2A T102C (rs6313) gene polymorphism was performed from genomic DNA isolated from blood. RESULTS The TMD group had higher anxiety scores than the control group (p < .05). The TMD group was similar to the control group regarding genotype and allele frequencies. However, the polymorphic CC genotype was more common in those with high anxiety (p < .05). CONCLUSION There was no clear evidence of an association between TMD and the T102C polymorphism in HTR2A and TMD. However, anxiety is closely related to the T102C polymorphism in HTR2A.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Evrim Suna Arıkan Söylemez
- Department of Medical Biology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Ro JY, Zhang Y, Asgar J, Shou H, Chung MK, Melemedjian OK, Da Silva JT, Chen S. Forced swim stress exacerbates inflammation-induced hyperalgesia and oxidative stress in the rat trigeminal ganglia. FRONTIERS IN PAIN RESEARCH 2024; 5:1372942. [PMID: 38721062 PMCID: PMC11076691 DOI: 10.3389/fpain.2024.1372942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 06/12/2024] Open
Abstract
This study investigates the impact of combining psychophysical stress, induced by forced swim (FSS), with masseter inflammation on reactive oxygen species (ROS) production in trigeminal ganglia (TG), TRPA1 upregulation in TG, and mechanical hyperalgesia. In a rat model, we demonstrate that FSS potentiates and prolongs CFA-induced ROS upregulation within TG. The ROS levels in CFA combined with FSS group surpass those in the CFA-only group on days 4 and 28 post-treatment. FSS also enhances TRPA1 upregulation in TG, with prolonged expression compared to CFA alone. Furthermore, CFA-induced mechanical hyperalgesia is significantly prolonged by FSS, persisting up to day 28. PCR array analyses reveal distinct alterations in oxidative stress genes under CFA and CFA combined with FSS conditions, suggesting an intricate regulation of ROS within TG. Notably, genes like Nox4, Hba1, Gpx3, and Duox1 exhibit significant changes, providing potential targets for managing oxidative stress and inflammatory pain. Western blot and immunohistochemistry confirm DUOX1 protein upregulation and localization in TG neurons, indicating a role in ROS generation under inflammatory and stress conditions. This study underscores the complex interplay between psychophysical stress, inflammation, and oxidative stress in the trigeminal system, offering insights into novel therapeutic targets for pain management.
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Affiliation(s)
- Jin Y. Ro
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Youping Zhang
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Jamila Asgar
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Huizhong Shou
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Ohannes K. Melemedjian
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Joyce T. Da Silva
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States
| | - Shou Chen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States
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Ganesan A, Kumar G, Gauthaman J, Lakshmi KC, Kumbalaparambil YA. Exploring the Relationship between Psychoneuroimmunology and Oral Diseases: A Comprehensive Review and Analysis. J Lifestyle Med 2024; 14:13-19. [PMID: 38665319 PMCID: PMC11039437 DOI: 10.15280/jlm.2024.14.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 04/28/2024] Open
Abstract
The relationship between psychoneuroimmunology (PNI) and oral health has recently garnered increasing attention due to the intricate interaction among psychological factors, the nervous system, immune responses, and oral diseases. This comprehensive review aims to elucidate the multifaceted connections between PNI and various oral conditions and conduct an in-depth analysis. Psychological factors, such as stress, anxiety, and depression, have been linked to oral microbiome alterations and immune function and the development and progression of oral diseases, such as periodontal disorders, oral ulcers, and temporomandibular disorders. Conversely, oral health conditions, particularly chronic periodontitis, have been associated with systemic inflammation, affecting mental health and overall well-being through neuroendocrine-immune pathways. Moreover, neural mechanisms, including the brain-gut axis and the autonomic nervous system, significantly influenced oral health through immune modulation and inflammatory responses. Understanding these complex interactions has implications for therapeutic interventions that target both psychological well-being and oral health outcomes. This review synthesizes current research findings from various disciplines, including immunology, neuroscience, dentistry, and psychology, to offer a comprehensive understanding of the bidirectional relationship between PNI and oral diseases. The implications of these interactions on treatment strategies, preventive measures, and interdisciplinary approaches underscore the need for integrated healthcare models that address psychological and oral health aspects to improve outcomes and quality of life in patients.
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Affiliation(s)
- Anuradha Ganesan
- Department of Oral Medicine and Radiology, SRM Dental College, Chennai, Tamil Nadu, India
| | - Gautham Kumar
- Department of Periodontics, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Jeevitha Gauthaman
- Department of Oral Medicine and Radiology, SRM Dental College, Chennai, Tamil Nadu, India
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Shen Z, Fan C, Ding C, Xu M, Wu X, Wang Y, Xing T. Loss of Slc39a12 in hippocampal neurons is responsible for anxiety-like behavior caused by temporomandibular joint osteoarthritis. Heliyon 2024; 10:e26271. [PMID: 38375280 PMCID: PMC10875581 DOI: 10.1016/j.heliyon.2024.e26271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024] Open
Abstract
Background An evident association between mood disorders and TMJ dysfunction has been demonstrated in previous studies. This study observed both the behavioral changes and the pathological changes in hippocampal tissue of rats in an animal model of TMJ-OA by injecting MIA into TMJ. Methods Eighteen SD rats were randomly assigned to the NC group and the MIA groups. A TMJ-OA model was established to assess the HWT in the TMJ region, and the rats were subjected to the OFT and EPM. HE, O-fast green staining, qRT-PCR and immunofluorescence were used to detect condylar damage. Serum and hippocampal oxidative stress levels were detected. Functions of genes obtained by RNA-Seq were investigated using H2O2, ZnCl2 and transfection of siRNA on HT22 cells. Results Injection of MIA resulted in disorganization of the chondrocyte layer on the condylar surface of rats, with reduced synthesis and increased degradation of the condylar cartilage matrix and reduced HWT. The results of the OFT and EPM showed that the rats in the MIA group developed anxiety-like behavior during the sixth week of MIA injection. Increased Nox4 expression, decreased SOD2 expression, elevated MDA level, and reduced GSH level were detected in serum and hippocampal neurons in the MIA group, with nuclear pyknosis and reduced Nissl bodies observed in neurons. The expression of Slc39a12 in hippocampal neurons of rats in the MIA group decreased. Slc39a12 knockdown in HT22 cells induced increased Nox4 expression, decreased SOD2 expression, increased MDA level, and reduced GSH and intracellular Zn2+. Oxidative stress in HT22 cells after transfection and H2O2 stimulation was reversed when ZnCl2 was added. Conclusion Loss of Slc39a12 in hippocampal neurons results in cellular oxidative stress, further leading to neuronal damage. This may potentially explain how TMJ-OA triggers anxiety-like behavior in rats.
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Affiliation(s)
- Zhenguo Shen
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chenyu Fan
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chunmeng Ding
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Mengyue Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Xian Wu
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Yuanyin Wang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
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Zanelatto FB, Vieira WF, Nishijima CM, Zanotto TM, Magalhães SFD, Sartori CR, Parada CA, Tambeli CH. Effect of propranolol on temporomandibular joint pain in repeatedly stressed rats. Eur J Oral Sci 2024; 132:e12957. [PMID: 37908149 DOI: 10.1111/eos.12957] [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: 07/06/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023]
Abstract
Stress substantially increases the risk of developing painful temporomandibular disorders (TMDs) by influencing the release of endogenous catecholamines. Propranolol, an antagonist of β-adrenergic receptors, has shown potential in alleviating TMD-associated pain, particularly when the level of catecholamines is elevated. The aim of this study was to explore whether intra-articular propranolol administration is effective in diminishing temporomandibular joint (TMJ) pain during repeated stress situations. Additionally, we investigated the effect of repeated stress on the expression of genes encoding β-adrenoceptors in the trigeminal ganglion. In the present study, rats were exposed to a stress protocol induced by sound, then to the administration of formalin in the TMJ (to elicit a nociceptive response), followed immediately afterward by different doses of propranolol, after which the analgesic response to propranolol was evaluated. We also assessed the levels of beta-1 and beta-2 adrenergic receptor mRNAs (Adrb1 and Adrb2, respectively) using reverse transcription-quantitative PCR (RT-qPCR). Our findings revealed that propranolol administration reduces formalin-induced TMJ nociception more effectively in stressed rats than in non-stressed rats. Furthermore, repeated stress decreases the expression of the Adrb2 gene within the trigeminal ganglion. The findings of this study are noteworthy as they suggest that individuals with a chronic stress history might find potential benefits from β-blockers in TMD treatment.
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Affiliation(s)
- Fernanda Barchesi Zanelatto
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | | | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Tamires Marques Zanotto
- Department of Internal Medicine, School of Medical Science, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Silviane Fernandes de Magalhães
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - César Renato Sartori
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, São Paulo, Brazil
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Lee KS, Song IS, Kim ES, Kim J, Jung S, Nam S, Ahn KH. Machine learning analysis with population data for the associations of preterm birth with temporomandibular disorder and gastrointestinal diseases. PLoS One 2024; 19:e0296329. [PMID: 38165877 PMCID: PMC10760735 DOI: 10.1371/journal.pone.0296329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
This study employs machine learning analysis with population data for the associations of preterm birth (PTB) with temporomandibular disorder (TMD) and gastrointestinal diseases. The source of the population-based retrospective cohort was Korea National Health Insurance claims for 489,893 primiparous women with delivery at the age of 25-40 in 2017. The dependent variable was PTB in 2017. Twenty-one predictors were included, i.e., demographic, socioeconomic, disease and medication information during 2002-2016. Random forest variable importance was derived for finding important predictors of PTB and evaluating its associations with the predictors including TMD and gastroesophageal reflux disease (GERD). Shapley Additive Explanation (SHAP) values were calculated to analyze the directions of these associations. The random forest with oversampling registered a much higher area under the receiver-operating-characteristic curve compared to logistic regression with oversampling, i.e., 79.3% vs. 53.1%. According to random forest variable importance values and rankings, PTB has strong associations with low socioeconomic status, GERD, age, infertility, irritable bowel syndrome, diabetes, TMD, salivary gland disease, hypertension, tricyclic antidepressant and benzodiazepine. In terms of max SHAP values, these associations were positive, e.g., low socioeconomic status (0.29), age (0.21), GERD (0.27) and TMD (0.23). The inclusion of low socioeconomic status, age, GERD or TMD into the random forest will increase the probability of PTB by 0.29, 0.21, 0.27 or 0.23. A cutting-edge approach of explainable artificial intelligence highlights the strong associations of preterm birth with temporomandibular disorder, gastrointestinal diseases and antidepressant medication. Close surveillance is needed for pregnant women regarding these multiple risks at the same time.
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Affiliation(s)
- Kwang-Sig Lee
- AI Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Eun Sun Kim
- Department of Gastroenterology, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Jisu Kim
- AI Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
- Department of Statistics, Korea University College of Political Science and Economics, Seoul, Korea
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Sohee Jung
- AI Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
- Department of Statistics, Korea University College of Political Science and Economics, Seoul, Korea
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Sunwoo Nam
- AI Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Ki Hoon Ahn
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Anam Hospital, Seoul, Korea
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Bogdanov V. Type of correlation between bite force and EMG activity of the temporalis and masseter muscles during maximal and submaximal clenching. Folia Med (Plovdiv) 2023; 65:975-985. [PMID: 38351788 DOI: 10.3897/folmed.65.e107180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/24/2023] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Maximal bite force is an important determinant of masticatory function and is essential for the estimation of dental status. Bite force is usually measured by gnathodynamometry.
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Pavlou IA, Spandidos DA, Zoumpourlis V, Adamaki M. Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review). Exp Ther Med 2023; 26:563. [PMID: 37954114 PMCID: PMC10632959 DOI: 10.3892/etm.2023.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023] Open
Abstract
Stress has been well-documented to have a significant role in the etiopathogenesis of bruxism. Activation of the hypothalamic-pituitary-adrenal axis (HPA) and subsequent release of corticosteroids lead to increased muscle activity. Neurological studies have demonstrated that chronic stress exposure induces neurodegeneration of important neuronal structures and destabilization of the mesocortical dopaminergic pathway. These disruptions impair the abilities to counteract the overactivity of the HPA axis and disinhibit involuntary muscle activity, while at the same time, there is activation of the amygdala. Recent evidence shows that overactivation of the amygdala under stressful stimuli causes rhythmic jaw muscle activity by over activating the mesencephalic and motor trigeminal nuclei. The present review aimed to discuss the negative effects of certain vitamin and mineral deficiencies, such as vitamin D, magnesium, and omega-3 fatty acids, on the central nervous system. It provides evidence on how such insufficiencies may increase stress sensitivity and neuromuscular excitability and thereby reduce the ability to effectively respond to the overactivation of the sympathetic nervous system, and also how stress can in turn lead to these insufficiencies. Finally, the positive effects of individualized supplementation are discussed in the context of diminishing anxiety and oxidative stress, neuroprotection and in the reversal of neurodegeneration, and also in alleviating/reducing neuromuscular symptoms.
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Affiliation(s)
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
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Chattrattrai T, Aarab G, Su N, Blanken TF, Mitrirattanakul S, Lobbezoo F. The association of self-reported awake bruxism and sleep bruxism with temporomandibular pain and dysfunction in adult patients with temporomandibular disorders. Clin Oral Investig 2023; 27:7501-7511. [PMID: 37864603 DOI: 10.1007/s00784-023-05338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/11/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To investigate the association of the severity of temporomandibular disorders (TMD) pain and dysfunction with the frequency of self-reported awake bruxism (AB), sleep bruxism (SB), and stress in an adult TMD-patient population. MATERIALS AND METHODS This cross-sectional study included 237 TMD patients based on the Diagnostic Criteria for TMD. Age, sex, frequency of self-reported AB and SB, and stress were included as independent variables. TMD pain and TMD dysfunction were included as dependent variables in regression analyses. Univariate and multivariable linear regression analyses were used to predict TMD pain and TMD dysfunction in two separate models. Finally, network analysis was performed to investigate the associations between all variables. RESULTS In the univariate analyses, TMD pain was significantly associated with self-reported AB-frequent (unstandardized coefficient (B) = 3.196, 95%CI 1.198-5.195, p = 0.002). TMD dysfunction was significantly associated with AB-frequent (B = 2.208, 95%CI 0.177-4.238, p = 0.033) and SB-sometimes (B = 1.698, 95%CI 0.001-3.394, p = 0.050). In the multivariable analyses, TMD pain was significantly associated with TMD dysfunction (B = 0.370, p < 0.001), stress (B=0.102, p < 0.001). TMD dysfunction was significantly associated with TMD pain (B = 0.410, p < 0.001) only. Network analysis showed that TMD pain is a bridge factor between AB, stress, and TMD dysfunction. CONCLUSIONS TMD pain is directly associated with AB, stress, and TMD dysfunction, while TMD dysfunction is only associated with TMD pain. CLINICAL RELEVANCE Reducing pain may improve pain-related dysfunction, and the management of AB and stress may improve TMD pain and dysfunction, and vice versa.
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Affiliation(s)
- Thiprawee Chattrattrai
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tessa F Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Oliveira-Souza AISD, Sales LRDV, Coutinho ADDF, Armijo Olivo S, de Oliveira DA. Oral health quality of life is associated to jaw function and depression in patients with myogenous temporomandibular dysfunction. Cranio 2023; 41:518-528. [PMID: 33616020 DOI: 10.1080/08869634.2021.1885893] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine which factors influence and better differentiate between good and poor oral health-related quality of life (OHRQoL) in patients with myogenous TMD and which cut-off could predict a good/poor OHRQoL. METHODS Fifty-eight women with myogenous TMD were included. Factors of interest were collected (i.e., demographic variables, depression symptoms (Symptom Checklist-90 R (RDC/TMD)), pain intensity (Visual Analog Scale), jaw function (Mandibular Functional Limitation Questionnaire), and OHRQoL (Oral Health Impact Profile-14). A multivariable regression model, logistic regression, and receiver operating curve (ROC) analyses were conducted. RESULTS Depression symptoms (β = 0.139) and jaw function (β = 0.478) were significantly associated with OHRQoL in the multivariable model. The best model to discriminate between good/poor OHRQoL included only jaw function (AUC = 0.90), with the best cut-off of 17 points (sensitivity: 0.93; specificity: 0.79). CONCLUSION Depression symptoms and jaw function were significantly associated with OHRQoL. The best model and cut-off to discriminate good/poor OHRQoL included only jaw function.
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Affiliation(s)
| | | | | | - Susan Armijo Olivo
- Faculty of Business and Social Sciences, University of Applied Sciences - Hochschule Osnabrück, Osnabrück, Germany. Faculty of Rehabilitation Medicine/Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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14
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Macrì M, Rotelli C, Pegreffi F, Festa F. Non-Pharmacological Pain Treatment of Patients with Myofascial Pain Syndrome of the Masticatory Muscles-Case Series. Biomedicines 2023; 11:2799. [PMID: 37893172 PMCID: PMC10604577 DOI: 10.3390/biomedicines11102799] [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: 08/27/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Myofascial pain is the most common cause of chronic pain in the masticatory region and can be assessed through clinical analysis and muscle palpation. Generally, it appears with headache and orofacial pain associated with sensitive points (trigger points) due to the excessive contraction of the masticatory muscle fibers. The study aims to evaluate how a correct treatment of myofascial pain can improve the life quality of affected patients. In this case series, 300 patients with myofascial pain were divided into two groups: 150 with intra- and extra-articular disorders and 150 with only extra-articular disorder. Each group included 75 males and 75 females. All the patients were treated with gnathological therapy through passive aligners and biofeedback exercises for four months. They underwent pain assessment (through a visual analogue scale and muscular palpation test) before, during, and after the treatment, as well as nuclear magnetic resonance of the temporomandibular joint before and after the gnathological treatment. The treatment considerably reduced the pain in all patients, without drugs, in four months according to the visual analogue scales and the palpation test. The temporomandibular magnetic resonance in each patient was similar before and after the gnathological treatment. The improvement in pain did not depend on a change in the relationship between the articular condyle and the disc.
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Affiliation(s)
- Monica Macrì
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Chiara Rotelli
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Pegreffi
- Department for Life Quality Studies, University of Bologna, 40126 Bologna, Italy
| | - Felice Festa
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
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15
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Ekici Ö. Association of stress, anxiety, and depression levels with sleep quality in patients with temporomandibular disorders. Cranio 2023; 41:407-415. [PMID: 33345727 DOI: 10.1080/08869634.2020.1861886] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the psychological symptoms of TMD and their effects on sleep quality in patients with temporomandibular disorders. METHODS The study was carried out with 425 consecutive TMD patients who sought care at the oral and maxillofacial surgery clinic of a faculty of dentistry. Perceived Stress Scale-14, Beck Anxiety Scale, and Beck Depression Scale were used to evaluate the psychological state. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index. RESULTS The mean sleep score of all participants was 6.52. As the level of anxiety and depression increased, the scores of both total sleep quality and sleep quality components increased significantly p < 0.01. On the other hand, those with poor sleep quality had significantly higher stress, anxiety, and depression levels than those with good sleep quality p < 0.01. CONCLUSION Negative emotional situations such as stress, anxiety, and depression seriously impair sleep quality in TMD patients.
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Affiliation(s)
- Ömer Ekici
- Department of Oral and Maxillofacial Surgery, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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16
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Zanelatto FB, Vieira WF, Nishijima CM, Sartori CR, Parada CA, Tambeli CH. Effect of sound-induced repeated stress on the development of pain and inflammation in the temporomandibular joint of female and male rats. Eur J Oral Sci 2023:e12936. [PMID: 37243959 DOI: 10.1111/eos.12936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 05/03/2023] [Indexed: 05/29/2023]
Abstract
Temporomandibular disorder (TMD) is a common painful condition of the temporomandibular joint (TMJ) and associated structures. Stress is a significant risk factor for developing this painful condition that predominantly affects women. This study aimed to test the hypothesis that stress increases the risk of developing TMJ pain by facilitating inflammatory mechanisms in female and male rats. To test this hypothesis, we evaluated TMJ carrageenan-induced expression of pro-inflammatory cytokines and migration of inflammatory cells and TMJ formalin-induced nociception in female and male rats submitted to a repeated stress protocol induced by sound. We found that sound-induced repeated stress facilitates TMJ inflammation and contributes to TMJ nociception development equally in females and males. We conclude that stress is a risk factor for developing painful TMJ conditions in males and females, at least in part, by favoring the inflammatory process similarly in both sexes.
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Affiliation(s)
- Fernanda Barchesi Zanelatto
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Willians Fernando Vieira
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - César Renato Sartori
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, São Paulo, Brazil
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17
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dos Santos Gonçalves RM, Fernandes GVO, Fernandes JCH, Seabra M, Figueiredo A. Impact of COVID-19 on Portuguese Dental Students: A Cohort Study. Healthcare (Basel) 2023; 11:healthcare11060818. [PMID: 36981475 PMCID: PMC10048692 DOI: 10.3390/healthcare11060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Introduction: The goal of this study was to assess the impact of COVID-19 on Portuguese dental students on their depression, anxiety, temporomandibular dysfunction, academic degree, and oral behaviors. Methods: The target of this population study was to enroll third-, fourth-, and fifth-year students of the Integrated Master’s degree in Dental Medicine at the Universidade Católica Portuguesa—Faculty of Dental Medicine (Viseu, Portugal) in the academic year 2021–2022. Temporomandibular disorders (TMD) symptoms, oral behaviors, anxiety, and depression were assessed using validated questionnaires. The variables under study were (a) age, gender, marital status, academic level, academic degree, medication, and any existing pathologies; (b) questions related to taste changes or thoughts that would indicate (or not) worsening psychological conditions (anxiety and depression). After data collection (Google Forms®), data were transferred to an Excel file and entered into SPSS® software. A chi-square test allowed the independence between ordinal or nominal variables. The Spearman correlation test was used to analyze the relationship between variables in the study (significant if p ≤ 0.05). Results: 98.2% of the students answered the questionnaire. TMD had a prevalence of 35%, and anxiety and depression a prevalence of 29% and 24%, respectively. The results showed that the female gender was the most affected by psychological and temporomandibular disorders. Statistically significant correlations were identified between variables, such as gender and anxiety, TDM, and depression (respectively, p = 0.0001, p = 0.014, and p = 0.026); between TDM and anxiety and depression (respectively, p = 0.001 and p < 0.001); and between performing oral behaviors and TMD, anxiety, and depression (respectively, p = 0.0001, p = 0.0001, and p = 0.006). The variables, such as age and academic degree, did not establish a statistically significant relationship with TMD, oral behaviors, and the two psychological conditions. Conclusions: It was possible to conclude that there was a moderate prevalence of TMD, anxiety, and depression in the period studied. Moreover, a statistically significant relationship was found between TMD, anxiety, and depression with gender and frequency of OBs; however, no significant association was found for TMD, anxiety, and depression with the age of students and with the academic degree.
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Affiliation(s)
| | - Gustavo Vicentis Oliveira Fernandes
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Correspondence:
| | | | - Mariana Seabra
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Andreia Figueiredo
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
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18
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Lopes RFT, Palinkas M, Pádua da Silva G, Verri ED, Regalo IH, Gonçalves CR, Hallak JEC, Costa Gomes GG, Regalo SCH, Siéssere S. Stroke: An electromyographic approach to the masseter and temporal muscles, orofacial soft tissue pressure, and occlusal force. PLoS One 2023; 18:e0282362. [PMID: 36857404 PMCID: PMC9976995 DOI: 10.1371/journal.pone.0282362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
Stroke is a cerebrovascular disease that triggers changes in the central and peripheral nervous systems, and can compromise human body function. This cross-sectional observational study aimed to analyze the electromyographic (EMG) activity of the masseter and temporal muscles, orofacial soft tissue pressure, and strength of occlusal contacts in patients who had suffered a stroke. Twenty-four patients were divided into two groups: stroke (n = 12) and control (n = 12). The EMG of the masseter and temporal muscles was evaluated during mandibular rest, protrusion, right laterality, left laterality, and maximal voluntary contraction. The Iowa Oral Pressure Instrument (IOPI) was used to measure pressure from the tongue, lips, and buccinator muscles. A computerized system for occlusal analysis (T-Scan III) was used to measure the occlusal contact points of the right and left hemiarches (upper and lower) and the upper and lower first molars. Data were subjected to Student's t-test (p < 0.05). The stroke group had lower normalized electromyographic activity, with a significant difference in the left temporal muscle during rest (p = 0.03) when compared to the control group. There was a significant difference between the groups in tongue pressure (p = 0.004) with a lower mean value in the stroke group. There was a significant difference between the groups in the evaluation of the occlusal contact points of the first permanent molars, with a lower mean percentage in the stroke group. The results indicate that stroke negatively affects functional performance of the stomatognathic system.
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Affiliation(s)
- Robson Felipe Tosta Lopes
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcelo Palinkas
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
- * E-mail:
| | - Gabriel Pádua da Silva
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Edson Donizetti Verri
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Isabela Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Camila Rosa Gonçalves
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jaime Eduardo Cecilio Hallak
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
| | - Guilherme Gallo Costa Gomes
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Simone Cecílio Hallak Regalo
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
| | - Selma Siéssere
- Department of Basic and Oral Biology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil
- Faculty of Medicine of Ribeirão Preto, Department of Neuroscience and Behavioral Sciences, University of São Paulo and National Institute and Technology—Translational Medicine (INCT.TM), São Paulo, Brazil
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Omezli MM, Torul D, Varer Akpinar C. Temporomandibular disorder severity and its association with psychosocial and sociodemographic factors in Turkish adults. BMC Oral Health 2023; 23:34. [PMID: 36681799 PMCID: PMC9862211 DOI: 10.1186/s12903-023-02737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There is a lack of awareness regarding temporomandibular disorder (TMD) and its association with psychological and sociodemographic factors in the Turkish population. This study aimed to evaluate the relationship between signs/symptoms of anxiety-depression, sociodemographic factors, parafunctional habits, bruxism, and the presence and severity of the symptoms of TMD in Turkish adults. METHODS The participants completed an online questionnaire consisting of sociodemographic questions, the Fonseca Anamnestic Index, and the Patient Health Questionnaire-4. RESULTS The mean age of the 2580 participants was 35.29 ± 12.70 years, and 63.3% were women. The frequency of the participants who showed symptoms of TMD was 69.8%. The severity of TMD symptoms was significantly greater in participants who had signs/symptoms of anxiety and depression (p < 0.05). Sociodemographic and psychological data showed an association between the presence and severity of the symptoms of TMD and sex (OR 1.52, 95% confidence interval (CI) 1.26-1.85), parafunctional habits (OR 2.64, 95% CI 2.36-2.99), bruxism (OR 3.14, 95% CI 1.78-4.90), signs/symptoms of anxiety (OR 2.30, 95% CI 1.76-3.00), and signs/symptoms of depression (OR 1.90, 95% CI 1.48-2.42). CONCLUSIONS The results of the present study suggest that females and those who report bruxism, parafunctional habits, and signs/symptoms of anxiety-depression are more likely to show symptoms of TMD with different severity.
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Affiliation(s)
- Mehmet Melih Omezli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, 52200, Ordu, Turkey
| | - Damla Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, 52200, Ordu, Turkey.
| | - Ceren Varer Akpinar
- Department of Public Health, Faculty of Medicine, Giresun University, 28000, Giresun, Turkey
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20
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Santos MAS, Ramos AG, de Sousa TC, de Medeiros RA. Prevalence of self-reported symptoms of temporomandibular disorders and associated factors in the period of distance learning. Clin Oral Investig 2023; 27:377-385. [PMID: 36220953 PMCID: PMC9553078 DOI: 10.1007/s00784-022-04743-z] [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: 01/19/2022] [Accepted: 10/02/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Assess the prevalence of self-reported TMD symptoms and anxiety and check the quality of sleep and life during the distance learning period in university students at the University of Brasilia (UnB). MATERIALS AND METHODS The participants were students from the Health Sciences College and Medicine College at UnB. Self-administered questionnaires were used to evaluate symptoms of TMD, quality of life, and sleep quality. One-way analysis of variance, followed by Bonferroni test, and Kruskal-Wallis test, followed by Dunn's test, were performed (P < 0.05). For qualitative data analysis, the chi-square test was applied (P < 0.05). RESULTS Total 156 students were included; prevalence of TMD, anxiety, sleep disturbance, and poor sleep quality was 73.1%, 84%, 12.8%, and 62.8%, respectively. A greater prevalence of painful TMD was observed in students with severe anxiety (P = 0.007). Students with symptoms of painful TMD, severe anxiety, and sleep disorders had statistically worse quality of life. CONCLUSIONS The implementation of distance learning in health courses to replace classroom teaching during the COVID-19 pandemic has impacted TMD prevalence, anxiety, quality of life, and sleep quality. CLINICAL RELEVANCE Psychological factors are directly associated with TMD symptoms and quality of life, TMD conditions are related to quality of life as well. COVID-19 pandemic and the distance learning in health courses are new situations that can lead to a great impact on mental health and in consequence to TMD conditions and quality of life.
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Affiliation(s)
| | - Alexia Guimarães Ramos
- Department of Dentistry, School of Health Sciences, University of Brasília (UnB), Brasília, Distrito Federal Brazil
| | - Thiago Carvalho de Sousa
- Department of Dentistry, School of Health Sciences, University of Brasília (UnB), Brasília, Distrito Federal Brazil
| | - Rodrigo Antonio de Medeiros
- Department of Dentistry, School of Health Sciences, University of Brasília (UnB), Brasília, Distrito Federal Brazil ,Faculdade de Ciências da Saúde, Departamento de Odontologia, Campus Universitário Darcy Ribeiro – UnB, Asa Norte, Brasília, DF 70910-900 Brazil
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21
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Psychological Profiles and Their Relevance with Temporomandibular Disorder Symptoms in Preorthodontic Patients. Pain Res Manag 2022; 2022:1039393. [PMID: 36247102 PMCID: PMC9553652 DOI: 10.1155/2022/1039393] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/03/2022] [Accepted: 09/10/2022] [Indexed: 11/17/2022]
Abstract
Background Temporomandibular disorders (TMDs) refer to a group of heterogenous musculoskeletal diseases with diverse clinical symptoms and an undetermined aetiology. The psychological profiles were closely related to the onset and treatment outcomes of TMDs. Objective To examine the relevance between psychological profiles and different symptoms of TMDs in preorthodontic patients. Methods The study was conducted among 570 preorthodontic patients. TMDs symptoms were recorded by the Diagnostic Criteria for TMD (DC/TMD) symptom questionnaire. The seven-item Generalized Anxiety Disorder Scale (GAD-7), the nine-item Patient Health Questionnaire (PHQ-9), and the Pain Catastrophizing Scale (PCS) were used for the evaluation of anxiety, depression, and pain catastrophizing levels. The relevance of three psychological profiles with TMDs and subtypes was evaluated with Spearman's rank correlation test and logistic regression analysis (P < 0.05). Results 34.56% of the enrolled preorthodontic patients were diagnosed with TMDs. Scores of GAD-7, PHQ-9, and PCS were significantly higher in the TMDs group than in the non-TMDs group. Participants with anxiety, depression, or high pain catastrophizing had a higher prevalence of both pain-related TMDs symptoms and intra-articular TMDs symptoms. The correlations among pain-related TMDs, intra-articular TMDs, and scores on the psychological scales were significant (P < 0.05). The adjusted logistic regression model revealed that anxiety, depression, and high pain catastrophizing were significant risk factors for TMDs with an odds ratio (OR) of 2.196, 1.741, and 1.601, respectively. Depression was associated with higher pain-related TMDs prevalence (OR = 2.136), while anxiety and depression were associated with higher intra-articular TMDs prevalence (OR = 2.341 and 1.473). Conclusion Anxiety, depression, and high pain catastrophizing were comorbid psychological conditions of TMDs. Depression was the top risk factor for pain-related TMDs, while anxiety rendered the highest risk for intra-articular TMDs. Inclusion of psychological assessments in preorthodontic evaluation might yield great benefits in TMDs screening.
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22
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Bal B, Sarak G, Oral K. Oral health-related quality of life and psychological states of dental students with temporomandibular disorders. J Dent Educ 2022; 86:1459-1467. [PMID: 35587362 DOI: 10.1002/jdd.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/14/2022] [Accepted: 05/01/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE/OBJECTIVES This study investigates the frequency of temporomandibular disorders (TMD) in dental students, and evaluates the association between TMDs, psychological states, and oral health-related quality of life (OHRQoL). The presence of bruxism was also determined. METHODS Two hundred ninety-three dental students completed the Symptom Checklist 90-Revised (SCL-90-R) and Oral Health Impact Profile 14 (OHIP-14) questionnaires and underwent a clinical examination according to Diagnostic Criteria for TMDs. RESULTS TMDs were detected in 46.4% of the dental students. OHIP-14 scores of students with TMDs were significantly higher than scores for students without TMDs (p < 0.05). Significant differences were observed in all SCL-90-R scores among students with and without TMDs, except for phobic anxiety and additional SCL-90-R subscale scores (p < 0.05). The prevalence of myalgia was significantly higher in clinical students (26.6%) than in preclinical students (15.6%). OHIP-14 scores of clinical students were significantly higher than preclinical students (p < 0.05). CONCLUSIONS In dental students, there was a high frequency of TMDs and bruxism. OHRQoL was poorer in clinical students. Levels of anxiety, depression, and somatization were not different in clinical and preclinical students. SCL-90-R scores are higher in students with TMDs except for phobic anxiety and additional SCL-90-R subscale scores.
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Affiliation(s)
- Burcu Bal
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Gözde Sarak
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Koray Oral
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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23
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Staniszewski K, Willassen L, Berge T, Johansson A, Schjødt B, Rosen A. High Pain Intensity is a Risk Factor of Non-Resolving TMD: A Three-Year Follow-Up of a Patient Group in a Norwegian Interdisciplinary Evaluation Program. J Pain Res 2022; 15:1283-1296. [PMID: 35529313 PMCID: PMC9075908 DOI: 10.2147/jpr.s341861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/10/2022] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate the outcome of patients with long-term refractory temporomandibular disorders (TMD) three years after a Norwegian interdisciplinary evaluation program with attention to patient satisfaction, function, pain, and psychosocial variables. Patients and Methods The study population consisted of 60 long-term refractory TMD patients who were investigated by a Norwegian interdisciplinary team. A questionnaire that covered medical history, function, pain, lifestyle factors, TMD-status and follow-up from their general medical practitioner (GMP) was sent to the patients three years after the evaluation. Questionnaires that assessed function (Mandibular Functional Index Questionnaire [MFIQ] and Roland Morrison Scale [RMS]), pain intensity (General Pain Intensity questionnaire [GPI]) and psychosocial factors (Hospital Anxiety and Depression scale [HADS]); a 2-item version of the Coping Strategies Questionnaire [CSQ]) were included in the package. Results Thirty-nine out of 60 TMD patients completed the questionnaires. Improvements in TMD symptoms were reported in 10 patients (26%), were unchanged in 16 patients (41%) and worsened in 13 patients (33%). Only 8 patients (21%) were satisfied with the follow-up of the suggested treatments from their GMP. Significant improvements of symptoms were noted in MFIQ (jaw function), GPI (including pain intensity at maximum and suffering from pain), and CSQ (pain related catastrophizing), in all 39 TMD patients as one group. However, a subgroup analysis showed that the significant improvements were mostly within patients who reported improvement of TMD symptoms. A high pain intensity at baseline was a significant risk factor (OR = 5.79, 95% CI: 1.34, 24.96) for patients who reported worsening of TMD symptoms at follow-up. Conclusion High pain intensity at baseline was a significant risk factor for poorer recovery three years after an interdisciplinary evaluation. Our data support the notion that improved coping with TMD pain includes both decreased pain intensity, CSQ and MFIQ scores.
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Affiliation(s)
- Kordian Staniszewski
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Correspondence: Kordian Staniszewski, Department of Clinical Dentistry University of Bergen, Årstadveien 19, Bergen, 5009, Norway, Tel +47 47602632, Email
| | - Lisa Willassen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Trond Berge
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Anders Johansson
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Borrik Schjødt
- Centre for Pain Management and Palliative Care, Haukeland University Hospital, Bergen, Norway
| | - Annika Rosen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
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Zhao YJ, Liu Y, Wang J, Li Q, Zhang ZM, Tu T, Lei R, Zhang M, Chen YJ. Activation of the Mesencephalic Trigeminal Nucleus Contributes to Masseter Hyperactivity Induced by Chronic Restraint Stress. Front Cell Neurosci 2022; 16:841133. [PMID: 35480958 PMCID: PMC9035558 DOI: 10.3389/fncel.2022.841133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/11/2022] [Indexed: 12/12/2022] Open
Abstract
Psychological stress is commonly accepted to be closely associated with masticatory muscle disorder, which is the main symptom of temporomandibular disorder (TMD). Previous studies have confirmed that exposure to stress may cause masticatory muscle hyperactivity. However, the central mechanism underlying this process remains unclear. The mesencephalic trigeminal nucleus (Vme), which resides in the brainstem, is the primary afferent center for masticatory proprioception and plays a key role in oral–motor movements by projecting to the trigeminal motor nucleus (Vmo). Therefore, the present study was designed to examine the role of Vme neurons in masseter overactivity induced by chronic stress. We found that subjecting mice to restraint stress (6 h/day) for 14 days caused significant anxiety-like behavior, obvious masseter overactivity, and markedly enhanced electrophysiological excitability of Vme neurons. By using anterograde tract tracing combined with immunofluorescence staining methods, we observed vesicular glutamate transporter 1 (VGLUT1)-positive glutamatergic projections from the Vme to the Vmo. Moreover, chronic restraint stress (CRS) elevated the expression of VGLUT1 and choline acetyltransferase (ChAT) in Vmo. Furthermore, administration of VGLUT1-targeted short hairpin RNA (shRNA) into the bilateral Vme significantly suppressed the enhanced overexcitability of Vme neurons, downregulated the overexpression of VGLUT1 and ChAT in the Vmo, and attenuated the elevated overactivity of the masseter caused by CRS. Taken together, we showed that CRS can excite neurons in the Vme, enhancing glutamatergic excitatory projections from the Vme to the Vmo and resulting in masseter muscle overactivity. These findings provide us with a novel central mechanism underlying the correlation between psychological factors and TMD.
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Affiliation(s)
- Ya-Juan Zhao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Yang Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Jian Wang
- Department of Cardiothoracic Surgery, General Hospital of Western Theater Command, Chengdu, China
| | - Qiang Li
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Zhou-Ming Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Teng Tu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Rong Lei
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
| | - Min Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
- Min Zhang,
| | - Yong-Jin Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi’an, China
- *Correspondence: Yong-Jin Chen,
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Marin R, Rolim GS, De Moraes ABA, Graner KM. DISFUNÇÕES TEMPOROMANDIBULARES E FATORES PSICOLÓGICOS: UMA REVISÃO DE LITERATURA. PSICOLOGIA EM ESTUDO 2022. [DOI: 10.4025/psicolestud.v27i0.47363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
As disfunções temporomandibulares (DTM) são condições biológicas que envolvem sinais e sintomas como dores crônicas na articulação temporomandibular e nos músculos da mastigação. O presente estudo tem como objetivo identificar quais e como conceitos psicológicos são descritos em artigos de intervenções odontológicas relacionadas à DTM, em artigos de revisão sistemática. Para isto foram utilizadas três bases de dados na busca e seleção: PubMed, Scopus e Web of Science. Aplicou-se em todas estas bases de dados a mesma formulação de termos-chave. Foram selecionados os artigos de revisões, publicados entre 2000 e 2017, escritos em inglês. Dos 4.092 artigos encontrados, sete foram selecionados descrevendo intervenções psicológicas envolvidas com o tratamento da DTM. Todos os artigos selecionados foram analisados com base em seus objetivos e discussões, considerando as características de apresentação e compreensão das variáveis psicológicas relacionadas à disfunção temporomandibular e às intervenções utilizadas. Para tanto, foram realizadas análises qualitativas e quantitativas. Pode-se concluir que a compreensão e a definição das variáveis psicológicas relacionadas à DTM não são evidentes, o que dificulta a produção de resultados claros sobre a eficácia dos diagnósticos e intervenções para DTM.
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Winocur-Arias O, Winocur E, Shalev-Antsel T, Reiter S, Shifra L, Emodi-Perlman A, Friedman-Rubin P. Painful Temporomandibular Disorders, Bruxism and Oral Parafunctions before and during the COVID-19 Pandemic Era: A Sex Comparison among Dental Patients. J Clin Med 2022; 11:jcm11030589. [PMID: 35160041 PMCID: PMC8837112 DOI: 10.3390/jcm11030589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/12/2022] Open
Abstract
Aim: To evaluate the effect of the current coronavirus pandemic on the prevalence of bruxism, oral parafunctions and painful Temporo-Mandibular Disorders (TMDs) and to evaluate the influence of the pandemic on both sexes. Methods: This retrospective study included 288 dental patients who underwent complete anamnesis and examination according to the Diagnostic Criteria for TMD. The study evaluated two patient populations according to the date of examination: (a) pre-COVID-19 pandemic era (108 patients); (b) COVID 19 pandemic era, where 180 patients were examined during the pandemic. Results: A significant increase in parafunction activity was found in both men and women (p < 0.001) during the COVID-19 pandemic. Awake bruxism (AB) and sleep bruxism (SB) was more prevalent during the COVID-19 pandemic solely in women (AB-p < 0.001; SB-p = 0.014). Conclusions: Men and women were affected by the ongoing stress due to the COVID-19 pandemic, yet women showed a higher influence as compared to men. The long-term exposure to elevated levels of anxiety and stress may aggravate or trigger stomatognathic detrimental conditions. Dentists should be aware and regularly monitor their patients regarding the possible existence and consequences of bruxism and TMD.
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Affiliation(s)
- Orit Winocur-Arias
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (O.W.-A.); (R.S.)
| | - Efraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Tamar Shalev-Antsel
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Shoshana Reiter
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (O.W.-A.); (R.S.)
| | - Levartovsky Shifra
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
- Correspondence:
| | - Pessia Friedman-Rubin
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
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Kim SY, Yoo DM, Kwon MJ, Kim JH, Kim JH, Byun SH, Park B, Lee HJ, Choi HG. Increased Risk of Temporomandibular Joint Disorder in Osteoporosis Patients: A Longitudinal Study. Front Endocrinol (Lausanne) 2022; 13:835923. [PMID: 35432214 PMCID: PMC9008302 DOI: 10.3389/fendo.2022.835923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/07/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the risk of temporomandibular joint disorder (TMD) in patients with osteoporosis. METHODS Data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 were collected. Participants ≥ 40 years old were enrolled, and the history of osteoporosis was evaluated. The 62,328 osteoporosis patients were matched for age, sex, income, and region of residence with 62,328 control participants. The occurrence of TMD was assessed in both the osteoporosis and control groups during the follow-up period. Stratified Cox proportional hazard analyses for TMD were conducted for the osteoporosis and control groups. The hazard ratios (HRs) of osteoporosis for TMD were further analyzed by age and sex subgroups. RESULTS A total of 1.2% (725/61,320) of the osteoporosis patients and 0.6% (339/61,320) of the control participants had TMD (P<0.001). Osteoporosis was associated with an elevated HR of TMD (adjusted HR=1.96, 95% CI=1.72-2.23, P<0.001). Among the age and sex subgroups, the < 60-year-old mal\e group demonstrated an adjusted HR of osteoporosis for TMD as high as 4.47 (95% CI=1.17-17.12, P=0.029). Other age and sex subgroups also showed a higher HR for TMD associated with osteoporosis (adjusted HR=2.30, 95% CI=1.90-2.78, P<0.001 for the ≥ 60-year-old female group). CONCLUSION Osteoporosis was related to a higher risk of TMD in the adult population. A prominent association of osteoporosis with TMD was noted in middle-aged men and older women.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Anyang, South Korea
| | - Ji Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Anyang, South Korea
| | - Joo-Hee Kim
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Soo-Hwan Byun
- Department of Oral and Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang, South Korea
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, South Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo-Jeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, South Korea
- *Correspondence: Hyo Geun Choi,
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Quinzi V, Paskay LC, Manenti RJ, Giancaspro S, Marzo G, Saccomanno S. Telemedicine for a Multidisciplinary Assessment of Orofacial Pain in a Patient Affected by Eagle’s Syndrome: A Clinical Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background:
Orofacial pain has a broad range of origins and a multidisciplinary approach occupies a relevant role.
Objective:
The aim of this study was to review the literature regarding the evolution of telemedicine and orofacial pain related to a case report of a patient affected by Eagle's syndrome.
Materials and Methods:
Two authors (RJM and SG) independently reviewed the literature up to March 2020. A case report was developed by including the interdisciplinary assessment and initial treatment of orofacial pain in a 38-year-old female patient affected by Eagle’s syndrome. The patient was interviewed by two different specialists (from Rome, Italy and Los Angeles, California) through an online meeting platform in order to evaluate her complex situation, demonstrating the possibilities that telemedicine offered during the COVID-19 pandemic.
Conclusion:
An interdisciplinary approach can be performed for future follow ups on patients as various advantages were found by the patient and by the clinicians themselves.
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Saccomanno S, Bernabei M, Scoppa F, Pirino A, Mastrapasqua R, Visco MA. Coronavirus Lockdown as a Major Life Stressor: Does It Affect TMD Symptoms? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238907. [PMID: 33266130 PMCID: PMC7731003 DOI: 10.3390/ijerph17238907] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
Temporomandibular disorders are multi-factorial conditions that are caused by both physical and psychological factors. It has been well established that stress triggers or worsens TMDs. This paper looks to present early research, still unfolding, on the relationship between COVID-19 as a major life stressor and TMDs. The main aims of this study were to: investigate the presence of symptoms related to TMDs and the time of onset and the worsening of painful symptoms in relation to the changes in social life imposed by the coronavirus pandemic; and to evaluate the perception of COVID-19 as a major stressful event in subjects who report worsening of painful TMD symptoms. One hundred and eighty-two subjects answered questionnaires—Axis II of the RDC/TMD, the PSS, and specific items about coronavirus as a stressful event—during the lockdown period for COVID-19 in Italy to evaluate the presence of reported symptoms of TMD and the level of depression, somatization, and stress perceived. The results showed that 40.7% of subjects complained about TMD symptoms in the past month. Regarding the time of onset, 60.8% of them reported that facial pain started in the last three months, while 51.4% of these subjects reported that their symptoms worsened in the last month and were related to the aggravation of pain due to the coronavirus lockdown as a major life event and to the stress experienced. The results of this study seem to support the hypothesis that stress during the pandemic lockdown influenced the onset of temporomandibular joint disorders and facial pain, albeit with individual responses.
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Affiliation(s)
- Sabina Saccomanno
- Orthodontic Residency, Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Mauro Bernabei
- Department of Dental Clinic, Catholic University of Sacred Hearth, 00198 Rome, Italy;
| | - Fabio Scoppa
- Faculty of Medicine and Dental Surgery, University of Rome “Sapienza”, 00185 Rome, Italy;
- Chinesis I.F.O.P. Istituto di Formazione in Osteopatia e in Posturologia, 00152 Rome, Italy
| | - Alessio Pirino
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | | | - Marina Angela Visco
- Faculty of Psychology, eCampus University, 22090 Novedrate, Italy
- Correspondence: ; Tel.: +39-351-9523-318
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Abstract
The coronavirus disease (COVID-19) has spread globally. Dentists, dental specialists, dental assistants, dental staff, and patients are potentially at higher risk of COVID-19 infection during dental treatments. The prosthodontic dental treatment procedures may range from low to very high risk of COVID-19. This article presents necessary recommendations regarding the prosthodontic dental treatment procedures with standards of care and infection control.
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α 1 adrenergic receptor activation has a dynamic effect on masticatory muscle afferent fibers. Neuropharmacology 2020; 175:108197. [PMID: 32544482 DOI: 10.1016/j.neuropharm.2020.108197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
Temporomandibular Disorder (TMD) patients report amplification of pain in the masticatory muscles after psychological trauma or stressful conditions. The mechanisms underlying this phenomenon are yet to be elucidated. This study combined immunohistochemistry with single cell in vivo electrophysiology recordings of masticatory muscle afferent fibers to investigate the role of α1-adrenergic receptors in muscle nociception. It was found that a subset of trigeminal afferent fibers which innervate the masseter and temporal muscles expressed α1a, α1b and α1d receptors, including a smaller number of putative nociceptors which co-expressed TrpV1 receptors. Local injection of the selective α1 adrenergic receptor agonist phenylephrine into masticatory muscle decreased and increased the mechanical activation threshold of slow and fast conducting afferent fibers, respectively. This effect was reversed by co-administration of the α1 selective antagonist terazosin. To rule out the possibility that local ischemia was responsible for the observed effect of phenylephrine on masticatory muscle afferent fibers, additional experiments were conducted where blood flow to the masticatory muscle was reduced by common carotid artery occlusion. This investigation found that muscle blood flow occlusion increased the mechanical activation threshold of the majority of masticatory muscle afferent fibers unrelated to conduction velocity. These findings suggest that under conditions of increased sympathetic tone, such as those related to stress, noradrenaline may sensitize masticatory muscle nociceptors to increase pain and desensitize muscle proprioceptors to alter muscle tone, through activation of α1 receptors.
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Effat KG, Berty A. A comparative clinical study of temporomandibular disorder patients in the otolaryngology clinic versus a rheumatology clinic. Cranio 2019; 37:329-334. [DOI: 10.1080/08869634.2017.1422846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kamal G. Effat
- Department of Otolaryngology, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Department of Rheumatology, St. Mark Center, Cairo, Egypt
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Liu X, Zhou KX, Yin NN, Zhang CK, Shi MH, Zhang HY, Wang DM, Xu ZJ, Zhang JD, Li JL, Wang MQ. Malocclusion Generates Anxiety-Like Behavior Through a Putative Lateral Habenula-Mesencephalic Trigeminal Nucleus Pathway. Front Mol Neurosci 2019; 12:174. [PMID: 31427925 PMCID: PMC6689965 DOI: 10.3389/fnmol.2019.00174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/01/2019] [Indexed: 01/06/2023] Open
Abstract
Malocclusion is an important risk factor for temporomandibular disorder (TMD), a series of disorders characterized by dysfunction in the orofacial region involving the temporomandibular joint (TMJ) and jaw muscles. We recently showed that experimental unilateral anterior crossbite (UAC) produced masseter hyperactivity through a circuit involving the periodontal proprioception, trigeminal mesencephalic nucleus (Vme), and trigeminal motor nucleus (Vmo). Anxiety is a common complication in patients with TMD. The lateral habenula (LHb) is involved in emotional modulation and has direct projections to the Vme. Therefore, the present research examined whether UAC facilitates excitatory input from the LHb to the Vme and, subsequently, anxiety-like behaviors in rats. The LHb activation was evaluated by the electrophysiological recording, assessment of vesicular glutamate transporter-2 (VGLUT2) mRNA expression, and measurement of anxiety-like behaviors. The effects of LHb activity on Vme were evaluated by electrophysiological recording from Vme neurons and local changes in VGLUT2 protein density. UAC produced anxiety in modeled rats and increased neuronal activity in the LHb. VGLUT2 mRNA expression was also increased in the LHb. Further, VGLUT2-positive boutons were observed in close apposite upon parvalbumin (PV)-labeled Vme neurons. VGLUT2 protein expression was also increased in the Vme. Significantly, injection of VGLUT2-targeted shRNA into the LHb reduced the expression of VGLUT2 protein in the Vme, attenuated UAC-associated anxiety-like behaviors, and attenuated electrophysiological changes in the Vme neurons. In conclusion, we show that UAC activates the LHb neurons as well as the periodontal proprioceptive pathway to provide excitatory input to the Vme and produce anxiety in rats. These findings provide a rationale for suppressing activity of the LHb to attenuate both the physical and psychological effects of TMD.
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Affiliation(s)
- Xin Liu
- State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China.,Department of Stomatology, The 960th Hospital of People's Liberation Army, Jinan, China
| | - Kai-Xiang Zhou
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Center, The Fourth Military Medical University, Xi'an, China
| | - Nan-Nan Yin
- Department of Stomatology, The 960th Hospital of People's Liberation Army, Jinan, China
| | - Chun-Kui Zhang
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Center, The Fourth Military Medical University, Xi'an, China
| | - Ming-Hong Shi
- State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Hong-Yun Zhang
- State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Dong-Mei Wang
- Department of Oral Medicine, School of Stomatology, Xinxiang Medical University, Xinxiang, China
| | - Zi-Jun Xu
- School of Clinical Medicine, University of South China, Hengyang, China
| | - Jing-Dong Zhang
- Department of Anesthesiology, University of Cincinnati Medical College of Medicine, Cincinnati, OH, United States
| | - Jin-Lian Li
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Center, The Fourth Military Medical University, Xi'an, China
| | - Mei-Qing Wang
- State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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Prevalence of Temporomandibular Disorder in Turkish University Students: a Questionnaire Study. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Summary
Background/Aim: Temporomandibular dysfunction (TMD) might influence any individual with different signs and symptoms irrespective of gender or age. The aim of this study is to assess the prevalence of TMD in Oral and Dental Health Program students of İstanbul University-Cerrahpaşa.
Material and Methods: This study include a sample of 486 students with age ranging from18 to 24 years. The presence and severity of TMD was evaluated using the Fonseca’s Anamnestic Index (FAI) and its questionnaire. The data were analysed using SPSS Version 22. The chisquare test was used to compare the data from different groups and to determine whether the differences were statistically significant.
Results: The results showed that a total of 47,53% of students had some degree of TMD and females were generally more affected than males. These degrees were as follows: 33,95 % were classified as mild, 11,52 % moderate and 2,05 % severe signs and symptoms. The women exhibited some degree of TMD (51,8%) at a higher frequency than men (40,33%). No significant differences were observed between gender for a same TMD severity degree (p>0.05).
Conclusions: A high prevalence of mild TMD was found in this study population. In addition, tense personalities, headaches, and temporomandibular joint (TMJ) sounds were the most prevalent findings of TMD. The present study suggests that Fonseca’s Anamnestic Index (FAI) has been used in screening for TMD for prevention and management of TMD in a non-patient young population.
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Effat KG. A comparative clinical and radiographic study on patients with chronic facial pain with and without temporomandibular disorder presenting to an otolaryngology clinic. Cranio 2019; 39:5-11. [PMID: 30608220 DOI: 10.1080/08869634.2018.1563338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: Facial pain associated with temporomandibular disorder (TMD) is considered a component of Costen's syndrome. However, prior to the current study, no previous clinical and radiographic studies have addressed facial pain in patients with TMD. Methods: The study included 212 patients with chronic facial pain examined in an otolaryngology clinic. These were stratified into 132 patients with TMD and 80 patients without TMD. Clinical and radiographic findings were documented in both groups. Results: Forty-eight patients in the TMD group had normal endoscopic findings and clear CT scans and had their facial pain directly attributable to TMD. Conclusion: In patients presenting with facial pain, where nasal endoscopy reveals no abnormality, TMD should be specifically addressed, especially if CT scans of the paranasal sinuses are clear.
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Affiliation(s)
- Kamal G Effat
- Department of Otolaryngology, El-Sahel Teaching Hospital , Cairo, Egypt
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Zhang L, Hu XZ, Li H, Li X, Yu T, Dohl J, Ursano RJ. Updates in PTSD Animal Models Characterization. Methods Mol Biol 2019; 2011:331-344. [PMID: 31273708 DOI: 10.1007/978-1-4939-9554-7_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a chronic, debilitating mental disorder afflicting more than 7% of the US population and 12% of military service members. Since the Afghanistan and Iraq wars, thousands of US service members have returned home with PTSD. Despite recent progress, the molecular mechanisms underlying the pathology of PTSD are poorly understood. To promote research on PTSD (especially its molecular mechanisms) and to set a molecular basis for discovering novel medications for this disorder, well-validated animal models are needed. However, to develop PTSD animal models is a challenging process, due to predisposing factors such as physiological, behavioral, emotional, and cognitive changes that emerge after trauma. Currently, there is no well-validated animal model of PTSD, although several stress paradigms mimic the behavioral symptoms and neurological alterations seen in PTSD. In this chapter, we will provide an overview of animal models of PTSD including learned helplessness, footshock, restraint stress, inescapable tail shock, single-prolonged stress, underwater trauma, social isolation, social defeat, early-life stress, and predator-based stress. We emphasize rodent models because they reproduce some of the behavioral and biotical phenotypes seen in PTSD. We will also present data showing that homologous biological measures are increasingly incorporated in studies to assess markers of risk and therapeutic response in these models. Therefore, PTSD animal models may be refined in hopes of capitalizing on the understanding of the molecular mechanisms and delivering tools in order to develop new and more efficacious treatments for PTSD.
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Affiliation(s)
- Lei Zhang
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Xian-Zhang Hu
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - He Li
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Xiaoxia Li
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tianzheng Yu
- Department of Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jacob Dohl
- Department of Military and Emergency Medicine, Consortium for Health and Military Performance, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Robert J Ursano
- Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Paulino MR, Moreira VG, Lemos GA, Silva PLPD, Bonan PRF, Batista AUD. Prevalence of signs and symptoms of temporomandibular disorders in college preparatory students: associations with emotional factors, parafunctional habits, and impact on quality of life. CIENCIA & SAUDE COLETIVA 2018; 23:173-186. [PMID: 29267822 DOI: 10.1590/1413-81232018231.18952015] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 11/26/2015] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) signs and symptoms, its correlation with gender, parafunctional habits, emotional stress, anxiety, and depression and its impact on oral health-related quality of life (OHRQL) in college preparatory students at public and private institutions in João Pessoa, Paraíba (PB). The sample consisted of 303 students. Presence of TMD symptoms was determined by an anamnesis questionnaire containing questions related to the presence of parafunctional habits and emotional stress. A simplified clinical evaluation protocol was used. Anxiety and depression were determined with the Hospital Anxiety and Depression (HAD) scale and the OHRQL using the short version contained in the Oral Health Impact Profile (OHIP-14). The Chi-square, Fisher Exact, Mann Whitney, and Kruskal-Wallis tests were performed. Presence of signs and symptoms of TMD was statistically associated (p ≤ 0,05) with female gender, parafunctional habits, emotional stress, and anxiety, and represented greater impairment of the OHRQL. The physical pain domain was the most affected. The increased prevalence of signs and symptoms of TMD among college preparatory students indicates that there is a need for education and clarification among teachers and students to improve early diagnosis and to prevent the problem.
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Affiliation(s)
- Marcilia Ribeiro Paulino
- Programa de Pós-Graduação em Odontologia, Centro de Ciências da Saúde, Universidade Federal de Pernambuco. Av. da Engenharia, Cidade Universitária. 50670-420 Recife PE Brasil.
| | | | - George Azevedo Lemos
- Departamento de Biologia Estrutural e Funcional Universidade Estadual de Campinas. Campinas SP Brasil
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Han W, Kwon SC, Lee YJ, Park C, Jang EC. The associations between work-related factors and temporomandibular disorders among female full-time employees: findings from the Fourth Korea National Health and Nutrition Examination Survey IV (2007-2009). Ann Occup Environ Med 2018; 30:42. [PMID: 29977568 PMCID: PMC6011415 DOI: 10.1186/s40557-018-0253-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/12/2018] [Indexed: 11/12/2022] Open
Abstract
Background The aim of this study was to investigate the association between work-related factors and temporomandibular disorders (TMD) among female full-time employees using representative data from a national population-based survey. Methods Data from the Fourth Korea National Health and Nutrition Examination Survey IV (2007–2009) were used to analyze 1,612 women. Complex samples logistic regression was applied for adjusting for general characteristics and work-related factors to examine the association between work-related factors and TMD. Results The prevalence of TMD was 12.8% in this study population. With respect to age, educational status, marital status, problem drinking, exercise, and stress, there were statistically significant differences in the prevalence of TMD. In logistic regression analyses on complex samples, based on 40 h or less per week, odds ratios (ORs) for respondents who worked 40–48 working hours, 49–60 working hours, and more than 60 h were 1.16 (95% confidence interval (CI) 0.69–1.94), 1.41 (95% CI 0.79–2.54), and 2.43 (95% CI 1.29–4.59), after adjusting for general characteristics, working schedule, employment status, and occupation. Conclusions This study found that long working hours were significantly associated with TMD in Korean female full-time employees.
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Affiliation(s)
- Wook Han
- 1Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
| | - Soon-Chan Kwon
- 1Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
| | - Yong-Jin Lee
- 1Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea.,2Environmental Health Center for Asbestos, Soonchunhyang University Cheonan Hospital, 67, Suncheonhyang 3-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
| | - Chan Park
- 1Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
| | - Eun-Chul Jang
- 1Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31, Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
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Temporomandibular Disorders Related to Stress and HPA-Axis Regulation. Pain Res Manag 2018; 2018:7020751. [PMID: 29854038 PMCID: PMC5954859 DOI: 10.1155/2018/7020751] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023]
Abstract
Temporomandibular disorders (TMDs) are characterized by pain and dysfunction in the masticatory apparatus and the temporomandibular joint (TMJ). Previous trauma, stress symptoms, psychosocial impairment, and catastrophizing have been related to TMD. To assess if the hypothalamic-pituitary-adrenal (HPA) axis is upregulated in TMD patients, we performed a cross-sectional study with saliva from 44 TMD patients and 44 healthy sex- and age-matched controls for cortisol (F) and cortisone (E) with liquid chromatography-tandem mass spectrometry. Furthermore, we calculated the F/E ratio for the evaluation of 11β-hydroxysteroid dehydrogenase activity. We also assessed anxiety/depression and pain catastrophizing scores from a questionnaire that participants completed prior to the examination. We found that F (P=0.01), E (P=0.04), the F/E ratio (P=0.002), and the sum of glucocorticoids (E + E) in saliva (P=0.02) were significantly higher in the TMD group. Anxiety/depression and catastrophizing scores were also significantly higher in the TMD group (P < 0.0001). Our findings indicate that patients with TMDs may have an upregulated HPA axis with higher F secretion from the adrenal cortex. Anxiety/depression and pain catastrophizing scores were significantly higher in the TMD group, and psychological factors may contribute to chronic upregulation of the HPA axis.
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Zhao YJ, Li JH, Hu B, Wang Y, Chang XF, Traub RJ, Cao DY. Extracellular signal-regulated kinase activation in the spinal cord contributes to visceral hypersensitivity induced by craniofacial injury followed by stress. Neurogastroenterol Motil 2018; 30. [PMID: 28730748 DOI: 10.1111/nmo.13161] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 06/20/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND We previously developed an animal model to examine mechanisms that underlie the emergence of visceral hypersensitivity modeling pain characteristics of temporomandibular disorder (TMD) patients with comorbid irritable bowel syndrome (IBS). In ovariectomized (OVx) rats with estradiol (E2) replacement, visceral hypersensitivity developed subsequent to masseter muscle inflammation followed by repeated forced swim (FS) stress. The purpose of this study was to investigate whether activation of extracellular signal-regulated kinase (ERK) in the spinal cord contributes to visceral hypersensitivity in this overlapping pain model. METHODS In OVx with E2 replacement rats masseter muscle inflammation was followed by 3 day FS (comorbid condition). Depression-like behaviors were assessed by sucrose preference and in the elevated plus maze, and visceral sensitivity was measured by the visceromotor response (VMR) to colorectal distention. The protein level of ERK1/2 and phosphorylated ERK1/2 (p-ERK1/2) in the L6-S2 dorsal spinal cord was analyzed by western blot. KEY RESULTS FS stress decreased sucrose consumption in E2 replaced rats in sucrose preference test. The expression of p-ERK1/2 in the L6-S2 dorsal spinal cord increased significantly in E2 with comorbid rats. Intrathecal injection of mitogen-activated protein kinase (MAPK) kinase (MEK) inhibitor PD98059 blocked the visceral hypersensitivity induced by masseter muscle inflammation combined with FS stress. CONCLUSIONS & INFERENCES These data indicate that ERK1/2 activation contributes to the visceral hypersensitivity evoked by craniofacial inflammation pain combined with stress. The results may provide a new therapeutic avenue for alleviating overlapping pain conditions.
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Affiliation(s)
- Y-J Zhao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - J-H Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - B Hu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - Y Wang
- Department of Medical Imaging, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - X-F Chang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
| | - R J Traub
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, UM Center to Advance Chronic Pain Research, Baltimore, MD, USA
| | - D-Y Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Research Center of Stomatology, Xi'an Jiaotong University College of Stomatology, Xi'an, Shaanxi, China
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Fernández RAR, Pereira YCL, Iyomasa DM, Calzzani RA, Leite-Panissi CRA, Iyomasa MM, Nascimento GC. Metabolic and vascular pattern in medial pterygoid muscle is altered by chronic stress in an animal model of hypodontia. Physiol Behav 2017; 185:70-78. [PMID: 29275100 DOI: 10.1016/j.physbeh.2017.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/06/2017] [Accepted: 12/20/2017] [Indexed: 02/07/2023]
Abstract
Psychological stress is an important perpetuating, worsening and risk factor for temporomandibular disorders of muscular or articular origin. Occlusion instability, by the way, is considered a risk factor of this pathology and can be reproduced in some experimental animal models. The exact physiologic mechanism underlying these relations however, remains unclear. Our purpose was to test the hypothesis that chronic stress and unilateral exodontia induce metabolic and vascular changes in the medial pterygoid muscle of rats. Adult Wistar rats were submitted to chronic unpredictable stress and/or unilateral exodontia and their plasma and medial pterygoid muscle were removed for analysis. The parameters evaluated included plasma levels of corticosterone, metabolic activity by succinate dehydrogenase, oxidative capacity by nicotinamide adenine dinucleotide diaphorase, capillary density by laminin and alfa-CD staining and reactive oxidative species production. Chronic unpredictable stress as an isolated factor, increased oxidative metabolism, capillary density and reactive oxygen species production at medial pterygoid muscle. Conversely, exodontia has a main effect in metabolism, promoting glycolytic transformation of muscle fibers. Association of both factors induced a major glycolytic pattern in muscle and vascular changes. Our findings provide insights into the mechanisms, possibly inducing metabolic and vascular alterations on medial pterygoid muscle of rats, by which chronic stress and occlusal instabilities might be involved as risk factors in the pathophysiology of temporomandibular disorders with muscular components.
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Affiliation(s)
- Rodrigo Alberto Restrepo Fernández
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Yamba Carla Lara Pereira
- Biology Dental Buco Graduate Program, School of Dentistry of Piracicaba, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Daniela Mizusaki Iyomasa
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Ricardo Alexandre Calzzani
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Christie Ramos Andrade Leite-Panissi
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil; Psychobiology Graduate Program, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-901, SP, Brazil
| | - Mamie Mizusaki Iyomasa
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil
| | - Glauce Crivelaro Nascimento
- Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto Dentistry Faculty, University of São Paulo, Ribeirão Preto 14040-904, SP, Brazil.
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Jivnani HM, Tripathi S, Shanker R, Singh BP, Agrawal KK, Singhal R. A Study to Determine the Prevalence of Temporomandibular Disorders in a Young Adult Population and its Association with Psychological and Functional Occlusal Parameters. J Prosthodont 2017; 28:e445-e449. [PMID: 29135060 DOI: 10.1111/jopr.12704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine the prevalence of temporomandibular disorders (TMD) in medical university students and to analyze the relationship of TMD with psychological and functional occlusal parameters. MATERIALS AND METHODS 200 students (mean age 21.81 ± 1.99) were screened for TMD with the TMD Pain Screener. Clinical examinations identified the participants with TMD. Based on their diagnostic criteria for TMD (DC/TMD) axis I diagnosis, participants were divided into three groups: group 1- non-TMD, group 2- pain related TMD and headaches, and group 3- intra-articular joint disorders. Further study was continued involving patients diagnosed with TMD as the study group, and an equal number of age- and sex-matched participants were selected in control group. Among these, emotional distress was evaluated using the "hospital anxiety and depression scale" (HADS). Occlusal evaluations were done by using the T-Scan computerized occlusal analysis system. Occlusion time, left lateral disclusion time, right lateral disclusion time, and protrusion disclusion time were measured with T-Scan III. These parameters were compared among the groups with ANOVA test at a significance level of 0.05. RESULTS 17% of the population were affected by TMD. The mean HADSd (depression) and HADSa (anxiety) scores were significantly higher (p < 0.05) in group 2 (7.67 ± 3.68; 10.60 ± 3.33) and group 3 (6.89 ± 3.23; 9.26 ± 4.05) as compared to group 1 (3.18 ± 2.33; 5.29 ± 3.21). The mean values of occlusion time, left lateral disclusion time, right lateral disclusion time, and protrusion-disclusion time were also higher for group 2 and group 3 as compared to group 1. CONCLUSIONS This study found that the prevalence of TMD in this university student population was 17%. There were significant associations of TMD with psychological parameters and functional occlusal parameters.
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Affiliation(s)
- Hemant Maheshkumar Jivnani
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Shuchi Tripathi
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Rama Shanker
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Balendra Pratap Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Kaushal Kishor Agrawal
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
| | - Rameshwari Singhal
- Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, India
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Xu N, Tang XH, Pan W, Xie ZM, Zhang GF, Ji MH, Yang JJ, Zhou MT, Zhou ZQ. Spared Nerve Injury Increases the Expression of Microglia M1 Markers in the Prefrontal Cortex of Rats and Provokes Depression-Like Behaviors. Front Neurosci 2017; 11:209. [PMID: 28458629 PMCID: PMC5394168 DOI: 10.3389/fnins.2017.00209] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/28/2017] [Indexed: 11/20/2022] Open
Abstract
Pain and depression are frequently co-existent in clinical practice, yet the underlying mechanisms remain largely to be determined. Microglia activation and subsequent pro-inflammatory responses play a crucial role in the development of neuropathic pain and depression. The process of microglia polarization to the pro-inflammatory M1 or anti-inflammatory M2 phenotypes often occurs during neuroinflammation. However, it remains unclear whether M1/M2 microglia polarization is involved in the neuropathic pain induced by spared nerve injury (SNI). In the present study, the mechanical withdrawal threshold, forced swim test, sucrose preference test, and open field test were performed. The levels of microglia markers including ionized calcium-binding adaptor molecule 1 (Iba1), cluster of differentiation 11b (CD11b), M1 markers including CD68, inducible nitric oxide synthase (iNOS), interleukin-1β (IL-1β), IL-6, tumor necrosis factor-a (TNF-α), 8-hydroxy-2-deoxyguanosine (8-OH-dG), and M2 markers including CD206, arginase 1 (Arg1), IL-4 in the prefrontal cortex were determined on day 14 after SNI. The results showed that SNI produced mechanical allodynia and depressive-like behaviors, and also increased the expressions of microglia markers (Iba1, CD11b) and M1 markers (CD68, iNOS, IL-1β, TNF-α, and 8-OH-dG) in the prefrontal cortex. Notably, minocycline administration reversed these abnormalities. In addition, minocycline also promoted M2 microglia polarization as evidenced by up-regulation of CD206 and Arg1. In conclusion, data from our study suggest that SNI can lead to depression-like behaviors, while M1 polarization and consequent overproduction of pro-inflammatory cytokines plays a key role in the pathogenesis of neuropathic pain. The data furthermore indicate that modulation of inflammation by inhibition of M1 polarization could be a strategy for treatment of neuropathic pain, and might prevent the induction of neuropathic pain-induced depression symptoms.
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Affiliation(s)
- Ning Xu
- Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityNanjing, China.,Jiangsu Province Key Laboratory of Anesthesiology, College of Anesthesiology, Xuzhou Medical UniversityXuzhou, China
| | - Xiao-Hui Tang
- Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing UniversityNanjing, China
| | - Wei Pan
- Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing UniversityNanjing, China
| | - Ze-Min Xie
- Jiangsu Province Key Laboratory of Anesthesiology, College of Anesthesiology, Xuzhou Medical UniversityXuzhou, China
| | - Guang-Fen Zhang
- Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Mu-Huo Ji
- Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityNanjing, China
| | - Jian-Jun Yang
- Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityNanjing, China.,Jiangsu Province Key Laboratory of Anesthesiology, College of Anesthesiology, Xuzhou Medical UniversityXuzhou, China
| | - Mai-Tao Zhou
- Jiangsu Province Key Laboratory of Anesthesiology, College of Anesthesiology, Xuzhou Medical UniversityXuzhou, China.,Department of Anesthesiology, 101st Hospital of PLAWuxi, China
| | - Zhi-Qiang Zhou
- Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast UniversityNanjing, China.,Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing UniversityNanjing, China
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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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Xie P, Qin B, Song G, Zhang Y, Cao S, Yu J, Wu J, Wang J, Zhang T, Zhang X, Yu T, Zheng H. Microstructural Abnormalities Were Found in Brain Gray Matter from Patients with Chronic Myofascial Pain. Front Neuroanat 2016; 10:122. [PMID: 28066193 PMCID: PMC5167736 DOI: 10.3389/fnana.2016.00122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/02/2016] [Indexed: 11/13/2022] Open
Abstract
Myofascial pain, presented as myofascial trigger points (MTrPs)-related pain, is a common, chronic disease involving skeletal muscle, but its underlying mechanisms have been poorly understood. Previous studies have revealed that chronic pain can induce microstructural abnormalities in the cerebral gray matter. However, it remains unclear whether the brain gray matters of patients with chronic MTrPs-related pain undergo alteration. In this study, we employed the Diffusion Kurtosis Imaging (DKI) technique, which is particularly sensitive to brain microstructural perturbation, to monitor the MTrPs-related microstructural alterations in brain gray matter of patients with chronic pain. Our results revealed that, in comparison with the healthy controls, patients with chronic myofascial pain exhibited microstructural abnormalities in the cerebral gray matter and these lesions were mainly distributed in the limbic system and the brain areas involved in the pain matrix. In addition, we showed that microstructural abnormalities in the right anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) had a significant negative correlation with the course of disease and pain intensity. The results of this study demonstrated for the first time that there are microstructural abnormalities in the brain gray matter of patients with MTrPs-related chronic pain. Our findings may provide new insights into the future development of appropriate therapeutic strategies to this disease.
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Affiliation(s)
- Peng Xie
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Bangyong Qin
- Department of Anesthesiology, Zunyi Medical University Zunyi, China
| | - Ganjun Song
- Department of Radiology, Zunyi Medical University Zunyi, China
| | - Yi Zhang
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Song Cao
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Jin Yu
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Jianjiang Wu
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Jiang Wang
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
| | - Tijiang Zhang
- Department of Radiology, Zunyi Medical University Zunyi, China
| | - Xiaoming Zhang
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City KS, USA
| | - Tian Yu
- Department of Anesthesiology, Zunyi Medical UniversityZunyi, China; Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical UniversityZunyi, China
| | - Hong Zheng
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University Urumqi, China
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Woda A, Picard P, Dutheil F. Dysfunctional stress responses in chronic pain. Psychoneuroendocrinology 2016; 71:127-35. [PMID: 27262345 DOI: 10.1016/j.psyneuen.2016.05.017] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/06/2016] [Accepted: 05/18/2016] [Indexed: 11/26/2022]
Abstract
Many dysfunctional and chronic pain conditions overlap. This review describes the different modes of chronic deregulation of the adaptive response to stress which may be a common factor for these conditions. Several types of dysfunction can be identified within the hypothalamo-pituitary-adrenal axis: basal hypercortisolism, hyper-reactivity, basal hypocortisolism and hypo-reactivity. Neuroactive steroid synthesis is another component of the adaptive response to stress. Dehydroepiandrosterone (DHEA) and its sulfated form DHEA-S, and progesterone and its derivatives are synthetized in cutaneous, nervous, and adipose cells. They are neuroactive factors that act locally. They may have a role in the localization of the symptoms and their levels can vary both in the central nervous system and in the periphery. Persistent changes in neuroactive steroid levels or precursors can induce localized neurodegeneration. The autonomic nervous system is another component of the stress response. Its dysfunction in chronic stress responses can be expressed by decreased basal parasympathethic activity, increased basal sympathetic activity or sympathetic hyporeactivity to a stressful stimulus. The immune and genetic systems also participate. The helper-T cells Th1 secrete pro-inflammatory cytokines such as IL-1-β, IL-2, IL-6, IL-8, IL-12, IFN-γ, and TNF-α, whereas Th2 secrete anti-inflammatory cytokines: IL-4, IL-10, IGF-10, IL-13. Chronic deregulation of the Th1/Th2 balance can occur in favor of anti- or pro-inflammatory direction, locally or systemically. Individual vulnerability to stress can be due to environmental factors but can also be genetically influenced. Genetic polymorphisms and epigenetics are the main keys to understanding the influence of genetics on the response of individuals to constraints.
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Affiliation(s)
- Alain Woda
- Dental faculty, EA 3847, CROC, 11 Boulevard Charles-de-Gaulle, Clermont-Ferrand, France; University Hospital of Clermont-Ferrand (CHU), Odontology department, Clermont-Ferrand, France
| | - Pascale Picard
- Pain center, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU), Clermont-Ferrand, France; University Clermont Auvergne, Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological conditions (AME2P, EA3533), Clermont-Ferrand, France; Australian Catholic University, Faculty of Health, Melbourne, Victoria, Australia; CNRS, UMR 6024, Physiological and Psychosocial Stress, LAPSCO, University Clermont Auvergne, Clermont-Ferrand, France.
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Hubbard CS, Karpowicz JM, Furman AJ, da Silva JT, Seminowicz DA, Traub RJ. Estrogen-dependent visceral hypersensitivity following stress in rats: An fMRI study. Mol Pain 2016; 12:12/0/1744806916654145. [PMID: 27317579 PMCID: PMC4956385 DOI: 10.1177/1744806916654145] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/11/2016] [Indexed: 12/17/2022] Open
Abstract
We used functional MRI and a longitudinal design to investigate the brain mechanisms in a previously reported estrogen-dependent visceral hypersensitivity model. We hypothesized that noxious visceral stimulation would be associated with activation of the insula, anterior cingulate cortex, and amygdala, and that estrogen-dependent, stress-induced visceral hypersensitivity would both enhance activation of these regions and recruit activation of other brain areas mediating affect and reward processing. Ovariectomized rats were treated with estrogen (17 β-estradiol, E2) or vehicle (n = 5 per group) and scanned in a 7T MRI at three different time points: pre-stress (baseline), 2 days post-stress, and 18 days post-stress. Stress was induced via a forced-swim paradigm. In a separate group of ovariectomized rats, E2 treatment induced visceral hypersensitivity at the 2 days post-stress time point, and this hypersensitivity returned to baseline at the 18 days post-stress time point. Vehicle-treated rats show no hypersensitivity following stress. During the MRI scans, rats were exposed to noxious colorectal distention. Across groups and time points, noxious visceral stimulation led to activations in the insula, anterior cingulate, and left amygdala, parabrachial nuclei, and cerebellum. A group-by-time interaction was seen in the right amygdala, ventral striatum-pallidum, cerebellum, hippocampus, mediodorsal thalamus, and pontine nuclei. Closer inspection of the data revealed that vehicle-treated rats showed consistent activations and deactivations across time, whereas estrogen-treated animals showed minimal deactivation with noxious visceral stimulation. This unexpected finding suggests that E2 may dramatically alter visceral nociceptive processing in the brain following an acute stressor. This study is the first to examine estrogen-stress dependent interactions in response to noxious visceral stimulation using functional MRI. Future studies that include other control groups and larger sample sizes are needed to fully understand the interactions between sex hormones, stress, and noxious stimulation on brain activity.
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Affiliation(s)
- Catherine S Hubbard
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center for Pain and the Brain, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA Department of Anaesthesia, Harvard Medical School, Boston, MA, USA
| | - Jane M Karpowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Andrew J Furman
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA
| | - Joyce Teixeira da Silva
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Department of Anaesthesia, Harvard Medical School, Boston, MA, USA Department of Anatomy, Institute of Biomedical Science-III, University of Sao Paulo, Sao Paulo, Brazil
| | - David A Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
| | - Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD, USA Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
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OLIVEIRA LK, ALMEIDA GDA, LELIS ÉR, TAVARES M, FERNANDES NETO AJ. Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals. Braz Oral Res 2015; 29:S1806-83242015000100265. [DOI: 10.1590/1807-3107bor-2015.vol29.0070] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/03/2015] [Indexed: 11/21/2022] Open
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Bouloux GF, Zerweck AG, Celano M, Dai T, Easley KA. Can Preoperative Psychological Assessment Predict Outcomes After Temporomandibular Joint Arthroscopy? J Oral Maxillofac Surg 2015; 73:2094-102. [PMID: 26032643 DOI: 10.1016/j.joms.2015.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 04/17/2015] [Accepted: 05/11/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Psychological assessment has been used successfully to predict patient outcomes after cardiothoracic and bariatric surgery. The purpose of this study was to determine whether preoperative psychological assessment could be used to predict patient outcomes after temporomandibular joint arthroscopy. MATERIALS AND METHODS Consecutive patients with temporomandibular dysfunction (TMD) who could benefit from arthroscopy were enrolled in a prospective cohort study. All patients completed the Millon Behavior Medicine Diagnostic survey before surgery. The primary predictor variable was the preoperative psychological scores. The primary outcome variable was the difference in pain between the pre- and postoperative periods. The Spearman rank correlation coefficient and the Pearson product-moment correlation were used to determine the association between psychological factors and change in pain. Univariable and multivariable analyses were performed using a mixed-effects linear model and multiple linear regression. A P value of .05 was considered significant. RESULTS Eighty-six patients were enrolled in the study. Seventy-five patients completed the study and were included in the final analyses. The mean change in visual analog scale (VAS) pain score 1 month after arthroscopy was -15.4 points (95% confidence interval, -6.0 to -24.7; P < .001). Jaw function also improved after surgery (P < .001). No association between change in VAS pain score and each of the 5 preoperative psychological factors was identified with univariable correlation analyses. Multivariable analyses identified that a greater pain decrease was associated with a longer duration of preoperative symptoms (P = .054) and lower chronic anxiety (P = .064). CONCLUSIONS This study has identified a weak association between chronic anxiety and the magnitude of pain decrease after arthroscopy for TMD. Further studies are needed to clarify the role of chronic anxiety in the outcome after surgical procedures for the treatment of TMD.
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Affiliation(s)
- Gary F Bouloux
- Associate Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Ashley G Zerweck
- Former Chief Resident, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA
| | - Marianne Celano
- Professor, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Tian Dai
- PhD Student, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Kirk A Easley
- Senior Associate, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA
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Traub RJ, Cao DY, Karpowicz J, Pandya S, Ji Y, Dorsey SG, Dessem D. A clinically relevant animal model of temporomandibular disorder and irritable bowel syndrome comorbidity. THE JOURNAL OF PAIN 2014; 15:956-66. [PMID: 24981128 DOI: 10.1016/j.jpain.2014.06.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/18/2014] [Accepted: 06/19/2014] [Indexed: 12/28/2022]
Abstract
UNLABELLED Temporomandibular disorder and irritable bowel syndrome are comorbid functional chronic pain disorders of unknown etiology that are triggered/exacerbated by stress. Here we present baseline phenotypic characterization of a novel animal model to gain insight into the underlying mechanisms that contribute to such comorbid pain conditions. In this model, chronic visceral hypersensitivity, a defining symptom of irritable bowel syndrome, is dependent on 3 factors: estradiol, existing chronic somatic pain, and stress. In ovariectomized rats, estradiol replacement followed by craniofacial muscle injury and stress induced visceral hypersensitivity that persisted for months. Omission of any 1 factor resulted in a transient (1 week) visceral hypersensitivity from stress alone or no hypersensitivity (no inflammation or estradiol). Maintenance of visceral hypersensitivity was estradiol dependent, resolving when estradiol replacement ceased. Referred cutaneous hypersensitivity was concurrent with visceral hypersensitivity. Increased spinal Fos expression suggests induction of central sensitization. These data demonstrate the development and maintenance of visceral hypersensitivity in estradiol-replaced animals following distal somatic injury and stress that mimics some characteristics reported in patients with temporomandibular disorder and comorbid irritable bowel syndrome. This new animal model is a powerful experimental tool that can be employed to gain further mechanistic insight into overlapping pain conditions. PERSPECTIVE The majority of patients with temporomandibular disorder report symptoms consistent with irritable bowel syndrome. Stress and female prevalence are common to both conditions. In a new experimental paradigm in ovariectomized rats with estradiol replacement, masseter inflammation followed by stress induces visceral hypersensitivity that persists for months, modeling these comorbid pain conditions.
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Affiliation(s)
- Richard J Traub
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland.
| | - Dong-Yuan Cao
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Jane Karpowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Sangeeta Pandya
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Yaping Ji
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland
| | - Susan G Dorsey
- Department of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland
| | - Dean Dessem
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland; UMB Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland
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