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Iodice G, Michelotti A, D'Antò V, Martina S, Valletta R, Rongo R. Prevalence of psychosocial findings and their correlation with TMD symptoms in an adult population sample. Prog Orthod 2024; 25:39. [PMID: 39397187 PMCID: PMC11471746 DOI: 10.1186/s40510-024-00538-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: 02/14/2024] [Accepted: 08/19/2024] [Indexed: 10/15/2024] Open
Abstract
BACKGROUND AND AIM Some studies suggested an association between Temporomandibular Disorders (TMD) and psychosocial status, but most of them are focused on samples of patients looking for treatment or present limits of sample representativeness. The aim of the present study was to evaluate the psychosocial status in a large sample of adult population, further than to assess its association to TMD symptoms, oral behaviours, and self-reported facial trauma. RESULTS the study sample included 4299 subjects older than 18 years randomly recruited from general population in public spaces during their daily life (1700 Males, 2599 Females mean ± SD age = 40.4 ± 18.1). Psychosocial status and pain-related disability were assessed by means of Patient Health Questionnaire 4 (PHQ-4) and Graded Chronic Pain Scale (GCPS). TMD symptoms were assessed by RDC/TMD and validated screening tools for TMD pain. Oral Behaviours Checklist was used to investigate on oral behaviours. Logistic regression model was used to evaluate the association of the psychosocial status, TMD symptoms, trauma, and oral behaviours. The association was tested using both univariate and multivariate models. The PHQ4 evaluation showed a severe impairment in 4.6% of our sample, moderate in 18.8% and mild in 32.5%. We found a Characteristic Pain Intensity (CPI) level and Interference Score greater that 30 respectively in 36.2% and 22.2% of the study sample. The GCPS status revealed a high disability with severe limitation in 2.5% of the sample, high disability with moderate limitation in 7.0%, low disability high pain intensity in 7.4% and low disability low pain intensity in 37.8%. Anxiety and depression's levels were significantly associated with gender, TMD pain, coexistence of TMD Pain and sound, and oral behaviours. GCPS status was significantly associated with age, TMD Pain, coexistence of TMD pain and sound, trauma, and oral behaviours. CONCLUSIONS In the general population, psychosocial impairment is associated to TMD pain, female gender, and report of oral behaviours. Hence, in adults with TMD accompanied by pain, psychosocial status should also be evaluated.
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Affiliation(s)
- Giorgio Iodice
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy.
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy
| | - Vincenzo D'Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Al-lende, Baronissi, 84081, Italy
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy
| | - Roberto Rongo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy
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Ishimaru T, Yamaguchi T, Saito T, Hattori Y, Ono T, Arai Y, Hasegawa Y, Shiga H, Tamaki K, Tanaka J, Tsuga K, Abekura H, Miyawaki S, Maeda-Iino A, Mikami S, Gotouda A, Satoh K, Shimizu K, Kato Y, Namita T. Actual state of the diurnal masseteric electromyogram: Differences between awareness and non-awareness of awake bruxism. J Prosthodont Res 2024; 68:456-465. [PMID: 38220162 DOI: 10.2186/jpr.jpr_d_23_00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
PURPOSE This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects. METHODS Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included. Waveforms longer than 0.25 s with the two amplitude conditions, exceeding twice the baseline and >5% of maximum voluntary clenching, were extracted. In addition, the number of bursts and episodes (groups of bursts), burst duration, and burst peak amplitude were calculated for each participant. RESULTS There were no significant differences in the EMG parameters between the groups with and without awareness of d-TC. Additionally, the frequency distribution of the number of EMG waveforms exhibited wide ranges and substantial overlap between the two groups. CONCLUSIONS The variability in the number of bursts and episodes, burst peak amplitude, and burst duration among subjects suggests the need for an objective classification of d-AB severity based on EMG values. The absence of significant differences and large overlap in frequency distributions between the groups with and without awareness of d-TC indicate difficulty in predicting muscle activity solely based on awareness of d-AB.
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Affiliation(s)
- Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Yoshiaki Arai
- Oral Implant & Temporomandibular Joint Clinic, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Shiga
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo, Japan
| | - Katsushi Tamaki
- Graduate School of Dentistry, Kanagawa Dental University Department of Oral Interdisciplinary Medicine (OIM) Division of Prosthodontic Dentistry for function of TMJ and Occlusion, Yokosuka, Japan
| | - Junko Tanaka
- Department of Fixed Prosthodontics and Occlusion Osaka Dental University, Osaka, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Aya Maeda-Iino
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kaoru Satoh
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Shimizu
- School of Optoelectronic Engineering, Xidian University, Xi'an, China
| | - Yuji Kato
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Takeshi Namita
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo, Japan
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Maeda-Iino A, Osako Y, Nakagawa S, Takahashi K, Oga Y, Furukawa-Sainoki M, Harada M, Fukushima M, Miyawaki S. Relationship between masseter muscle activity during wakefulness and temporomandibular disorder-related symptoms. J Oral Rehabil 2024; 51:455-468. [PMID: 38030583 DOI: 10.1111/joor.13617] [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: 12/21/2022] [Revised: 10/20/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Masseter muscle activity during wakefulness may be associated with temporomandibular disorder (TMD)-related symptoms, psychosocial status and pain-related disability; however, this relationship is unclear. OBJECTIVES This study aimed to determine the relationship between masseter muscle electromyography (EMG) burst/duration during wakefulness and TMD-related symptoms, psychosocial status and pain-related disability. METHODS Sixty participants were assessed masseter muscle activity during wakefulness using a data-logger-type ultraminiature EMG system and TMD-related symptoms, psychosocial status and pain-related disability through Axis I and II of the diagnostic criteria for TMD (DC/TMD). EMG bursts lasting longer than 0.25 s but less than 2.0 s and those lasting longer than 2.0 s were classified as phasic and tonic bursts, respectively. RESULTS Participants with palpation-related pain in the temporalis and masseter muscles, as assessed through the DC/TMD examination form in Axis I, had more bursts (number/h) (p = .035 and p = .009, respectively) and longer duration (time/h) (p = .013 and p = .004, respectively) of tonic bursts of the masseter muscle during wakefulness. Participants with palpation-related pain in the masseter muscles had higher oral behaviour scores during wakefulness using Axis II (p = .001), which affected the number and duration of tonic bursts of the masseter muscle activity during wakefulness (p = .011 and p = .007, respectively). CONCLUSION As tonic bursts mainly reflect clenching, individuals with pain in the masseter muscles by palpation may have a high frequency and longer duration of clenching, as well as a high frequency of oral behaviours during wakefulness.
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Affiliation(s)
- Aya Maeda-Iino
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuki Osako
- Department of Orthodontics, Center of Developmental Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Shoko Nakagawa
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kotaro Takahashi
- Department of Orthodontics, Center of Developmental Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Yasuhiko Oga
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Minami Furukawa-Sainoki
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Marina Harada
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mika Fukushima
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Solis ACDO, Corchs F, Duran ÉP, Silva C, Del Real N, Araújo ÁC, Wang YP, Lotufo-Neto F. Self-reported bruxism in patients with post-traumatic stress disorder. Clin Oral Investig 2024; 28:152. [PMID: 38363350 DOI: 10.1007/s00784-024-05534-4] [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: 09/18/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD). METHODS A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles. RESULTS Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain. CONCLUSIONS PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events. CLINICAL RELEVANCE We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.
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Affiliation(s)
- Ana Cristina de Oliveira Solis
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil.
| | - Felipe Corchs
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Érica Panzani Duran
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Cláudio Silva
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Natalia Del Real
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Álvaro Cabral Araújo
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
| | - Yuan-Pang Wang
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
- Departamento e Instituto de Psiquiatria (LIM-23), Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Francisco Lotufo-Neto
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, R. Dr. Ovídio Pires de Campos, 785, Caixa Postal 3671, Sao Paulo, SP, CEP 01060-970, Brazil
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Mikami S, Yamaguchi T, Takahashi M, Kudo A, Saito M, Nakajima T, Maeda M, Saito T, Sakuma T, Takahashi S, Ishimaru T, Gotouda A. Examination of the relationship between masseter muscle activity during sleep and wakefulness measured by using a wearable electromyographic device. J Prosthodont Res 2024; 68:92-99. [PMID: 37005256 DOI: 10.2186/jpr.jpr_d_22_00231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Purpose This study aimed to measure masseter muscle activity throughout the day in outpatients suspected of having awake bruxism (AB) and/or sleep bruxism (SB) and examine the relationship between AB and SB by comparing muscle activity during daytime wakefulness and nighttime sleep.Methods Fifty outpatients with suspected SB and/or AB participated in this study. A single-channel wearable electromyogram (EMG) device was used for EMG recording. The selected EMG bursts were divided into bursts during sleep (S-bursts) and bursts during awake state (A-bursts). The number of bursts per hour, average burst duration, and ratio of burst peak value to maximum voluntary contraction were calculated for both the S- and A-bursts. These values of the S- and A-bursts were then compared, and the correlations between them were analyzed. Additionally, the ratios of phasic and tonic bursts in the S- and A-bursts were compared.Results The number of bursts per hour was significantly higher for A-bursts than for S-bursts. No significant correlation was found between the numbers of S- and A-bursts. The ratio of phasic bursts was large and that of tonic bursts was small in both the S- and A-bursts. A comparison of the S- and A-bursts showed that the S-bursts had a significantly lower ratio of phasic bursts and higher ratio of tonic bursts than the A-bursts.Conclusions The number of masseteric EMG bursts during wakefulness did not show any association with that during sleep. It became clear that sustained muscle activity was not dominant in AB.
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Affiliation(s)
- Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Mebae Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Ai Kudo
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Miku Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshimitsu Sakuma
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Sota Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
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Asami K, Fujisawa M, Saito-Murakami K, Miura S, Fujita T, Imamura Y, Koyama S. Assessment of awake bruxism-Combinational analysis of ecological momentary assessment and electromyography. J Prosthodont Res 2024; 68:166-171. [PMID: 37286504 DOI: 10.2186/jpr.jpr_d_22_00289] [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: 06/09/2023]
Abstract
PURPOSE No consensus exists regarding the examination methods and assessment criteria for awake bruxism (AB). In this study, masticatory muscle activity measured using electromyography (EMG) was recorded simultaneously with the ecological momentary assessment (EMA) of bruxism events. Data were collected to identify distinctive EMG parameters in AB. METHODS A total of 104 individuals were classified into the bruxism (BR) or control (CO) groups based on clinical findings. The participants recorded EMA on a tablet device under continuous EMG recording using a data log-type wireless EMG device. For EMA recording, a warning was randomly provided three times each hour for five hours. A receiver operating characteristic (ROC) curve was obtained based on EMA and EMG events. Maximum voluntary contraction (MVC) at the time of maximum bite force was set at 100%. The muscle activity was assessed as a relative value. RESULTS Based on discriminant analysis, analysis of participants who had four or more positive clenching EMA responses was appropriate. The assessed parameters for the EMG cutoff value determination procedure, which combined EMG and EMA, resulted in a cutoff value that enabled the distinction between the BR and CO groups. The area under the ROC curve was 0.77 and the cut-off value was 3.2 events/hour under the EMG of 20% MVC with a duration of ≥1 s. CONCLUSIONS This is the first study to report a combined analysis of the EMA and EMG. These results suggest its effectiveness as a cutoff value for AB screening.
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Affiliation(s)
- Kazuya Asami
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Konatsu Saito-Murakami
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Takafumi Fujita
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Yoshiki Imamura
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Shiho Koyama
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
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Bracci A, Lobbezoo F, Colonna A, Bender S, Conti PCR, Emodi-Perlman A, Häggman-Henrikson B, Klasser GD, Michelotti A, Lavigne GJ, Svensson P, Ahlberg J, Manfredini D. Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies. J Oral Rehabil 2024; 51:150-161. [PMID: 37191494 DOI: 10.1111/joor.13514] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged. OBJECTIVE In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management. METHODS We summarised current strategies for AB assessment and proposed a research route for improving its metrics. RESULTS Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity. CONCLUSIONS Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach.
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Affiliation(s)
- Alessandro Bracci
- Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | - Paulo C R Conti
- Bauru School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Telaviv, Israel
| | | | - Gary D Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, and Universite de Montreal, Montreal, Quebec, Canada
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
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Pittar N, Firth F, Bennani H, Farella M. The effect of passive clear aligners on masticatory muscle activity in adults with different levels of oral parafunction. J Oral Rehabil 2023; 50:1409-1421. [PMID: 37615269 DOI: 10.1111/joor.13575] [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: 02/17/2023] [Revised: 05/13/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND There is limited knowledge of the possible side-effects of clear aligners on jaw function. OBJECTIVES To determine the short-term effect of passive clear aligners (PCAs) on masticatory muscle activity (MMA), occlusal discomfort (OD) and temporomandibular disorder (TMD) symptoms in adults with different levels of self-reported oral parafunction. MATERIALS AND METHODS Participants were screened for oral parafunctional behaviours using the oral behavioural checklist. Respondents in ≥85th and ≤15th percentiles were invited to participate and allocated to a high (HPF: N = 15) or low (lower parafunction [LPF]: N = 16) parafunction group. Participants underwent a TMD clinical examination; somatisation and somatosensory amplification were assessed by questionnaires; OD and stress were assessed by visual analogue scales. While wearing PCAs, awake-time MMA was assessed three times over 9 days using a wearable electromyography device, along with OD, stress and TMD symptoms. RESULTS The wearing of PCAs was associated with a significant decrease in mean contraction episode amplitude in both groups (p = 0.003). OD levels increased and remained raised in all participants after insertion of the PCAs (p < 0.001), more so in the HPF group (p = 0.048). The HPF group had higher somatisation scores (p = 0.006) and reported more TMD symptoms at all time points (p ≤ 0.004). No significant changes in stress or TMD symptoms were found in either group during the study period. CONCLUSIONS PCAs were associated with a decrease in MMA in all participants. HPF individuals had greater somatisation and reported greater discomfort when wearing PCAs than LPF individuals.
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Affiliation(s)
- Nicholas Pittar
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Fiona Firth
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Hamza Bennani
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- Discipline of Orthodontics, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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9
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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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10
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Kim SR, Chang M, Kim AH, Kim ST. Effect of Botulinum Toxin on Masticatory Muscle Pain in Patients with Temporomandibular Disorders: A Randomized, Double-Blind, Placebo-Controlled Pilot Study. Toxins (Basel) 2023; 15:597. [PMID: 37888628 PMCID: PMC10610636 DOI: 10.3390/toxins15100597] [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: 08/29/2023] [Revised: 09/25/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
This study aimed to evaluate the efficacy of botulinum toxin type A (BoNT/A) in patients with temporomandibular disorders (TMDs) associated with masticatory muscle pain (MMP) and headaches. This randomized, double-blind, placebo-controlled pilot study is the first clinical trial to evaluate both disorders simultaneously. Twenty-one patients with myogenous TMD were randomly assigned to two groups. The experimental and control groups received injections of either BoNT/A or saline into the sites showing tenderness after palpation of a total of 16 muscle areas, including each masseter, a temporalis, splenius capitis, sternocleidomastoid, and trapezius muscle. During each visit, the clinical effects, based on the intensity of orofacial pain (OVAS), headache (HVAS), number of tender points (TPs), maximum mouth opening (MMO), and headache frequency (HF), were evaluated at four time points, namely, pre-injection and 4, 8, and 12 weeks after the injection, in both groups. Friedman and Mann-Whitney tests were used for the analyses. In the experimental group, the reductions in OVAS, TP, HVAS, and HF showed significant differences over time, excluding MMO, whereas there was no significant difference in any of the variables in the control group. In addition, the decline in TPs was significantly different between the experimental and control groups at all time points, especially after 4 and 12 weeks, compared to that during pre-injection. In conclusion, treatment with BoNT/A was relatively effective for masticatory muscle pain caused by TMDs and headache compared to the saline placebo.
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Affiliation(s)
- So Ra Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
| | - Min Chang
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
| | - Alec Hyung Kim
- TMJ & Orofacial Pain Center, Los Angeles, CA 90006, USA;
| | - Seong Taek Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea; (S.R.K.); (M.C.)
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11
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Barragán Nuñez MI, Flores DM, DE LA Torre Canales G, Quevedo HMD, Conti PR, Costa YM, Bonjardim LR. Influence of awake bruxism behaviors on fatigue of the masticatory muscles in healthy young adults. Braz Oral Res 2023; 37:e080. [PMID: 37531516 DOI: 10.1590/1807-3107bor-2023.vol37.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/17/2023] [Indexed: 08/04/2023] Open
Abstract
The present cross-sectional study aimed to analyze the relationship between awake bruxism and fatigue of masticatory muscles in healthy young adults. For this purpose, 121 graduate students participated in this study. Frequency of awake bruxism was collected for 7 consecutive days by ecological momentary assessment (EMA) using an online survey (mentimeter). Muscle fatigue was tested one day after EMA assessment, which consisted of voluntarily and continuously clenching at 30% (kgf/cm2) of maximum bite force (MBF) until exhaustion. The percentage of change in MBF after the clenching task, as compared to the MBF before the clenching task was measured. The average frequency of awake bruxism was 45.5% during 7 days. Sustained clenching resulted in a significant reduction in MBF values in the total sample (p < 0.05). Nevertheless, no significant correlation was found between frequency of awake bruxism behaviors and percent of change in MBF and endurance time during the fatigue test. Therefore, it can be concluded that young healthy adults present a relatively high frequency of awake bruxism behaviors that do not seem to impact the degree of masticatory muscle fatigue.
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Affiliation(s)
| | - Dyanne Medina Flores
- Universidade de São Pulo - USP, Bauru School of Dentistry, Department of Prosthodontics, Bauru, SP, Brazil
| | - Giancarlo DE LA Torre Canales
- Egas Moniz - Cooperativa de Ensino Superior, Centro de Investigação Interdisciplinar Egas Moniz, Clinical Research Unit, Caparica, Portugal
| | - Henrique Müller de Quevedo
- Universidade de São Pulo - USP, Bauru School of Dentistry, Department of Prosthodontics, Bauru, SP, Brazil
| | - Paulo Rodrigues Conti
- Universidade de São Pulo - USP, Bauru School of Dentistry, Department of Prosthodontics, Bauru, SP, Brazil
| | - Yuri Martins Costa
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Biosciences, Piracicaba, SP, Brazil
| | - Leonardo Rigoldi Bonjardim
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
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12
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Makar D, Nazemi A, Gong SG, Bhardwaj N, De Guzman R, Sessle BJ, Cioffi I. Development of a model to investigate the effects of prolonged ischaemia on the muscles of mastication of male Sprague Dawley rats. Arch Oral Biol 2023; 146:105602. [PMID: 36543038 DOI: 10.1016/j.archoralbio.2022.105602] [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: 05/20/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aims of this study were to develop a novel rodent model of masticatory muscle ischaemia via unilateral ligation of the external carotid artery (ECA), and to undertake a preliminary investigation to characterize its downstream effects on mechanosensitivity and cellular features of the masseter and temporalis muscles. DESIGN The right ECA of 18 male Sprague-Dawley rats was ligated under general anaesthesia. Mechanical detection thresholds (MDTs) at the masseter and temporalis bilaterally were measured immediately before ECA ligation and after euthanasia at 10-, 20-, and 35-days (n = 6 rats/timepoint). Tissue samples from both muscles and sides were harvested for histological analyses and for assessing changes in the expression of markers of hypoxia and muscle degeneration (Hif-1α, VegfA, and Fbxo32) via real time PCR. Data were analyzed using mixed effect models and non-parametric tests. Statistical significance was set at p < 0.05. RESULTS MDTs were higher in the right than left hemiface (p = 0.009) after 20 days. Histological changes indicative of muscle degeneration and fibrosis were observed in the right muscles. Hif-1α, VegfA, and Fbxo32 were more highly expressed in the masseter than temporalis muscles (all p < 0.05). Hif-1α and, VegfA did not change significantly with time in all muscles (all p > 0.05). Fbxo32 expression gradually increased in the right masseter (p = 0.024) and left temporalis (p = 0.05). CONCLUSIONS ECA ligation in rats induced hyposensitivity in the homolateral hemiface after 20 days accompanied by tissue degenerative changes. Our findings support the use of this model to study pathophysiologic mechanisms of masticatory muscle ischaemia in larger investigations.
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Affiliation(s)
- D Makar
- University of Toronto, Faculty of Dentistry, Centre for Multimodal Sensorimotor and Pain Research, Toronto, ON, Canada; University of Toronto, Faculty of Dentistry, Graduate Orthodontics, Toronto, ON, Canada
| | - A Nazemi
- University of Toronto, Faculty of Dentistry, Centre for Multimodal Sensorimotor and Pain Research, Toronto, ON, Canada
| | - S G Gong
- University of Toronto, Faculty of Dentistry, Graduate Orthodontics, Toronto, ON, Canada
| | - N Bhardwaj
- University of Toronto, Faculty of Medicine, Department of Comparative Medicine, Toronto, ON, Canada; Peter Gilgan Centre for Research and Learning, Sickkids Hospital, Toronto, ON, Canada
| | - R De Guzman
- University of Toronto, Faculty of Medicine, Department of Comparative Medicine, Toronto, ON, Canada
| | - B J Sessle
- University of Toronto, Faculty of Dentistry, Toronto, ON, Canada; University of Toronto, Faculty of Medicine, Department of Physiology, Toronto, ON, Canada
| | - I Cioffi
- University of Toronto, Faculty of Dentistry, Centre for Multimodal Sensorimotor and Pain Research, Toronto, ON, Canada; Mount Sinai Hospital, Department of Dentistry, Toronto, ON, Canada; University of Toronto, Faculty of Dentistry, Graduate Orthodontics, Toronto, ON, Canada.
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13
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Câmara-Souza MB, Bracci A, Colonna A, Ferrari M, Rodrigues Garcia RCM, Manfredini D. Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders. J Clin Med 2023; 12:501. [PMID: 36675431 PMCID: PMC9862722 DOI: 10.3390/jcm12020501] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Self-reported awake bruxism (AB) has been associated with temporomandibular disorders (TMD). However, the daily amount of AB behavior has not been quantified in pain patients. Therefore, this study aimed to assess AB frequency in patients with myofascial pain and temporomandibular joint (TMJ) pain and compare it to a group of pain-free individuals. Eighty-four individuals belonging to either a TMD group (n = 54) or a healthy control group (n = 30) were selected. AB frequency was obtained by ecological momentary assessment with a dedicated smartphone application that sent sound alerts at random intervals during the day for one week. Upon receiving the alert, the volunteer reported the current muscular condition and/or the teeth position, i.e., relaxed jaw muscle, jaw bracing, teeth contact, teeth clenching, or teeth grinding. Data were evaluated by independent t-test (α = 0.05). During the seven days, AB frequency was 62.1% ± 26.8% for TMD patients and 36.2% ± 27.3% for pain-free subjects (p < 0.001). Mandible bracing was most common in the TMD group (p < 0.001), while teeth contact, clenching, and grinding did not differ between groups. Moreover, no differences were found in AB frequency between myofascial pain and TMJ pain patients. Therefore, TMD patients have higher AB frequency characterized by jaw bracing, irrespective of pain location.
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Affiliation(s)
- Mariana Barbosa Câmara-Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
- School of Dentistry, Ingá University Center, Paraná 87035-510, Brazil
| | - Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | | | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
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14
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Yamaguchi T, Mikami S, Maeda M, Saito T, Nakajima T, Yachida W, Gotouda A. Portable and wearable electromyographic devices for the assessment of sleep bruxism and awake bruxism: A literature review. Cranio 2023; 41:69-77. [PMID: 32870753 DOI: 10.1080/08869634.2020.1815392] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The current state of portable/wearable electromyographic (EMG) devices for assessment of bruxism was reviewed. METHODS A search of full-text articles relevant to portable/wearable EMG devices capable of being used at home was performed. The data source used was MEDLINE via PubMed from January 1970 to July 2019. RESULTS There were nine kinds of wearable EMG devices capable of being used under unrestrained conditions. Ultra-miniaturized wearable EMG devices with a level of performance equivalent to that of conventional stationary EMG devices have been developed and are being used during sleep and in the daytime. The devices have a high level of diagnostic accuracy for sleep bruxism. A definite cut-off value for awake bruxism has not been established. DISCUSSION Assessment of sleep bruxism with a high level of accuracy can be performed using a portable/wearable EMG device. However, a definite cut-off value is required for assessment of awake bruxism.
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Affiliation(s)
- Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Wataru Yachida
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
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15
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Puel AN, da Silva Paes AG, Macedo C, Miranda LS, Graciosa M, Sonza A. Peripheral muscle oxygenation and symptoms of stress in adolescents with and without temporomandibular disorder. Clin Oral Investig 2022; 27:1509-1517. [PMID: 36376615 DOI: 10.1007/s00784-022-04770-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare peripheral muscle oxygenation levels and the prevalence of psychological stress in adolescents with and without temporomandibular disorder (TMD). METHODS A cross-sectional study was performed with adolescents submitted into two groups: those diagnosed with TMD (DG) and control (CG). Muscle oxygenation was measured by near-infrared spectroscopy in the masseter and upper trapezius muscles. Symptoms of stress were assessed by Lipp's Stress Symptom Inventory for Adults or Child Stress Scale. A Student t-test was used for intergroup comparisons and association between categorical variables by chi-square test, phi coefficient of correlation, odds ratio, and two-way ANOVA. RESULTS Fifty-three adolescents were evaluated and a significant reduction was observed in the oxyhemoglobin level in the masseter muscle at rest (p = 0.04) and contraction (p = 0.02). A greater total hemoglobin level was found in the upper trapezius muscle at rest in DG (p = 0.03), with a significant difference in the tissue saturation index during contraction (p = 0.05) intergroup. Individuals in the DG were 4.523 times more likely to exhibit signs and symptoms of stress than in CG. CONCLUSION Adolescents from DG showed reduced masseter oxyhemoglobin values at rest and during contraction and showed more signs and symptoms of stress than healthy controls. In the upper trapezius, DG showed higher values of total circulating hemoglobin, essential for greater blood flow and efficient maximum voluntary contraction. CLINICAL RELEVANCE Changes in tissue oxygenation and stress in adolescents with TMD prompted the earlier treatment of this population to prevent disease progression into adulthood.
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Affiliation(s)
- Alexia Nadine Puel
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
- Post-Graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Andreza Garrett da Silva Paes
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
- Post-Graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Carolina Macedo
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Letícia Souza Miranda
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Maylli Graciosa
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
- Post-Graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil
| | - Anelise Sonza
- Laboratory of Development and Postural Control (LADESCOP), Center of Health Sciences and Sport, Santa Catarina State University (UDESC), Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil.
- Post-Graduate Program in Physiotherapy, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil.
- Post-Graduate Program in Human Movement Sciences, Center of Health Sciences and Sport, Santa Catarina State University, Rua Pascoal Simone, 358-Coqueiros, Florianópolis, SC, 88080-350, Brazil.
- Physiotherapy Department, UDESC, Rua Pascoal Simone, 358, Florianópolis, SC, CEP 88080350, Brazil.
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16
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Dorado S, Arias A, Jimenez-Octavio JR. Biomechanical Modelling for Tooth Survival Studies: Mechanical Properties, Loads and Boundary Conditions-A Narrative Review. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7852. [PMID: 36363451 PMCID: PMC9657341 DOI: 10.3390/ma15217852] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Recent biomechanical studies have focused on studying the response of teeth before and after different treatments under functional and parafunctional loads. These studies often involve experimental and/or finite element analysis (FEA). Current loading and boundary conditions may not entirely represent the real condition of the tooth in clinical situations. The importance of homogenizing both sample characterization and boundary conditions definition for future dental biomechanical studies is highlighted. The mechanical properties of dental structural tissues are presented, along with the effect of functional and parafunctional loads and other environmental and biological parameters that may influence tooth survival. A range of values for Young's modulus, Poisson ratio, compressive strength, threshold stress intensity factor and fracture toughness are provided for enamel and dentin; as well as Young's modulus and Poisson ratio for the PDL, trabecular and cortical bone. Angles, loading magnitude and frequency are provided for functional and parafunctional loads. The environmental and physiological conditions (age, gender, tooth, humidity, etc.), that may influence tooth survival are also discussed. Oversimplifications of biomechanical models could end up in results that divert from the natural behavior of teeth. Experimental validation models with close-to-reality boundary conditions should be developed to compare the validity of simplified models.
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Affiliation(s)
- Saúl Dorado
- Department of Mechanical Engineering, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
| | - Ana Arias
- Department of Conservative and Prosthetic Dentistry, School of Dentistry, Complutense University, 28040 Madrid, Spain
| | - Jesus R. Jimenez-Octavio
- Instituto de Investigación Tecnológica, Escuela Técnica Superior de Ingeniería ICAI, Universidad Pontificia Comillas, 28015 Madrid, Spain
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17
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Rongo R, Ekberg E, Nilsson IM, Al-Khotani A, Alstergren P, Conti PCR, Durham J, Goulet JP, Hirsch C, Kalaykova SI, Kapos FP, King CD, Komiyama O, Koutris M, List T, Lobbezoo F, Ohrbach R, Palermo TM, Peck CC, Penlington C, Restrepo C, Rodrigues MJ, Sharma S, Svensson P, Visscher CM, Wahlund K, Michelotti A. Diagnostic criteria for temporomandibular disorders (DC/TMD) in children and adolescents: an international Delphi study-Part 2-Development of Axis II. J Oral Rehabil 2021; 49:541-552. [PMID: 34951729 DOI: 10.1111/joor.13301] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 10/27/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Unlike the psychosocial assessment established for adults in the diagnostic criteria for temporomandibular disorders (DC/TMD), a standardized psychosocial assessment for children and adolescents with TMD complaints has not yet been established. OBJECTIVES To develop a new standardized instrument set to assess the psychosocial functioning in children and adolescents by adapting the psychosocial status and pain-related disability (Axis II) of the adult DC/TMD and by including new instruments. METHODS A modified Delphi method was used to survey 23 international TMD experts and four international experts in pain-related psychological factors for consensus regarding assessment tools for psychosocial functioning and pain-related disability in children and adolescents. The TMD experts reviewed 29 Axis II statements at round 1, 13 at round 2, and 2 at round 3. Agreement was set at 80% for first-round consensus level and 70% for each of the second and third rounds. The psychological experts completed a complementary Delphi survey to reach a consensus on tools to use to assess more complex psychological domains in children and adolescents. For the psychological experts, the first round included 10 open-ended questions on preferred screening tools for depression, anxiety, catastrophizing, sleep problems, and stress in children (ages 6-9 years old) and adolescents (ages 10-19 years old) as well as on other domains suggested for investigation. In the second round, the psychological experts received a 9-item questionnaire to prioritize the suggested instruments from most to least recommended. RESULTS The TMD experts, after three Delphi rounds, reached consensus on the changes of DC/TMD to create a form to evaluate Axis II in children and adolescents with TMD complaints. The psychological experts added tools to assess depression and anxiety, sleep disorders, catastrophizing, stress, and resilience. CONCLUSION Through international expert consensus, this study adapted Axis II of the adult DC/TMD to assess psychosocial functioning and pain-related disability in children and adolescents. The adapted Axis II protocols will be validated in the target populations.
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Affiliation(s)
- Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ing-Marie Nilsson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Center for Oral Rehabilitation, FTV Östergötland, Norrköping, Sweden
| | - Amal Al-Khotani
- Scandinavian Center for Orofacial Neurosciences, Sweden.,East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Paulo Cesar Rodrigues Conti
- 7Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.,Bauru Orofacial Pain Group, University of São Paulo, Bauru, Brazil
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Stanimira I Kalaykova
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, United States
| | - Christopher D King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Center for Understanding Pediatric Pain (CUPP), Cincinnati Children's Hospital Medical Center, Cincinnati, United States.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Osamu Komiyama
- Division of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo, Japan
| | - Michail Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas List
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden
| | - Frank Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, United States.,Seattle Children's Research Institute, Seattle, United States
| | - Christopher C Peck
- Faculty of Medicine and Health, University of Sydney, Westmead, Australia
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | | | - Maria Joao Rodrigues
- Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sonia Sharma
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, United States
| | - Peter Svensson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Sweden.,Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.,Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark
| | - Corine M Visscher
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Wahlund
- Department of Stomatognathic Physiology, Kalmar County Hospital, Kalmar, Sweden
| | - Ambrosina Michelotti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
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18
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Janal MN, Lobbezoo F, Quigley KS, Raphael KG. Stress-evoked muscle activity in women with and without chronic myofascial face pain. J Oral Rehabil 2021; 48:1089-1098. [PMID: 34370315 DOI: 10.1111/joor.13238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Amplified muscle activity in reaction to daily life stressors might explain chronic pain in temporomandibular disorder (TMD). OBJECTIVES To assess whether patients with myofascial TMD pain (MFP) react to standardised stressors with greater masticatory muscle activity than demographically matched controls. METHODS A total of 124 female MFP patients and 46 demographically matched and pain-free controls rated distress while performing a series of standardised stress-reactivity tasks (viz., cold pressor test, mental arithmetic test, speech stressor test and reaction time/startle response test) as well as a vanilla baseline control task. Blood pressure was measured before and after each task, and electromyographic (EMG) activity was continuously recorded over the jaw-closing muscles and several non-masticatory muscles during each task. Linear mixed model analyses were used to test the hypothesis that case status, stress-reactivity task and muscle recording site influenced EMG activity. RESULTS Stress induction was successful, as evidenced by distress ratings and blood pressure measurements that were significantly elevated during performance of the stress tasks. Participants reported that some of the tasks were stressful in a way that resembled stressors experienced in their daily lives. Elevated muscle activity could be confirmed only for the reaction time/startle response task, where mean EMG activity was elevated more in cases than in controls, specifically in the jaw-closing muscles. CONCLUSION These data could not provide clear support for the theory that psychological stressors produce a differential increase in masticatory muscle activity in MFP patients than pain-free controls.
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Affiliation(s)
- Malvin N Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York, NY, USA
| | - Frank Lobbezoo
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Oral & Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA
| | - Karen S Quigley
- Department of Psychology, Northeastern University, Boston, MA, USA
- Edith Nourse Rogers Memorial VA Hospital, Bedford, MA, USA
| | - Karen G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA
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19
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Donnarumma V, Ohrbach R, Simeon V, Lobbezoo F, Piscicelli N, Michelotti A. Association between waking-state oral behaviours, according to the oral behaviors checklist, and TMD subgroups. J Oral Rehabil 2021; 48:996-1003. [PMID: 34192368 PMCID: PMC8457156 DOI: 10.1111/joor.13221] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the association between waking-state oral behaviours and temporomandibular disorder (TMD) subgroups and to develop new scoring methods for the Oral Behavior Checklist (OBC). METHODS Patients with any TMD diagnosis, according to the diagnostic criteria for TMD (DC/TMD), were divided into subgroups: 'Dysfunctional-TMD' (n = 70), only mechanical dysfunction; 'Painful-TMD' (n = 204), only myalgia, arthralgia or both; and 'Painful-Dysfunctional TMD' (n = 95), combined pain and dysfunction. A group of individuals without TMD, 'Non-TMD' (n = 374), was used for testing associations. Participants completed the OBC. An exploratory factor analysis, followed by a confirmatory factor analysis of the OBC responses, identified 2 major factors, named non-functional activities (NFA) and functional activities (FA). Component total scores were computed. Differences among subgroups for OBC-MS (mean score) and NFA and FA factor scores were estimated using one-way ANOVA and Tukey post hoc tests. Significance was set at p < .05. RESULTS The OBC-MS in Non-TMD, Painful-TMD and Painful-Dysfunctional TMD subgroups was higher than in the Dysfunctional-TMD subgroup (p ≤ .001). NFA in Painful-TMD and Painful-Dysfunctional TMD subgroups were higher than in the Non-TMD group (p < .05); NFA in the Dysfunctional-TMD subgroup were lower than in the Painful-TMD subgroup (p = .034). In contrast, FA in Painful-TMD, Dysfunctional-TMD and Painful-Dysfunctional TMD subgroups were lower than in the Non-TMD group (p < .0001). CONCLUSIONS A new scoring method for the OBC results in item reduction and creation of meaningful subscales for functional and non-functional behaviours, which are differentially associated with painful and dysfunctional TMDs. This may help clinicians to better tailor treatment for the management of subtypes of TMD patients.
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Affiliation(s)
- Valeria Donnarumma
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA
| | - Vittorio Simeon
- Medical Statistics Unit, Department of Mental Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Noemi Piscicelli
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
| | - Ambrosina Michelotti
- Division of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples 'Federico II', Naples, Italy
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20
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Proença JDS, Baad-Hansen L, Braido GVDV, Mercante FG, Campi LB, Gonçalves DADG. Lack of correlation between central sensitization inventory and psychophysical measures of central sensitization in individuals with painful temporomandibular disorder. Arch Oral Biol 2021; 124:105063. [PMID: 33529837 DOI: 10.1016/j.archoralbio.2021.105063] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the correlation between the Central Sensitization Inventory (CSI) scores and the results of psychophysical tests and psychosocial questionnaires according to the presence of painful temporomandibular disorder (TMD). DESIGN It was a cross-sectional study involving 146 participants, aged 20-65 years. Painful TMD was classified using the Research Diagnostic Criteria for Temporomandibular Disorders. CSI was applied to assess "central sensitization-related symptoms", as has been suggested. Wind-up ratio, pressure pain threshold and conditioned pain modulation were used as psychophysical tests to evaluate signs and symptoms of central sensitization. Psychosocial factors were assessed by the presence of non-specific physical symptoms, depressive and anxiety symptoms. The sample was divided into two groups: Control (n = 31); Painful TMD (n = 115). Descriptive statistics characterized the sample. Correlation analysis were performed using Pearson's and Spearman's correlation coefficients (α = 5%). RESULTS Of the total sample, 78.8 % presented painful TMD, and the mean (standard deviation) age was 37.4 (±11.5) years. Anxiety symptoms (p = 0.028) and non-specific physical symptoms (p < 0.001) were more frequent in the painful TMD group than in controls. Painful TMD patients presented higher scores of the CSI (p < 0.001) and lower pressure pain thresholds (p ≤ 0.020) compared to controls. CSI scores were significantly correlated with psychosocial measures (p < 0.001) but not with psychophysical tests (p ≥ 0.089). CONCLUSION The CSI scores did not correlate with psychophysical measures of central sensitization but were positively correlated with the results of psychosocial questionnaires.
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Affiliation(s)
- Juliana Dos Santos Proença
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Guilherme Vinícius do Vale Braido
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Fernanda Gruninger Mercante
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Letícia Bueno Campi
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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21
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Dinsdale A, Liang Z, Thomas L, Treleaven J. Is jaw muscle activity impaired in adults with persistent temporomandibular disorders? A systematic review and meta-analysis. J Oral Rehabil 2021; 48:487-516. [PMID: 33369753 DOI: 10.1111/joor.13139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022]
Abstract
Understanding jaw muscle activity changes in temporomandibular disorders (TMD) is crucial to guide clinical management. The nature of these changes is currently unclear. Explore changes in jaw muscle activity in TMD. Electronic databases (PubMed, EMBASE, CINAHL, Scopus, Web of Science, Cochrane) and bibliographies were searched from inception to 9 July 2020 for eligible studies, including grey literature. Case-control and interventional studies reporting time-domain and frequency-domain electromyographic measures of jaw muscle activity in TMD and control groups were included. SIGN checklist for case-control studies was used to evaluate risk of bias. Results were pooled for meta-analysis using random-effects model. Confidence in cumulative evidence was established using American Academy of Neurology guidelines. Forty-five studies were included. Most were rated moderate risk of bias. Activity of four muscles (masseter, temporalis, lateral pterygoid, suprahyoids) was assessed across six domains (resting, clenching, chewing, swallowing, concentrating, resisted mandibular movements), with partial meta-analysis scope. Masseter and temporalis activity were significantly higher at rest (P = .05, P < .0001), but lower during brief maximal clenching (P = .005, P = .04) in TMD vs controls. Insufficient data precluded meta-analysis of remaining outcomes and subgroup analysis. Confidence in cumulative evidence ranged from moderate to very low. Changes in jaw muscle activity exist in TMD, which are both task-specific and muscle-specific. It remains unclear whether jaw muscle activity changes vary between TMD subgroups. Muscle function should be considered in clinical management of TMD. Insufficient subgroup data highlight future direction for research.
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Affiliation(s)
| | - Zhiqi Liang
- The University of Queensland, St Lucia, QLD, Australia
| | - Lucy Thomas
- The University of Queensland, St Lucia, QLD, Australia
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22
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Lou T, Tran J, Castroflorio T, Tassi A, Cioffi I. Evaluation of masticatory muscle response to clear aligner therapy using ambulatory electromyographic recording. Am J Orthod Dentofacial Orthop 2020; 159:e25-e33. [PMID: 33234460 DOI: 10.1016/j.ajodo.2020.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Patients undergoing clear aligner therapy (CAT) report muscle tenderness and produce wear facets on their aligner trays. However, little is known about the masticatory muscle response to clear aligners. Here, we measured the activity of the masseter during CAT using ambulatory electromyography. We also explored whether psychological traits modulate the masticatory muscle response to CAT. METHODS Using portable data loggers, we recorded the electromyographic (EMG) activity in the right masseter muscle of 17 healthy adults without temporomandibular disorder (16 females, 1 male; mean age ± standard deviation, 35.3 ± 17.6 years) commencing treatment with CAT over 4 weeks, under the following conditions: week 1 without aligners (baseline), week 2 with a passive aligner (dummy), week 3 with their first active aligner (active1), and week 4 with their second active aligner (active2). We used a mixed-effect model to test differences in EMG activity over the 4-weeks and a general linear model to test the effect of psychological traits on EMG activity. RESULTS The EMG activity of the masseter increased significantly with aligners compared with baseline. The largest relative increase in EMG activity was seen during the dummy (152%; P <0.001) and active1 (155%; P <0.001) stages. During active2, the activity of the masseter decreased significantly toward baseline levels. Participants' trait anxiety was positively associated with increases in EMG activity (P = 0.027). CONCLUSIONS CAT is associated with a transient increase in masticatory muscle activity, possibly because of an increase in wake-time parafunctional tooth clenching. Temporomandibular disorder-free patients adapt well to CAT as the masticatory muscle activity decreases toward baseline levels after 2 weeks.
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Affiliation(s)
- Tiantong Lou
- Faculty of Dentistry, Graduate Program in Orthodontics, University of Toronto, Toronto, Ontario, Canada
| | - Johnny Tran
- Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | | | - Ali Tassi
- Division of Graduate Orthodontics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, Discipline of Orthodontics, Centre for Multimodal Sensorimotor and Pain Research, Centre for The Study of Pain, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
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23
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The intensity of awake bruxism episodes is increased in individuals with high trait anxiety. Clin Oral Investig 2020; 25:3197-3206. [PMID: 33098032 DOI: 10.1007/s00784-020-03650-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/16/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Trait anxiety is associated with an increased occurrence of awake bruxism episodes, a behavior characterized by clenching of the teeth contributing to temporomandibular disorders in some individuals. Here we measured the activity of the masseter and the intensity and duration of spontaneous wake-time tooth clenching episodes in healthy individuals with different levels of trait anxiety (TA). MATERIALS AND METHODS Two hundred fifty-five individuals completed a web survey. Using their TA scores, we allocated them in low (< 20th percentile of the TA score distribution), intermediate (between 20th and 80th ), and high (> 80th) TA groups. We analyzed the electromyographic (EMG) activity of the right masseter during a 15-min silent reading task in forty-three individuals with low (n = 12), intermediate (n = 17), and high TA (n = 14). We tested between-group differences in EMG activity of the masseter, as well as postural activity-the muscular activity that maintains mandibular posture, and amplitude and duration of spontaneous tooth clenching episodes. RESULTS The activity of the masseter (mean ± SEM %maximum voluntary contraction/MVC) was greater in the high TA (10.23 ± 0.16%MVC) than the intermediate (8.49 ± 0.16%MVC) and low (7.97 ± 0.22%MVC) TA groups (all p < 0.001). Postural activity did not differ between groups (all p > 0.05). The EMG amplitude of tooth clenching episodes was greater in the high TA (19.97 ± 0.21 %MVC) than the intermediate (16.40 ± 0.24%MVC) and low (15.48 ± 0.38 %MVC) TA groups (all p < 0.05). The cumulative duration of clenching episodes was not different between groups (p = 0.390). CONCLUSIONS Increased TA is associated with both increased masseter muscle activity and intensity of wake-time tooth clenching episodes. CLINICAL RELEVANCE TA may contribute significantly to masticatory muscle overload.
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24
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Abe S, Miyagi A, Yoshinaga K, Matsuka Y, Matsumoto F, Uyama E, Suzuki Y, Oshima M, Okura K, Tanaka E. Immediate Effect of Masticatory Muscle Activity with Transcutaneous Electrical Nerve Stimulation in Muscle Pain of Temporomandibular Disorders Patients. J Clin Med 2020; 9:jcm9103330. [PMID: 33081336 PMCID: PMC7603025 DOI: 10.3390/jcm9103330] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/12/2020] [Accepted: 10/14/2020] [Indexed: 02/08/2023] Open
Abstract
Transcutaneous electrical nerve stimulation (TENS) is a non-invasive treatment modality for acute and chronic pain. However, little information for muscle activity is available on the immediate effects of TENS in masticatory muscle pain related to temporomandibular disorders (TMDs). The present study aimed to evaluate the immediate effects of TENS treatment on TMD-related muscle pain. Thirty-six patients with TMD-related muscle pain and 39 healthy subjects served as TMD and control groups, respectively. For objective evaluations, maximum mouth opening, and maximum bite force were measured before and after TENS. The pain intensity was assessed according to a 100-mm visual analog scale (VAS). TENS was applied to painful muscles for 20 min with frequencies of 100–200 Hz. The treatment outcome was evaluated using Global Rating of Change (GRC) scales. In the TMD group, VAS values significantly decreased after TENS. Although there was significant increase in the maximum mouth opening after TENS for only TMD group, the maximum bite force of both groups was significantly greater after TENS. According to GRC scales, one patient with TMD-related muscle pain expressed negative feelings after TENS. Conclusively, TENS treatment might quickly relieve pain in masticatory muscles and improve masticatory functions in patients with TMD-related muscle pain.
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Affiliation(s)
- Susumu Abe
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan;
- Correspondence: ; Tel.: +81-88-633-9181
| | - Akane Miyagi
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan;
| | - Kaoru Yoshinaga
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (K.Y.); (E.T.)
| | - Yoshizo Matsuka
- Department of Stomatognathic Function and Occlusal Reconstruction, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (Y.M.); (Y.S.); (M.O.); (K.O.)
| | - Fumihiro Matsumoto
- Department of Oral Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima 7708504, Japan;
| | - Emi Uyama
- Department of Biomaterials and Bioengineering, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan;
| | - Yoshitaka Suzuki
- Department of Stomatognathic Function and Occlusal Reconstruction, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (Y.M.); (Y.S.); (M.O.); (K.O.)
| | - Masamitsu Oshima
- Department of Stomatognathic Function and Occlusal Reconstruction, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (Y.M.); (Y.S.); (M.O.); (K.O.)
| | - Kazuo Okura
- Department of Stomatognathic Function and Occlusal Reconstruction, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (Y.M.); (Y.S.); (M.O.); (K.O.)
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 7708504, Japan; (K.Y.); (E.T.)
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25
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Spano VE, Imbriglio TV, Ho KCJ, Chow JCF, Cioffi I. Increased somatosensory amplification is associated with decreased pressure pain thresholds at both trigeminal and extra-trigeminal locations in healthy individuals. J Oral Rehabil 2020; 48:10-17. [PMID: 32979854 DOI: 10.1111/joor.13101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The diagnosis of temporomandibular disorders (TMD) is based on patient history and physical examination, and may require medical imaging. Masticatory muscle palpation is essential to make a diagnosis of TMD. However, the response of masticatory muscles to mechanical pressure stimuli depends on many physical and psychological factors. OBJECTIVE This study aimed at determining the impact of somatosensory amplification (SSA)-an estimate of somatic awareness and bodily hypervigilance-on pressure pain thresholds (PPTs) measured at both trigeminal and extra-trigeminal locations in healthy individuals. METHODS PPTs were measured at the right anterior temporalis and superficial masseter, and the thenar eminence of the right hand in one hundred healhty individuals (69F, 31M), divided in three groups based on their SSA scores: low (N = 32), intermediate (N = 34) and high (N = 34). General linear models were used to test between-group differences in PPTs including sex as a covariate. The level of significance was set at P < .05. RESULTS Individuals with high SSA had lower PPTs at the anterior temporalis than individuals with low (P = .006) and intermediate (P = .001) SSA. No significant between-group differences were found in PPTs measured at the masseter (P = .372). PPTs measured at the thenar eminence were significantly lower in the high than the low SSA group (P = .009). Females had lower PPTs at the masseter than males (P = .021) but not at other muscle locations (all P > .05). CONCLUSION Increased somatosensory amplification is associated with decreased pressure pain thresholds at both trigeminal and extra-trigeminal locations in healthy individuals. SSA could be a potential confounder while diagnosing TMD and evaluating treatment outcomes.
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Affiliation(s)
- Valerie E Spano
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Tina V Imbriglio
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Ka Chun Jeremy Ho
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Jeffrey C F Chow
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
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26
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Imbriglio TV, Moayedi M, Freeman BV, Tenenbaum HC, Thaut M, Cioffi I. Music Modulates Awake Bruxism in Chronic Painful Temporomandibular Disorders. Headache 2020; 60:2389-2405. [PMID: 32997813 DOI: 10.1111/head.13971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/15/2020] [Accepted: 08/16/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In this experimental study, we aimed to determine whether guided music listening (GML) - a music intervention based on models of mood mediation and attention modulation - modulates masticatory muscle activity and awake bruxism in subjects with chronic painful muscular temporomandibular disorders (TMD myalgia, mTMD), a condition causing a significant burden to patients, their families, and healthcare systems. BACKGROUND Awake bruxism - a stress behavior characterized by clenching of the teeth - is a strong contributor to chronic mTMD. GML modulates psychological stress and motor responses and could thus reduce muscle activity in chronic musculoskeletal conditions, including mTMD. METHODS We recorded the electromyographic (EMG) activity in the right masseter of 14 women with chronic (>6 months) mTMD (median [IQR] = 39.5.3 [24.3] years) and 15 pain-free women (median [IQR] = 30.0 [3.5] years) during a GML session, including 3 music (stressful, relaxing, and participants' favorite music) and a no-music (pink noise) control blocks, each lasting 15 minutes. We measured the motor effort of the right masseter relative to the participants' maximum voluntary contraction (MVC), the muscular effort to maintain mandibular posture (EMGposture ), and to produce spontaneous awake bruxism episodes (EMGbruxism ), and the duration and frequency of spontaneous awake bruxism episodes. We tested between-group and within-group (between blocks) differences, as well as the effect of the interaction group by experimental block on these outcome measures. RESULTS In both groups, EMGposture was significantly affected by the interaction group by experimental block (P < .001). Compared to pink noise [mean (95% CI); mTMD: 2.2 (1.6-2.8) %MVC; Controls: 1.1 (0.5-1.7) %MVC], EMGposture increased during the stressful music block [contrast estimate (95% CI); mTMD: +0.8 (0.7-0.8) %MVC; Controls: +0.3 (0.3-0.4) %MVC; both P < .001], and decreased during the relaxing [mTMD: -0.4 (-0.5 to -0.4) %MVC; Controls: -0.3 (-0.4 to -0.3) %MVC; both P < .001] and favorite [mTMD: -0.5 (-0.6 to -0.5) %MVC; Controls: -0.5 (-0.5 to -0.4) %MVC; both P < .001] music blocks. EMGposture was greater in mTMD individuals than controls during the favorite music [contrast estimate (95% CI): +1.1 (0.2-1.9) %MVC; P = .019] and the pink noise [+1.1 (0.2-2.0) %MVC; P = .014] blocks. EMGbruxism was significantly affected by the interaction group by experimental block (P < .001). In mTMD participants, compared to the pink noise block [mean (95% CI); 23.8 (16.0-31.6) %MVC], EMGbruxism increased during the stressful music block [contrast estimate (95% CI); +10.2 (8.6-11.8) %MVC], and decreased during the relaxing [-6.2 (-8.1 to -4.3) %MVC; P < .001] and favorite [-10.2 (-12.2 to -9.1) %MVC; P < .001] music blocks. These effects were not observed in the control group [mean (95% CI); pink noise: 19.3 (10.9-27.6); stressful: 21.2 (12.9-29.4) %MVC; relaxing: 21.6 (13.3-29.9) %MVC; favorite: 24.2 (15.8-32.7) %MVC; all P > .05]. EMGbruxism was significantly greater in mTMD participants than controls during the stressful music block [contrast estimate (95% CI): +12.9 (1.6-24.2) %MVC; P = .026). GML did not affect the duration or the frequency of awake bruxism in either group (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108). The frequency of awake bruxism episodes was greater in the mTMD group compared to controls only during the pink noise block (median [IQR], mTMD: 5 [15.3] episodes, range 0-62 episodes; Controls: 1 [3] episode, range 0-27 episodes; P = .046). No significant between-group differences were found in either the overall time spent engaging in awake bruxism (median [IQR], mTMD: 23.5 [96.7] s, range 1-1300 seconds; Controls: 5.5 [22.5], range 0-246 seconds; P = .108), or during each block (all P > .05). CONCLUSIONS In subjects with chronic mTMD, relaxing music and the individual's favorite music decreased the muscular effort during spontaneous awake bruxism episodes by 26% and 44% (relative changes), respectively. In contrast, stressful music increases it by about 43%. Because of its positive effects on awake bruxism, GML with selected music could be a promising and non-invasive component of a multimodal approach for the management of chronic mTMD.
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Affiliation(s)
- Tina Veronica Imbriglio
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Massieh Moayedi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Bruce Victor Freeman
- Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Howard Charles Tenenbaum
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Michael Thaut
- Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,University of Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
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Owczarek JE, Lion KM, Radwan‐Oczko M. The impact of stress, anxiety and depression on stomatognathic system of physiotherapy and dentistry first-year students. Brain Behav 2020; 10:e01797. [PMID: 32862554 PMCID: PMC7559601 DOI: 10.1002/brb3.1797] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/11/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION It is well proven that psychoemotional factors play causative role in development of many civilization diseases. Psychosocial stress is effecting with development of certain oral parafunctions like teeth grinding, bruxism, or cheeks biting. Eventually, all of those parafunctional activities may cause increase of masticatory muscles tone and provoke its intensification. Literature indicates that students must cope with greater level of stressful situations than the average representative of the society. METHODS The research group comprised Ist-year physiotherapy and dentistry students from University School of Physical Education in Wroclaw and Wroclaw Medical University. The study consisted the following: psychological and health questionnaires, and stomatological examination with masseter muscles' electromyography. RESULTS In intraoral examination, symptoms of parafunctions were more frequently observed in physiotherapy students. The mean tone of masseters was higher also among physiotherapy students. The level of perceived stress was high in both groups, and the experienced borderline and incorrect results in Hospital Anxiety and Depression Scale were more frequently observed in dentistry students. The mean tone of masseter muscle was rising with the level of anxiety in physiotherapy group. Among dentistry, the tendency for rise of masseter muscle tone together with level of anxiety and depression was observed. CONCLUSIONS Physiotherapy and dentistry beginners differ between each other's by prevalence of temporomandibular disorders (TMD) and oral parafunction symptoms. The level of perceived stress is high in both groups. The level of experienced anxiety and depression is higher in dentistry group. In both study groups, there is significant growth and tendency for simultaneous rise of masseter muscle tone accordingly to stress, anxiety, and depression indicators.
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Cantó-Navés O, Marimon X, Ferrer M, Cabratosa-Termes J. Comparison between experimental digital image processing and numerical methods for stress analysis in dental implants with different restorative materials. J Mech Behav Biomed Mater 2020; 113:104092. [PMID: 33010696 DOI: 10.1016/j.jmbbm.2020.104092] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/24/2022]
Abstract
The aim of this study is to evaluate the stresses transferred to peri-implant areas from single implants restored with different restorative materials and subjected to a static vertical load with low eccentricity. A total of 12 crowns were made with four types of materials: carbon fiber-composite, metal-ceramic, metal-composite, and full-metal, all of them cemented over a titanium abutment. Three different ways of approaching the problem have been used independently to verify the robustness of the conclusions. The experimental results of stress distribution around the implant were obtained by two image processing techniques: Digital Photoelasticity and Digital Image Correlation (DIC). The tests have been modelled by 3D Finite Element Method (FEM). The FEM models have also been used to study the sensitivity of the results to slight changes in geometry or loads, so that the robustness of the experimental techniques can be analyzed. In addition, the realistic bone morphology of the mandible has also been modelled by FEM, including the cortical and trabecular bone property distinctions.
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Affiliation(s)
- Oriol Cantó-Navés
- Faculty of Dentistry, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Xavier Marimon
- Automatic Control Department, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), Barcelona, Spain.
| | - Miquel Ferrer
- Department of Strength of Materials and Structural Engineering, Universitat Politècnica de Catalunya (UPC-BarcelonaTECH), Barcelona, Spain
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29
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Tran J, Lou T, Nebiolo B, Castroflorio T, Tassi A, Cioffi I. Impact of clear aligner therapy on tooth pain and masticatory muscle soreness. J Oral Rehabil 2020; 47:1521-1529. [PMID: 32898936 DOI: 10.1111/joor.13088] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/18/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical findings suggest that orthodontic treatment with clear aligners (clear aligner therapy/CAT) may cause masticatory muscle soreness in some patients. OBJECTIVE This multi-site prospective study investigated tooth pain and masticatory muscle soreness and tenderness in patients undergoing CAT and explored whether psychological traits affected these outcomes. METHODS Twenty-seven adults (22F, 5M; mean age ± SD=35.3 ± 17.6 years) about to start CAT were recruited at three clinics. During CAT, they reported on 100-mm visual analogue scales their tooth pain, masticatory muscle soreness and stress three times per day over 4 weeks (week 1 = baseline; week 2 = dummy aligner; week 3 = first active aligner; week 4 = second active aligner). Pressure pain thresholds (PPTs) were measured at the masseter and temporalis at baseline and after week 4. Mixed models were used to evaluate the outcome measures over time. RESULTS Clear aligner therapy caused mild tooth pain, which was greater with the passive than the first and second active aligners (both P < .001). Mild and clinically not relevant masticatory muscle soreness was produced by all aligners (all P < .05), with the first active aligner producing less soreness than the dummy aligner (P < .001). PPTs did not change significantly after 4 weeks. Both tooth pain and masticatory muscle soreness were affected by stress and trait anxiety, whilst muscle soreness was affected also by oral behaviours. CONCLUSIONS In the short term, CAT produces tooth pain and masticatory muscle soreness of limited significance. Frequent oral behaviours are related to increased masticatory muscle soreness during CAT. The medium- and long-term effects of CAT should be further explored.
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Affiliation(s)
- Johnny Tran
- Division of Graduate Orthodontics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
| | - Tiantong Lou
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Bianca Nebiolo
- Department of Orthodontics, Dental School, University of Turin, Turin, Italy
| | | | - Ali Tassi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, Discipline of Orthodontics and Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, ON, Canada.,Centre for The Study of Pain, University of Toronto, Toronto, ON, Canada.,Department of Dentistry, Mount Sinai Hospital, Toronto, ON, Canada
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30
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Moayedi M, Krishnamoorthy G, He PYT, Agur A, Weissman-Fogel I, Tenenbaum HC, Lam EWN, Davis KD, Henderson L, Cioffi I. Structural abnormalities in the temporalis musculo-aponeurotic complex in chronic muscular temporomandibular disorders. Pain 2020; 161:1787-1797. [PMID: 32701839 DOI: 10.1097/j.pain.0000000000001864] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Some forms of chronic pain are thought to be driven and maintained by nociceptive input, which can drive plasticity within nociceptive pathways. We have previously identified abnormalities along the entire nociceptive pathway in chronic myalgic temporomandibular disorders (mTMD), including the trigeminal nerves, brainstem pathways, and in the thalamus and somatosensory cortex. These data suggest that there is a peripheral nociceptive drive in mTMD, but the source of this nociceptive activity remains unknown. Here, our aim was to determine whether structural abnormalities exist in the muscles of mastication of patients with chronic mTMD. Specifically, we tested whether the volume of the temporalis muscle and its tendon-aponeurosis complex (TAC, a structure that dissipates forces in a muscle) in mTMD patients differ compared to age- and sex-matched controls. To do so, we segmented these structures on T1-weighted structural magnetic resonance images. We found that muscle volumes in mTMD were not different to controls. However, the mTMD group had significantly smaller volumes of the bilateral temporalis TAC, and thus a smaller TAC-to-muscle volume ratio. These findings were consistent across 2 independent cohorts of 17 mTMD patients, compared to 17 age- and sex-matched controls. We propose a model where reduced TAC-to-muscle ratio could result in a predisposition to muscle tissue injury. In sum, abnormalities of the temporalis muscles in mTMD supports our hypothesis that chronic mTMD pathophysiology may be related to peripheral nociceptive barrage originating from the muscles of mastication.
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Affiliation(s)
- Massieh Moayedi
- Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- University of Toronto Centre for the Study of Pain, Toronto, ON, Canada
- Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Gaurav Krishnamoorthy
- Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Pei-Yuan Tony He
- Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Anne Agur
- Division of Anatomy, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Irit Weissman-Fogel
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Howard C Tenenbaum
- University of Toronto Centre for the Study of Pain, Toronto, ON, Canada
- Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ernest W N Lam
- Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Karen D Davis
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- Krembil Brain Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Luke Henderson
- Department of Anatomy and Histology, University of Sydney, Sydney, Australia
| | - Iacopo Cioffi
- Centre for Multimodal Sensorimotor and Pain Research, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
- University of Toronto Centre for the Study of Pain, Toronto, ON, Canada
- Department of Dentistry, Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, ON, Canada
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31
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Al Sayegh S, Vasilatou I, Kumar A, Al Barwari C, Fredriksson L, Grigoriadis A, Christidis N. Experimental pain and fatigue induced by excessive chewing. BMC Oral Health 2020; 20:179. [PMID: 32600327 PMCID: PMC7322929 DOI: 10.1186/s12903-020-01161-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/08/2020] [Indexed: 12/18/2022] Open
Abstract
Background The study was aiming to optimize excessive gum chewing as an experimental model to induce jaw muscle pain and fatigue similar to those in painful TMDs with durations that would allow immediate investigations of jaw-motor function. Further, if any sex differences would be detected in the expression of pain. Methods This randomized, double blinded study included 31 healthy participants of both sexes. A standardized chewing protocol of either 40- or 60-min of chewing was used with a wash-out period of 1 week. Subjective fatigue, pain characteristics and functional measures were assessed. For statistical analyses, Wilcoxon Signed Rank test, Mann–Whitney Rank Sum test and Friedman’s ANOVA with Tukey post-hoc test were used. Results High subjective fatigue scores that lasted up to 20 min after the end of the trial were significantly induced both in the 40- and 60-min chewing trials (P < 0.001*). Significant but mild pain was induced only in the 60-min trial (P = 0.004*) and only in men (P = 0.04*). Also, the induced pain area was significantly bigger in the 60-min trial (P = 0.009*). However, this increase in pain and pain area did not last to the first 10-min follow-up. There were no significant differences neither between the 40- and 60-min chewing trials, except regarding the pain area (P = 0.008*), nor between the sexes. Conclusion Taken together, excessive chewing in its current form does not seem to be a proper pain experimental model. The model needs further adjustments in order to mimic TMD-pain especially in women and to prolong the pain duration.
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Affiliation(s)
- Samaa Al Sayegh
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden. .,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
| | - Ioanna Vasilatou
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden
| | - Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Ceva Al Barwari
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden
| | - Lars Fredriksson
- Department of Clinical Oral Physiology at the Eastman Institute, Folktandvården Stockholms län AB, SE-113 24, Stockholm, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Box 4046, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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Calil BC, da Cunha DV, Vieira MF, de Oliveira Andrade A, Furtado DA, Bellomo Junior DP, Pereira AA. Identification of arthropathy and myopathy of the temporomandibular syndrome by biomechanical facial features. Biomed Eng Online 2020; 19:22. [PMID: 32295597 PMCID: PMC7161015 DOI: 10.1186/s12938-020-00764-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/01/2020] [Indexed: 02/04/2023] Open
Abstract
Background Temporomandibular disorders (TMDs) are pathological conditions affecting the temporomandibular joint and/or masticatory muscles. The current diagnosis of TMDs is complex and multi-factorial, including questionnaires, medical testing and the use of diagnostic methods, such as computed tomography and magnetic resonance imaging. The evaluation, like the mandibular range of motion, needs the experience of the professional in the field and as such, there is a probability of human error when diagnosing TMD. The aim of this study is therefore to develop a method with infrared cameras, using the maximum range of motion of the jaw and four types of classifiers to help professionals to classify the pathologies of the temporomandibular joint (TMJ) and related muscles in a quantitative way, thus helping to diagnose and follow up on TMD. Methods Forty individuals were evaluated and diagnosed using the diagnostic criteria for temporomandibular disorders (DC/TMD) scale, and divided into three groups: 20 healthy individuals (control group CG), 10 individuals with myopathies (MG), 10 individuals with arthropathies (AG). A quantitative assessment was carried out by motion capture. The TMJ movement was captured with camera tracking markers mounted on the face and jaw of each individual. Data was exported and analyzed using a custom-made software. The data was used to identify and place each participant into one of three classes using the K-nearest neighbor (KNN), Random Forest, Naïve Bayes and Support Vector Machine algorithms. Results Significant precision and accuracy (over 90%) was reached by KNN when classifying the three groups. The other methods tested presented lower values of sensitivity and specificity. Conclusion The quantitative TMD classification method proposed herein has significant precision and accuracy over the DC/TMD standards. However, this should not be used as a standalone tool but as an auxiliary method for diagnostic TMDs.
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Affiliation(s)
- Bruno Coelho Calil
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil.
| | - Danilo Vieira da Cunha
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goias, Av. Esperanca, s/n, Campus Samambaia, Goiania, GO, 74690-900, Brazil
| | - Adriano de Oliveira Andrade
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Daniel Antônio Furtado
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Douglas Peres Bellomo Junior
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
| | - Adriano Alves Pereira
- Laboratory of Biomedical Engineering, Faculty of Electrical Engineering, Federal University of Uberlandia, Av. Joao Naves de Avila, 2121, Uberlandia, 38408-100, Brazil
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Maeda-Iino A, Fukushima M, Sakoguchi Y, Omure H, Oishi A, Oga Y, Furukawa-Sainoki M, Kanmura S, Ido A, Miyawaki S. Effects of intra-oesophageal acid infusion and a stress task on masseter muscle activity and autonomic nervous activity in wakefulness. J Oral Rehabil 2020; 47:567-576. [PMID: 32064657 DOI: 10.1111/joor.12947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/27/2020] [Accepted: 02/09/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gastroesophageal reflux disease may be an important risk factor for awake bruxism. Additionally, it has been known that a psychological stress task affects masseter muscle activity, and autonomic nervous system (ANS) activity modulation induces masseter muscle activity. OBJECTIVES This study aimed to investigate whether task-induced stress and experimental oesophageal acid infusion increase masseter muscle activity and alter ANS activity, compared to rest task and oesophageal saline infusion, respectively. METHODS Polygraphic monitoring, consisting of electromyography of the masseter muscle and electrocardiography, was performed in 12 healthy adult men during 30-min interventions with intra-oesophageal saline or acid infusion, while reading a book quietly, as rest, and while performing calculation, as a stress task. RESULTS At rest, masseter muscle activity and parasympathetic nervous system (PNS) activity during acid infusion were significantly higher (P = .019) and lower (P = .021) than during saline infusion, respectively. During saline infusion, both masseter muscle activity and sympathetic nervous system (SNS) activity or PNS activity while performing the calculation task were higher (P = .022 and .012, respectively) or lower (P = .007) than those during the reading task, respectively. In two-way repeated-measures ANOVA, intra-oesophageal infusion (saline or acid) significantly affected masseter muscle activity (P = .008) and PNS activity (P = .021). However, performing tasks (reading or calculation) significantly affected only PNS activity (P = .028). CONCLUSION Intra-oesophageal acid infusion significantly increased masseter muscle activity and decreased PNS activity. In contrast, stress task not only significantly decreased PNS activity, but only modestly increased masseter muscle activity and SNS activity.
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Affiliation(s)
- Aya Maeda-Iino
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mika Fukushima
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoko Sakoguchi
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Sakoguchi Dental Clinic, Kagoshima, Japan
| | - Haruhito Omure
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Omure Orthodontic Clinic, Matsuyama, Japan
| | - Akihito Oishi
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yasuhiko Oga
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Minami Furukawa-Sainoki
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shuji Kanmura
- Department of Endoscopy, Kagoshima University Hospital, Kagoshima, Japan
| | - Akio Ido
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shouichi Miyawaki
- Field of Developmental Medicine, Health Research Course, Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.,Faculty of Dental Medicine, Airlangga University, Surabaya, Indonesia
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Takeuchi‐Sato T, Ono Y, Funato M, Sato H, Suganuma T, Baba K. Efficacy of an email‐based recording and reminding system for limiting daytime non‐functional tooth contact in patients with temporomandibular disorders: A randomized controlled trial. J Oral Rehabil 2019; 47:158-163. [DOI: 10.1111/joor.12875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/23/2019] [Accepted: 08/10/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Tamiyo Takeuchi‐Sato
- Division of Temporomandibular Disorders and Orofacial Pain, Department of Special Needs Dentistry Showa University School of Dentistry Ohta‐ku Japan
| | - Yasuhiro Ono
- Department of Prosthodontics Showa University School of Dentistry Ohta‐ku Japan
| | - Masahiko Funato
- Research Institute for Sport and Exercise Sciences Showa University Yokohama Japan
| | - Hitoshi Sato
- Department of Oral and Maxillofacial Surgery Showa University School of Dentistry Ohta‐ku Japan
| | - Takeshi Suganuma
- Division of Temporomandibular Disorders and Orofacial Pain, Department of Special Needs Dentistry Showa University School of Dentistry Ohta‐ku Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics Showa University School of Dentistry Ohta‐ku Japan
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WAGNER BDA, MOREIRA FILHO PF, BERNARDO VG. Association of bruxism and anxiety symptoms among military firefighters with frequent episodic tension type headache and temporomandibular disorders. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:478-484. [DOI: 10.1590/0004-282x20190069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/13/2019] [Indexed: 01/03/2023]
Abstract
ABSTRACT Objective To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs). Methods The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety. Results Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011). Conclusion Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.
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Shah N, Melo L, Reid WD, Cioffi I. Masseter Deoxygenation in Adults at Risk for Temporomandibular Disorders. J Dent Res 2019; 98:666-672. [PMID: 30946624 DOI: 10.1177/0022034519837249] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Patients with muscular temporomandibular disorder (TMD) present with abnormal oxygenation of the jaw muscles. Nonetheless, the deoxygenation pattern of jaw muscles of healthy subjects with frequent wake-time tooth-clenching episodes, who are at greater risk for TMD, has never been investigated. This case-control study compared the deoxygenation of the masseter during standardized tasks between TMD-free individuals with frequent self-reports of wake-time clenching and those with infrequent self-reports. University students ( N = 255) filled out the Oral Behavior Checklist. Fourteen females with high versus low scores-high parafunctional (HP) group ( n = 7, ≥80th percentile of score distribution) versus low parafunctional (LP) group ( n = 7, ≤20th percentile)-completed 2 sessions during which they clenched at their maximum voluntary contraction (MVC) for 2 min and at 10% to 20% MVC for 20 min. Tissue oxygen saturation (StO2) and changes in oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin of the masseter were measured via near-infrared spectroscopy and analyzed with a generalized mixed effect model. A significant interaction effect (task × study group) was found on all outcome measures, indicating that the deoxygenation pattern of the HP group differed from the LP group (all P < 0.001). MVC of the masseter induced an almost 5-times-greater reduction of StO2 in the HP group as compared with the LP group ( P = 0.023). However, the relative increase in StO2 at rest after the MVC was similar between groups ( P > 0.05). At the end of the prolonged MVC task (10% to 20%), the blood flow (change in total hemoglobin) was almost 6 times higher in the LP group as compared with baseline. On the contrary, it increased minimally in the HP group (all P < 0.001). Healthy individuals at risk for TMD have abnormalities in masseter deoxygenation. Future prospective studies are needed to test whether this contributes to the onset of muscular TMD.
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Affiliation(s)
- N Shah
- 1 Faculty of Medicine, McMaster University, Hamilton, ON, Canada
- 2 Center for the Study of Pain, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - L Melo
- 3 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - W D Reid
- 3 Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- 4 Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- 5 KITE, Toronto Rehab-University Health Network, Toronto, ON, Canada
| | - I Cioffi
- 2 Center for the Study of Pain, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Valentino R, Cioffi I, Vollaro S, Cimino R, Baiano R, Michelotti A. Jaw muscle activity patterns in women with chronic TMD myalgia during standardized clenching and chewing tasks. Cranio 2019; 39:157-163. [DOI: 10.1080/08869634.2019.1589703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Roberta Valentino
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto Centre for the study of Pain, Toronto, ON, Canada
| | - Stefano Vollaro
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Roberta Cimino
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Roberta Baiano
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
| | - Ambrosina Michelotti
- Department of Neuroscience, Reproductive Sciences and Oral Sciences, University of Naples “Federico II”, Naples, Italy
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Smartphone-assisted monitoring of masticatory muscle activity in freely moving individuals. Clin Oral Investig 2019; 23:3601-3611. [DOI: 10.1007/s00784-018-2785-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 12/18/2018] [Indexed: 10/27/2022]
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Effects of trait anxiety, somatosensory amplification, and facial pain on self-reported oral behaviors. Clin Oral Investig 2018; 23:1653-1661. [PMID: 30151704 DOI: 10.1007/s00784-018-2600-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/21/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Oral behaviors are activities, like gum chewing, teeth clenching, and biting of objects, that go beyond normal functioning demands and contribute to the onset of temporomandibular disorders (TMD). Somatosensory amplification refers to the tendency to experience somatic sensations as intense, noxious, and disturbing and is related to bodily hypervigilance. Clinical experience suggests that individuals with bodily hypervigilance also present with occlusal hypervigilance and continuously check their occlusion. This study aimed at investigating whether somatosensory amplification and trait anxiety, a characteristic correlated with hypervigilance, are associated with a greater incidence of oral behaviors, and verifying how self-reported facial TMD pain affect this relationship. MATERIALS AND METHODS The State-Trait Anxiety Inventory, the Somatosensory Amplification Scale, the Oral Behavior Checklist (OBC), and the TMD-Pain Screener Questionnaire were filled out by 255 University students with self-reported facial TMD pain (PAIN group; 47 subjects, 24.8 ± 4.2 years) and without pain (CTR group; 208 subjects, 26.0 ± 4.8 years) using a web survey. RESULTS Trait anxiety, somatosensory amplification, and OBC scores were greater in the PAIN than CTR group (all p < 0.05). Trait anxiety and somatosensory amplification were positively associated with the frequency of oral behaviors, as measured with the OBC (all p < 0.05). A significant effect of the interaction study group*trait anxiety (p = 0.028) on OBC scores was found. CONCLUSIONS Individuals with greater trait anxiety and somatosensory amplification report more frequent oral behaviors. The relationship between anxiety and oral behaviors is affected by concurrent facial pain. CLINICAL RELEVANCE Individuals with increased trait anxiety and concurrent facial pain report more frequent oral behaviors than those without pain. Clinicians should evaluate patients' anxiety and somatosensory amplification before starting dental treatment.
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The Role of Stress in the Etiology of Oral Parafunction and Myofascial Pain. Oral Maxillofac Surg Clin North Am 2018; 30:369-379. [PMID: 29866454 DOI: 10.1016/j.coms.2018.04.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Oral parafunction during waking comprises possible behaviors that can be measured with a comprehensive checklist or behavioral monitoring. Multiple studies lead to largely consistent findings: stressful states can trigger parafunctional episodes that contribute to myofascial pain. However, this simple causal pathway coexists with at least 3 other pathways: anxiety and stress are potent direct contributors to pain, pain results in maladaptive behaviors such as parafunction, and parafunction may be a coping response to potential threat coupled with hypervigilance and somatosensory amplification. Awake parafunction remains an important risk factor for myofascial pain onset and overuse models alone of causation are insufficient.
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Miralles R, Gamboa NA, Gutiérrez MF, Santander H, Valenzuela S, Bull R, Fuentes AD, Córdova R. Effect of breathing type on electromyographic activity of respiratory muscles during tooth clenching at different decubitus positions. Cranio 2018; 37:28-34. [PMID: 29730974 DOI: 10.1080/08869634.2018.1470274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To compare the effect of breathing type on electromyographic (EMG) activity of respiratory muscles during tooth clenching at different decubitus positions. METHODS Forty young men participants were included, 11 with upper costal, 9 with mixed, and 20 with costo-diaphragmatic breathing type. EMG recordings of diaphragm (DIA), external intercostal (EIC), sternocleidomastoid (SCM), and latissimus dorsi (LAT) muscles during tooth clenching in the intercuspal position were performed in dorsal, left lateral, and ventral decubitus positions. RESULTS DIA EMG activity was higher in subjects with upper costal or mixed than with costodiaphragmatic breathing type (p = 0.006; 0.021, respectively), whereas it was similar between upper costal and mixed breathing types. EIC, SCM, and LAT activity was similar among breathing types. CONCLUSION Higher DIA activity would be a risk factor to exceed the adaptive capability of healthy subjects with upper costal or mixed breathing type.
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Affiliation(s)
- Rodolfo Miralles
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Natalia Andrea Gamboa
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,b Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile
| | - Mario Felipe Gutiérrez
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,b Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile
| | - Hugo Santander
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Saúl Valenzuela
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,b Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile
| | - Ricardo Bull
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile
| | - Aler Daniel Fuentes
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,b Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile
| | - Rosa Córdova
- a Faculty of Medicine, Oral Physiology Laboratory, Biomedical Sciences Institute , University of Chile , Santiago , Chile.,b Faculty of Dentistry, Institute for Research in Dental Sciences , University of Chile , Santiago , Chile.,c Faculty of Medicine , Diego Portales University , Santiago , Chile
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Bracci A, Djukic G, Favero L, Salmaso L, Guarda-Nardini L, Manfredini D. Frequency of awake bruxism behaviours in the natural environment. A 7-day, multiple-point observation of real-time report in healthy young adults. J Oral Rehabil 2018; 45:423-429. [DOI: 10.1111/joor.12627] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2018] [Indexed: 12/11/2022]
Affiliation(s)
- A. Bracci
- School of Dentistry; University of Padova; Padova Italy
| | - G. Djukic
- Institute of Clinical Physiology; National Research Council; Pisa Italy
| | - L. Favero
- School of Dentistry; University of Padova; Padova Italy
| | - L. Salmaso
- Department of Management and Engineering; University of Padova; Padova Italy
| | - L. Guarda-Nardini
- Department of Dentistry and Maxillofacial Surgery; Hospital of Treviso; Treviso Italy
| | - D. Manfredini
- School of Dentistry; University of Padova; Padova Italy
- School of Dentistry; University of Siena; Siena Italy
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Donnarumma V, Cioffi I, Michelotti A, Cimino R, Vollaro S, Amato M. Analysis of the reliability of the Italian version of the Oral Behaviours Checklist and the relationship between oral behaviours and trait anxiety in healthy individuals. J Oral Rehabil 2018; 45:317-322. [DOI: 10.1111/joor.12614] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 12/24/2022]
Affiliation(s)
- V. Donnarumma
- Department of Neurosciences, Reproductive Sciences and Oral Sciences; Division of Orthodontics; University of Naples ‘Federico II’; Naples Italy
| | - I. Cioffi
- Department of Neurosciences, Reproductive Sciences and Oral Sciences; Division of Orthodontics; University of Naples ‘Federico II’; Naples Italy
- Faculty of Dentistry; Discipline of Orthodontics; Centre for the Study of Pain; University of Toronto; Toronto ON Canada
| | - A. Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences; Division of Orthodontics; University of Naples ‘Federico II’; Naples Italy
| | - R. Cimino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences; Division of Orthodontics; University of Naples ‘Federico II’; Naples Italy
| | - S. Vollaro
- Department of Neurosciences, Reproductive Sciences and Oral Sciences; Division of Orthodontics; University of Naples ‘Federico II’; Naples Italy
| | - M. Amato
- Department of Medicine; Surgery and Dentistry; Faculty of Medicine and Surgery; University of Salerno; Fisciano Salerno Italy
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Cioffi I, Farella M, Chiodini P, Ammendola L, Capuozzo R, Klain C, Vollaro S, Michelotti A. Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine. J Oral Rehabil 2017; 44:333-339. [DOI: 10.1111/joor.12498] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- I. Cioffi
- Discipline of Orthodontics; Faculty of Dentistry; University of Toronto - University of Toronto Center for the Study of Pain; Toronto ON Canada
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - M. Farella
- Sir John Walsh Research Institute; University of Otago; Dunedin New Zealand
| | - P. Chiodini
- Medical Statistics Unit; University of Campania Luigi Vanvitelli; Naples Italy
| | - L. Ammendola
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - R. Capuozzo
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - C. Klain
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - S. Vollaro
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
| | - A. Michelotti
- Section of Orthodontics; Department of Neuroscience, Reproductive Sciences and Oral Sciences; University of Naples Federico II; Naples Italy
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