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Nikolaos Z, Marcus G, Dimitrios N, Michail T, Dimitrios MD, Vasileios P. Instrumental Occlusal Analysis in Migraine Patients: A Quantitative Cross Sectional Study. Clin Exp Dent Res 2024; 10:e938. [PMID: 39039942 PMCID: PMC11263750 DOI: 10.1002/cre2.938] [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: 05/10/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES This study aimed to investigate possible differences of functional occlusal variables between a group of migraine patients (MG) and a control group (CG). MATERIALS AND METHODS Each group included 50 individuals. Instrumental functional analysis and digital occlusal analysis were performed. Variables examined were condylar displacement from a reference position to maximum intercuspation; angular difference between the steepness of the articular eminence and the contra-lateral canine guidance; and angular difference between the steepness of the articular eminence and the ipsilateral central incisor guidance and occlusal plane inclination. Self-reported grinding and occlusal index were also investigated. RESULTS There were statistically significant differences in the extent of retral condylar displacement assessed both clinically [MG: 0.49 mm (SD 0.67 mm), CG: 0.29 mm (SD 0.27 mm), p = 0.012] and digital-mechanically [MG: 1.53 mm (SD 0.95 mm), CG: 0.9 mm (SD 0.66 mm), p = 0.001], the angular difference between the steepness of the articular eminence and the contra-lateral canine guidance [MG: 13.11° (SD 8.33°), CG: 9.47° (SD 7.08°), p = 0.021 and MG: 12.94° (SD 8.71°), CG: 9.44° (SD 8.70°), p = 0.017], and the occlusal plane inclination [MG: 11.16° (SD 4.66°), CG: 9.09° (SD 4.37°), p = 0.024]. Self-reported grinding (MG: 39/50, CG: 12/50, p < 0.001) and occlusal index [MG: 1.92 (SD 0.46), CG: 0.21 (SD 0.66), p < 0.001] were also significantly higher in migraineurs. CONCLUSIONS Articular and occlusal structures could play a role in migraine and thus should be considered in an interdisciplinary approach.
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Affiliation(s)
- Zokaris Nikolaos
- 251 Hellenic Air Force and VA Hospital, Department of ProsthodonticsAthensGreece
| | - Greven Marcus
- Medical University of Vienna, University Clinic of DentistryViennaAustria
| | | | - Tzakis Michail
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
| | - Mitsikostas Dimos Dimitrios
- School of Medicine, First Department of Neurology, Aeginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Psarras Vasileios
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
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Figueiró C, Knorst JK, Fensterseifer CK, Folchini S, Milanesi JDM, Bernardon Silva T, Marquezan M. Changes in oral health-related quality of life after self-care treatment in patients with myofascial pain. Cranio 2024; 42:199-205. [PMID: 33928869 DOI: 10.1080/08869634.2021.1922229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the changes in oral health-related quality of life (OHRQoL) of patients with myofascial pain treated by means of self-care measures. METHODS Fifteen patients with myofascial pain had OHRQoL evaluated by the Oral Health Impact Profile (OHIP-TMD) questionnaire and were instructed for self-care measures verbally and with a printed guide in the first consultation (T0), after 30 days (T1) and 60 days (T2). Paired t-test was performed to evaluate changes through time. RESULTS OHIP-TMD scores were 29.3 (SD 10.2) at T0, 18.9 (SD 11.2) at T1, and 15.9 (SD 10.7) at T2. There was a reduction of scores related to the OHIP-TMD domains of functional limitation, physical pain, psychological and social inability and incapacity (T1 and T2), and psychological discomfort (T2). CONCLUSION Self-care measures had positive effects on the myofascial pain treatment, reducing physical pain generated by TMD and improving patients' OHRQoL.
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Affiliation(s)
- Cláudio Figueiró
- Restorative Dentistry Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Jéssica Klöckner Knorst
- Student, Postgraduation Program in Dental Sciences, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | | | - Stella Folchini
- Student, Postgraduation Program in Dental Sciences, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Jovana De Moura Milanesi
- Physiotherapist, External Collaborator, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Tatiana Bernardon Silva
- Restorative Dentistry Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Marquezan
- Stomatology Department, Federal University of De Santa Maria, Santa Maria, RS, Brazil
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Altunan B. Primary headaches in scuba divers and the effect of temporomandibular dysfunction. Cranio 2024; 42:18-24. [PMID: 33794749 DOI: 10.1080/08869634.2021.1909457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the frequency of episodic primary headaches (EPH) and temporomandibular dysfunction's (TMD) effect in experienced scuba divers. METHODS A form consisting of the Fonseca Anamnestic Index and a structured headache questionnaire was sent to individuals using social media platforms. RESULTS A total of 132 divers and 104 non-divers were included the study. In male divers, EPH and TMD were not different from the non-diver group (p = 0.1, p = 0.1), and TMD had an effect on increasing the possibility of migraine (OR = 2.5, p = 0.04). In female divers, the possibility of EPH and TMD were also lower (OR = 0.1, p < 0.001, OR = 0.2, p = 0.01). CONCLUSION Scuba diving does not pose a risk for EPH or TMD in either gender. TMD treatment in male divers is important for uncontrolled migraine attacks.
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Affiliation(s)
- Bengü Altunan
- Faculty of Medicine, Department of Neurology, Tekirdag Namik Kemal University, Tekırdag, Turkey
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Monaco A, Cattaneo R, Di Nicolantonio S, Strada M, Altamura S, Ortu E. Central effects of trigeminal electrical stimulation. Cranio 2023:1-24. [PMID: 38032105 DOI: 10.1080/08869634.2023.2280153] [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: 12/01/2023]
Abstract
This is a review of the literature on the main neuromodulation techniques, focusing on the possibility of introducing sensory threshold ULFTENS into them. Electro neuromodulation techniques have been in use for many years as promising methods of therapy for cognitive and emotional disorders. One of the most widely used forms of stimulation for orofacial pain is transcutaneous trigeminal stimulation on three levels: supraorbital area, dorsal surface of the tongue, and anterior skin area of the tragus. The purpose of this review is to trigger interest on using dental ULFTENS as an additional trigeminal neurostimulation and neuromodulation technique in the context of TMD. In particular, we point out the possibility of using ULFTENS at a lower activation level than that required to trigger a muscle contraction that is capable of triggering effects at the level of the autonomic nervous system, with extreme ease of execution and few side effects.
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Affiliation(s)
- Annalisa Monaco
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Ruggero Cattaneo
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | | | - Marco Strada
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Serena Altamura
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Eleonora Ortu
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
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Demir MG. Comparison of symptoms, signs and magnetic resonance imaging in children aged 5-18 years with temporomandibular joint disease. Cranio 2023:1-5. [PMID: 37982425 DOI: 10.1080/08869634.2023.2281203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Temporomandibular joint diseases (TMD) are an important clinical condition in childhood as in adults. There is variation in the frequency and distribution of complaints in children about this disorder. MATERIALS AND METHODS This study was conducted on 407 children aged 5-18 years. Patients with dentofacial function problems, trauma, history of surgery, and malignancy were excluded from the study. Patients with temporomandibular magnetic resonance imaging in their records were classified as normal, reduction disc displacement and non-reduction disc displacement. RESULTS Patients symptoms were click (77.2%), pain (71.5%), headache (61.2%), bruxism (31.9%), locking (28%), difficulty in mouth opening (24.3%). The most common clinical findings are normal mouth opening (62.2%) and deviation (44.9%). When the MR results were examined, 55.1% of female and 66.6% of male were observed to be normal, and this statistically shows that males have more normal MR findings. CONCLUSION TMD are also observed in children. Clinical history and findings are helpful in diagnosis, but the contribution of imaging methods may be limited. If head and neck pain is detected in children, TMD should be kept in mind.
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Affiliation(s)
- Mehmet Gökhan Demir
- Istanbul Medical School, Department Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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Wei J, Zhang S, Chen Z, Tu S, Wang Y, Feng Y, Kuang Z, Wu L, Ai H. The prevalence of temporomandibular disorder and temporomandibular morphology among diverse chronotype profiles. Chronobiol Int 2023; 40:1444-1453. [PMID: 37850303 DOI: 10.1080/07420528.2023.2270054] [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: 04/02/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
This study investigates the influence of chronotype on the prevalence of temporomandibular joint disorders (TMD) and the morphology of temporomandibular joint (TMJ). According to the Morningness-Eveningness Questionnaire-Self-Assessment, the participants were divided into morning group (n = 30), intermediate group (n = 83), and evening group (n = 30). Thirty participants were randomly selected from the intermediate group for subsequent examination and measurements. The morphology of TMJs was investigated using questionnaire and clinical examination form in Diagnostic Criteria for Temporomandibular Disorder. Meanwhile, the morphological results of TMJs were measured from cone-beam computed tomography images. The prevalence rate of TMD in the morning group (23%) was significantly lower than that in the intermediate group (56.7%), while there was no difference between the evening (53.4%) and intermediate groups. As to morphological measurements, there was no significant difference among three groups in mediolateral width of condylar process, anteroposterior width of condylar process, radius of condyle, medial joint space, lateral joint space, condylar stress angle, horizontal condylar inclination, width of glenoid fossa, depth of glenoid fossa, and posterior joint space, while there was a significant difference in horizontal condylar angle (p = 0.00490), articular eminence inclination (p < .0001), anterior joint space (p = 0.0163), and superior joint space (p = 0.0004). The morphology of TMJ in the morning group was better than that in the evening and intermediate groups. An association was found between TMD prevalence, temporomandibular morphology, and chronotype.
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Affiliation(s)
- Jiaming Wei
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sai Zhang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng Chen
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaoqin Tu
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuxuan Wang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yi Feng
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhili Kuang
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liping Wu
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Hong Ai
- Department of Stomatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Yap AU, Marpaung C. Correlates between temporomandibular disorder severity, emotional distress, and eudaimonic well-being among young adults. Oral Dis 2023; 29:2780-2788. [PMID: 35942541 DOI: 10.1111/odi.14343] [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: 04/28/2022] [Revised: 07/09/2022] [Accepted: 07/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study examined the correlates between severity of temporomandibular disorders (TMDs), emotional distress, and eudaimonic well-being. SUBJECTS AND METHODS TMD severity, negative emotions, and eudaimonia were assessed with the Fonseca Anamnestic Index (FAI), Depression, Anxiety, Stress Scales-21 (DASS-21), and Psychological Well-being Scale-18 (PWBS-18) in a cohort of community young adults. Statistical evaluations were done with non-parametric tests/correlation and multivariate regression analyses (α = 0.05). RESULTS Amongst the 873 participants (mean age 19.8 ± 1.66 years), 40.7%, 49.0%, and 10.3% had no (NT), mild (MT), and moderate-to-severe (ST) TMD, respectively. Significant differences in total-DASS, depression, anxiety, and stress were ST ≥ MT > NT. Significant variances in total-PWSB and self-acceptance were NT > MT > ST while that for environmental mastery, positive relations, and purpose in life were NT > MT, ST. An inverse relationship was discerned between total-DASS and total-PWBS (correlation coefficient = -0.54). The prospect of ST was increased by anxiety but reduced by positive relations and self-acceptance. CONCLUSIONS Young adults with mild and moderate-to-severe TMD experienced substantially higher emotional distress and lower eudaimonia than those with no TMD. As emotional distress and eudaimonic well-being are interrelated, positive psychological interventions may be beneficial for managing TMD-related psychosocial disabilities.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore
- National Dental Research Institute, National Dental Centre Singapore and Duke-NUS Medical School, SingHealth, Singapore
- Department of Prosthodontics, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
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Piekartz HV, van der Meer H, Olivo SA. Craniofacial disorders and headaches. A narrative review. Musculoskelet Sci Pract 2023; 66:102815. [PMID: 37419842 DOI: 10.1016/j.msksp.2023.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Craniofacial- and headache disorders are common co-morbid disorders. The aim of this review is to provide an overview of the research discussing craniofacial pain, especially temporomandibular disorders, and its relationship and impact on headaches, as well as suggestions for diagnostic assessment tools and physical therapeutic management strategies. METHOD A narrative structured review was performed. A search was conducted in MEDLINE using terms related to craniofacial pain and headaches. Additionally, papers regarding this topic were also extracted from the authors' personal libraries. Any study design (i.e., RCT, observational studies, systematic review, narrative review) that reported the concepts of interest was included, using Covidence. Results were narratively synthesized and described. RESULTS From an epidemiological perspective, craniofacial pain and headaches are strongly related and often co-existing. This may be due to the neuroanatomical connection with the trigeminal cervical complex, or due to shared predisposing factors such as age, gender, and psychosocial factors. Pain drawings, questionnaires, and physical tests can be used to determine the cause of pain, as well as other perpetuating factors in patients with headaches and craniofacial pain. The evidence supports different forms of exercise and a combination of hands-on and hands-off strategies aimed at both the craniofacial pain as well as the headache. CONCLUSION Headaches may be caused or aggravated by different disorders in the craniofacial region. Proper use of terminology and classification may help in understanding these complaints. Future research should look into the specific craniofacial areas and how headaches may arise from problems from those regions. (249 words).
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Affiliation(s)
- Harry von Piekartz
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Cranial Facial Therapy Academy (CRAFTA), Hamburg, Germany.
| | - Hedwig van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, the Netherlands; SOMT University of Physiotherapy, Amersfoort, Netherlands
| | - Susan Armijo Olivo
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Faculty of Rehabilitation Medicine, Faculty of Medicine and Dentistry Rehabilitation Research Center, University of Alberta, Edmonton, Canada
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Thomas DC, Khan J, Manfredini D, Ailani J. Temporomandibular Joint Disorder Comorbidities. Dent Clin North Am 2023; 67:379-392. [PMID: 36965938 DOI: 10.1016/j.cden.2022.10.005] [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: 02/04/2023]
Abstract
Comorbidity is a distinct additional condition that either existed or exists during the clinical course of a patient afflicted by the condition/entity in question. The clinician attempting to manage temporomandibular joint disorder (TMD) and TMD pain must realize that recognition and management of the comorbidities are essential to the successful management of the same with optimal pain control. When TMD presents with multiple comorbidities, the task for the clinician becomes more complex. It is the hope of the authors that this condensed version of TMD-associated comorbidities acts as a primer for understanding the significance of the same in pain management.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY, USA.
| | - Junad Khan
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, 2400 South Clinton Avenue, Building H, Suite #125, Rochester, NY 14618, USA
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Viale Bracci - 53100 Siena, Italy
| | - Jessica Ailani
- Georgetown Headache Center, Strategic Planning Neurology, Medstar Georgetown University Hospital 3800 Reservoir Road. NW, Washington, DC 20007, USA
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Chen CM, Chen PJ, Hsu HJ. Changes in Preexisting Temporomandibular Joint Clicking after Orthognathic Surgery in Patients with Mandibular Prognathism. Bioengineering (Basel) 2022; 9:bioengineering9120725. [PMID: 36550931 PMCID: PMC9774496 DOI: 10.3390/bioengineering9120725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/13/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate the changes in preexisting temporomandibular joint (TMJ) clicking and the new incidence of TMJ clicking after orthognathic surgery. A total of 60 patients (30 men and 30 women) with mandibular prognathism underwent intraoral vertical ramus osteotomy (IVRO) for a mandibular setback. The setback amount and TMJ clicking symptoms (preoperative and one year postoperative) were recorded. To assess the risk of new incidence of TMJ clicking in asymptomatic patients, the cutoff value for postoperative mandibular setback was set at 8 mm. The left and right mandibular setbacks were 11.1 and 10.9 mm in men, respectively, and 10.7 and 10.0 mm in women, respectively. Thus, no difference in setback amount on either side was observed between the sexes. The improvement rate in patients with preexisting TMJ clicking was 69.2% (18 of 26 sides); the postoperative improvement rates were 71.4% (setback amount > 8 mm) and 60% (setback amount ≤ 8 mm). IVRO may reduce the severity of preexisting TMJ clicking. A high setback amount (>8 mm) may not be associated with a considerable increase in the risk of postoperative TMJ clicking.
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Affiliation(s)
- Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pei-Jung Chen
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Han-Jen Hsu
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Oral Hygiene, College of Dental Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101
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Crăciun MD, Geman O, Leuciuc FV, Holubiac IŞ, Gheorghiţă D, Filip F. Effectiveness of Physiotherapy in the Treatment of Temporomandibular Joint Dysfunction and the Relationship with Cervical Spine. Biomedicines 2022; 10:biomedicines10112962. [PMID: 36428529 PMCID: PMC9687864 DOI: 10.3390/biomedicines10112962] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Temporomandibular dysfunctions are a heterogeneous group of conditions involving the temporomandibular joints (TMJs) and periarticular musculoskeletal structures. This study aimed to evaluate the effectiveness of a physiotherapy program for TMJ dysfunctions and the relationship with cervical spine. The study design was a non-randomized clinical trial with two parallel treatment groups: 33 subjects in the experimental group that underwent conservative drug treatment and physiotherapy treatment, and 31 subjects in the control group that underwent only conservative drug treatment. The participants were examined at baseline and re-examined after 3 months. In this study there was a higher incidence of female subjects. After 3 months of treatment of the TMJs and cervical spine, pain decreased in both groups (p = 0001). Muscle testing at the cervical spine and temporomandibular level showed a decrease in pain and muscles spasms. The average percentage values of the Neck Disability Index (NDI) and the Jaw Functional Limitation Scale 8 (JFLS 8) decreased significantly in both groups, but especially in the experimental group (p = 0.001). Physiotherapy treatments could maintain the functional state at the temporomandibular and cervical levels, thus contributing to increasing the quality of daily life.
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Affiliation(s)
- Maria Daniela Crăciun
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Oana Geman
- Neuroaesthetics Laboratory, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
- Correspondence: (M.D.C.); (O.G.)
| | - Florin Valentin Leuciuc
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Iulian Ştefan Holubiac
- Interdisciplinary Research Centre in Motricity Sciences and Human Health, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Daniela Gheorghiţă
- Dentist’s Office Omnis Dental, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Florin Filip
- County Hospital of Suceava, Ştefan cel Mare University of Suceava, 720229 Suceava, Romania
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Peck CM, Bereiter DA, Eberly LE, Lenglet C, Moana-Filho EJ. Altered brain responses to noxious dentoalveolar stimuli in high-impact temporomandibular disorder pain patients. PLoS One 2022; 17:e0266349. [PMID: 36240243 PMCID: PMC9565712 DOI: 10.1371/journal.pone.0266349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
Abstract
High-impact temporomandibular disorder (TMD) pain may involve brain mechanisms related to maladaptive central pain modulation. We investigated brain responses to stimulation of trigeminal sites not typically associated with TMD pain by applying noxious dentoalveolar pressure to high- and low-impact TMD pain cases and pain-free controls during functional magnetic resonance imaging (fMRI). Fifty female participants were recruited and assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Graded Chronic Pain Scale: controls (n = 17), low-impact (n = 17) and high-impact TMD (n = 16). Multimodal whole-brain MRI was acquired following the Human Connectome Project Lifespan protocol, including stimulus-evoked fMRI scans during which painful dentoalveolar pressure was applied to the buccal gingiva of participants. Group analyses were performed using non-parametric permutation tests for parcellated cortical and subcortical neuroimaging data. There were no significant between-group differences for brain activations/deactivations evoked by the noxious dentoalveolar pressure. For individual group mean activations/deactivations, a gradient in the number of parcels surviving thresholding was found according to the TMD pain grade, with the highest number seen in the high-impact group. Among the brain regions activated in chronic TMD pain groups were those previously implicated in sensory-discriminative and motivational-affective pain processing. These results suggest that dentoalveolar pressure pain evokes abnormal brain responses to sensory processing of noxious stimuli in high-impact TMD pain participants, which supports the presence of maladaptive brain plasticity in chronic TMD pain.
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Affiliation(s)
- Connor M. Peck
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, United States of America
| | - David A. Bereiter
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, United States of America
| | - Lynn E. Eberly
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America
| | - Christophe Lenglet
- Department of Radiology, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Estephan J. Moana-Filho
- Department of Diagnostic and Biological Sciences, University of Minnesota School of Dentistry, Minneapolis, Minnesota, United States of America
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13
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Demir MG. Comparison of symptoms, signs, gender, and magnetic resonance images of temporomandibular joint disorder patients. Cranio 2022:1-5. [PMID: 36170015 DOI: 10.1080/08869634.2022.2128591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To compare patients' complaints, clinician's examination findings, and magnetic resonance imaging (MRI) findings by considering gender. METHODS Temporomandibular joint (TMJ) pain, difficulty in mouth opening, masseter tenderness, deviation, clicking sound, bruxism, restriction, normal occlusion and normal mouth opening symptoms, and findings of temporomandibular disorder (TMD) patients who came to the author's outpatient clinic were recorded. These recordings were compared with MRI. RESULTS In the study, symptoms, signs, and MRIs of 276 TMD patients were analyzed, including gender. No difference was observed in terms of symptoms, signs, or MRI results for either gender. MRI findings were correlated with restriction and normal mouth opening in both groups (p < 0.05). Normal MRI findings were observed in 52.5% of the MRI results. CONCLUSION Except for normal mouth opening and limitation, MRI findings did not provide a significant result. Therefore, careful detection of symptoms and signs rather than MRI helps in diagnosis.
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Affiliation(s)
- Mehmet Gökhan Demir
- Istanbul Medical School, Department Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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14
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The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137974. [PMID: 35805650 PMCID: PMC9265370 DOI: 10.3390/ijerph19137974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.
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Electroacupuncture for Temporomandibular Disorders: A Systematic Review of Randomized Controlled Trials. Healthcare (Basel) 2021; 9:healthcare9111497. [PMID: 34828543 PMCID: PMC8624061 DOI: 10.3390/healthcare9111497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/02/2022] Open
Abstract
Although electroacupuncture (EA) is an effective treatment for pain relief, there has been no systematic review of EA treatment for temporomandibular disorder TMD. This systematic review aimed to evaluate the efficacy and safety of EA in TMD management. We searched 14 databases until April 2021 for randomized controlled trials (RCTs) evaluating the effects of EA on TMDs. Eleven RCTs with 667 patients that used three acupuncture points (ST6, ST7, and LI4) were included. Two RCTs reported significant effects of EA plus microwave treatment compared with EA treatment alone on the total effectiveness rate (TER) for TMD. Further, two studies reported that compared with ultrashort wave alone, EA plus ultrashort wave had a significant effect on the TER for TMD and visual analog scale. All RCTs did not report adverse events. Our findings demonstrated the positive potential of EA in TMD management. However, there was weak evidence regarding EA use for TMD management given the poor quality and small sample sizes of the included studies. In the future, well-designed RCTs are required. It is necessary to investigate clinical trials and systematic reviews to compare the effectiveness and safety of EA and acupuncture for TMD.
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16
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Rhinogenic and sinus headache - Literature review. Am J Otolaryngol 2021; 42:103113. [PMID: 34175774 DOI: 10.1016/j.amjoto.2021.103113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/13/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Headache is a common, yet challenging symptom to evaluate given its wide range of clinical presentations and different etiologies. For centuries, conceptual understanding of headache causation has been attributed to anatomic abnormalities of the nose and paranasal sinuses. METHODS Structured literature review. RESULTS The number of cases, categorized as migraines or other primary headaches, misdiagnosed as a "sinus headache" is high in the literature, ranging from 50 to 80%. The potential mechanisms for rhinogenic headaches were classically described as pain secondary to prolonged mucosal contact points, hypoxia in the paranasal sinuses secondary to poor ventilation, or pressure caused by the growth of nasal polyps. Additionally, other mechanisms were described and are still being studied. Corrective surgery for mucosal contact points in the nasal cavity is deemed necessary for relieving the headache, although patient outcomes are variable. CONCLUSION Delay in proper diagnosis and treatment negatively impact patient quality of life. Most cases of "sinus headache" or "rhinogenic headache" seen in clinical practice are in fact misdiagnosed as either primary headaches or migraines. Because of increased misdiagnoses, Otolaryngologists should establish a direct and precise diagnosis congruent with a chief complaint being a headache. Vital information such as a good clinical history, well-performed nasal endoscopy, and occasional CT scan may decrease misdiagnosis probability.
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17
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Association between primary headaches and temporomandibular disorders: A systematic review and meta-analysis. J Am Dent Assoc 2021; 153:120-131.e6. [PMID: 34649707 DOI: 10.1016/j.adaj.2021.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The primary objective of this systematic review was to answer the following question systematically: Is there any association between primary headaches (PHs) and temporomandibular disorders (TMDs) in adults? TYPES OF STUDIES REVIEWED The protocol was registered with the International Prospective Register of Systematic Reviews. The authors performed the search in 7 main databases and 3 gray literature sources. The included articles had to have adult samples. PHs must have been diagnosed using the International Classification of Headache Disorders, and TMDs must have been diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or International Classification of Orofacial Pain. Risk of bias was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools. The meta-analysis was performed using Review Manager software, Version 5.4. Certainty of evidence was screened according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS Eight of 2,574 articles reviewed met the inclusion criteria for qualitative analysis and, of these, 6 met the inclusion criteria for quantitative analysis. Odds ratios (ORs) for painful TMD and tension-type headache (OR, 3.16; 95% CI, 1.80 to 5.54 to OR, 13.06; 95% CI, 2.79 to 61.12), migraines (OR, 5.35; 95% CI, 3.04 to 9.40 to OR, 6.22; 95% CI, 3.81 to 10.14), and chronic headaches (OR, 40.40; 95% CI, 8.67 to 188.15 to OR, 95.93; 95% CI, 12.53 to 734.27) were calculated. Articular TMDs without pain were evaluated in only 1 article, in which ORs of 1.78 (95% CI, 0.90 to 3.51) for migraines and 1.04 (95% CI, 0.53 to 2.06) for tension-type headache were reported. Three studies were classified as moderate risk of bias and 5 as low risk of bias. The certainty of evidence varied between very low and low. CONCLUSIONS AND PRACTICAL IMPLICATIONS Recognizing the positive association between painful TMD and PHs can help dentists and physicians treat the pain and avoid it, or recommend the patient to a specialist.
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18
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Moleirinho-Alves PMM, Almeida AMCSD, Cebola PMTC, Oliveira RANDS, Pezarat-Correia PLCD. Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headaches. J Appl Oral Sci 2021; 29:e20210059. [PMID: 34524370 PMCID: PMC8428817 DOI: 10.1590/1678-7757-2021-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/19/2021] [Indexed: 08/30/2023] Open
Abstract
Objective To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). Results At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven’t change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.
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Affiliation(s)
- Paula Manuela Mendes Moleirinho-Alves
- Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER Laboratório de Função Neuromuscular, Lisboa, Portugal; Centro de Investigação Interdisciplinar Egas Moniz, Escola Superior de Saúde Egas Moniz, Monte de Caparica, Portugal; Cuf Tejo Hospital, Lisboa, Portugal
| | - André Mariz Coelho Santos de Almeida
- Instituto Universitário Egas Moniz, Centro de Investigação Interdisciplinar Egas Moniz; Monte de Caparica, Portugal; Cuf Tejo Hospital, Lisboa, Portugal
| | - Pedro Miguel Teixeira Carvas Cebola
- Instituto Universitário Egas Moniz, Centro de Investigação Interdisciplinar Egas Moniz; Monte de Caparica, Portugal; Cuf Tejo Hospital, Lisboa, Portugal
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19
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Manrriquez SL, Robles K, Pareek K, Besharati A, Enciso R. Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021; 21:183-205. [PMID: 34136641 PMCID: PMC8187022 DOI: 10.17245/jdapm.2021.21.3.183] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 12/20/2022] Open
Abstract
This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with “general HA.” Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.
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Affiliation(s)
- Salvador L Manrriquez
- Orofacial Pain and Oral Medicine Clinic, Division of Diagnostic Sciences, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kenny Robles
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kam Pareek
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA.,Department of Diagnostic Sciences, University of the Pacific-Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | - Alireza Besharati
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
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20
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Temporomandibular Disorders Slow Down the Regeneration Process of Masticatory Muscles: Transcriptomic Analysis. ACTA ACUST UNITED AC 2021; 57:medicina57040354. [PMID: 33916982 PMCID: PMC8067552 DOI: 10.3390/medicina57040354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Musculoskeletal injuries represent a pathological condition due to limited joint motility and morphological and functional alterations of the muscles. Temporomandibular disorders (TMDs) are pathological conditions due to alterations in the musculoskeletal system. TMDs mainly cause temporomandibular joint and masticatory muscle dysfunctions following trauma, along with various pathologies and inflammatory processes. TMD affects approximately 15% of the population and causes malocclusion problems and common symptoms such as myofascial pain and migraine. The aim of this work was to provide a transcriptomic profile of masticatory muscles obtained from TMD migraine patients compared to control. Materials and Methods: We used Next Generation Sequencing (NGS) technology to evaluate transcriptomes in masseter and temporalis muscle samples. Results: The transcriptomic analysis showed a prevalent downregulation of the genes involved in the myogenesis process. Conclusions: In conclusion, our findings suggest that the muscle regeneration process in TMD migraine patients may be slowed, therefore therapeutic interventions are needed to restore temporomandibular joint function and promote healing processes.
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21
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Quinzi V, Paskay LC, Manenti RJ, Giancaspro S, Marzo G, Saccomanno S. Telemedicine for a Multidisciplinary Assessment of Orofacial Pain in a Patient Affected by Eagle’s Syndrome: A Clinical Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background:
Orofacial pain has a broad range of origins and a multidisciplinary approach occupies a relevant role.
Objective:
The aim of this study was to review the literature regarding the evolution of telemedicine and orofacial pain related to a case report of a patient affected by Eagle's syndrome.
Materials and Methods:
Two authors (RJM and SG) independently reviewed the literature up to March 2020. A case report was developed by including the interdisciplinary assessment and initial treatment of orofacial pain in a 38-year-old female patient affected by Eagle’s syndrome. The patient was interviewed by two different specialists (from Rome, Italy and Los Angeles, California) through an online meeting platform in order to evaluate her complex situation, demonstrating the possibilities that telemedicine offered during the COVID-19 pandemic.
Conclusion:
An interdisciplinary approach can be performed for future follow ups on patients as various advantages were found by the patient and by the clinicians themselves.
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22
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Memmedova F, Emre U, Yalın OÖ, Doğan OC. Evaluation of temporomandibular joint disorder in headache patients. Neurol Sci 2021; 42:4503-4509. [PMID: 33604763 DOI: 10.1007/s10072-021-05119-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 02/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The present study is aimed at determining the percentage of temporomandibular joint disorder (TMD) in patients admitted to the neurology outpatient clinic with a headache complaint and to evaluate the association of TMD with the presence of bruxism and headache traits. MATERIALS AND METHODS A total of 349 headache patients were included in the study. The headache type, characteristics of the headache (incidence, duration, and severity of attacks), and the scores of the migraine disability scale (MIDAS) and Allodynia Symptom Scale (ASC-12T) were examined considering the presence of sleep bruxism. The International Classification of Headache Disorders (ICHD-3 Beta) criteria were used for diagnosing headaches. The presence of TMD was evaluated by using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All patients diagnosed with TMD and/or bruxism were evaluated by a dentist. RESULTS A total of 349 patients, 259 females and 90 males, were included in the study. The mean age of the patients was 36 years. Primary and secondary headaches were diagnosed in 317 (90.80%) and 32 (9.20%) patients, respectively. In the primary headache group, there were 227 migraines (182 females, 45 males), 74 tension-type headaches (TTH) (48 females, 26 males), and 15 trigeminal autonomic cephalalgias (TACs) (7 females, 8 males) patients. The remaining patients were diagnosed with other types of diagnoses. The rate of patients with chronic headache was 86.50%. TMD was detected in 89 (25.50%) of the patients while sleep bruxism was present in 80 (23.30%) patients. TMD was detected in 68 (30.0%) migraine patients and 13 (17.60%) TTH patients. The rate of TMD was statistically significantly higher in migraine patients compared to the TTH patients (p=0.037). CONCLUSION Our cross-sectional outpatient-based study determined the incidence of TMD in headache patients as 25%. Among the primary headaches, the incidence of TMD was higher in migraine patients compared to the other diagnoses. Considering these data, the presence of TMD is a clinical condition that should be considered in the pathophysiology of headache, primarily migraine, and especially in cases of non-response to treatment.
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Affiliation(s)
- Fergane Memmedova
- T.R. Health Sciences University Istanbul Training and Research Hospital Neurology Clinic, Istanbul, Turkey.
| | - Ufuk Emre
- T.R. Health Sciences University Istanbul Training and Research Hospital Neurology Clinic, Istanbul, Turkey
| | - Osman Özgür Yalın
- T.R. Health Sciences University Istanbul Training and Research Hospital Neurology Clinic, Istanbul, Turkey
| | - Onur Can Doğan
- T.R. Health Sciences University Istanbul Training and Research Hospital Dentistry Clinic, Istanbul, Turkey
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23
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Tchivileva IE, Ohrbach R, Fillingim RB, Lim PF, Giosia MD, Ribeiro-Dasilva M, Campbell JH, Hadgraft H, Willis J, Arbes SJ, Slade GD. Effect of comorbid migraine on propranolol efficacy for painful TMD in a randomized controlled trial. Cephalalgia 2021; 41:839-850. [PMID: 33560875 PMCID: PMC8166404 DOI: 10.1177/0333102421989268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction The migraine-preventive drug propranolol is efficacious in reducing pain from temporomandibular disorder, suggesting potential modifying or mediating effects of comorbid migraine. Methods In this randomized controlled trial, myofascial temporomandibular disorder patients were treated with propranolol or placebo for 9 weeks. The primary endpoint was change in a facial pain index derived from daily symptom diaries. Linear and logistic regression models tested for a migraine × treatment-group interaction in reducing facial pain index. Counterfactual models explored changes in headache impact and heart rate as mediators of propranolol's efficacy. Results Propranolol's efficacy in reducing facial pain index was greater among the 104 migraineurs than the 95 non-migraineurs: For example, for the binary ≥ 30% reduction in facial pain index, odds ratios were 3.3 (95% confidence limits: 1.4, 8.1) versus 1.3 (0.5, 3.2), respectively, although the interaction was statistically non-significant (p = 0.139). Cumulative response curves confirmed greater efficacy for migraineurs than non-migraineurs (differences in area under the curve 26% and 6%, respectively; p = 0.081). While 9% of the treatment effect was mediated by reduced headache impact, 46% was mediated by reduced heart rate. Conclusions Propranolol was more efficacious in reducing temporomandibular disorder pain among migraineurs than non-migraineurs, with more of the effect mediated by reduced heart rate than by reduced headache impact. Study identification and registration SOPPRANO; NCT02437383; https://clinicaltrials.gov/ct2/show/NCT02437383
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Affiliation(s)
- Inna E Tchivileva
- Center for Pain Research and Innovation, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, College of Dentistry, 3463University of Florida, Gainesville, FL, USA
| | - Pei Feng Lim
- Center for Pain Research and Innovation, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Division of Diagnostic Sciences, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Massimiliano Di Giosia
- Center for Pain Research and Innovation, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Division of Diagnostic Sciences, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margarete Ribeiro-Dasilva
- Department of Restorative Dental Science, Prosthodontics Division, College of Dentistry, 3463University of Florida, Gainesville, FL, USA
| | - John H Campbell
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA
| | | | | | | | - Gary D Slade
- Center for Pain Research and Innovation, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Division of Pediatric and Public Health, Adams School of Dentistry, 2331University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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24
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Rahmayani L, Yahya M, Soraya C, Syahreza S. Thermal Condition of Muscle Area Around the Temporomandibular Joint in Patient with Systemic Lupus Erythematosus Using Infrared Thermography Application: A Case Report. J Int Soc Prev Community Dent 2020; 10:674-679. [PMID: 33282779 PMCID: PMC7685285 DOI: 10.4103/jispcd.jispcd_126_20] [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: 03/21/2020] [Revised: 04/06/2020] [Accepted: 05/15/2020] [Indexed: 12/31/2022] Open
Abstract
Recently, the use of infrared thermography in medical has been increasingly developed and widely used in medical devices to detect diseases, including one used in the field of dentistry, which can be used to detect joint conditions in case of temporomandibular disorder (TMD). Some literature has shown this method of infrared thermography was used to determine the surface temperature of the skin based on the emission of infrared radiation from the body. Thermal measurement is also a noninvasive method that does not provide patient inconvenience, but its application until now has not been so wide. The case study reported on the description of thermal condition of muscle area around temporomandibular joint (TMJ) in a 42-year-old woman with systemic lupus erythematosus (SLE) disease. She had experienced TMD. Infrared thermography is applied to observe the thermal condition of the muscle area around the right and left joints by thermal detection. Thermal measurement was obtained on infrared image capture, and the temperature difference was found to be greater than 0.3°C. Several studies have shown that temperature in the area around TMJ was higher, and thermal asymmetry was greater in individuals with joint disorder/TMD when compared with normal groups.
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Affiliation(s)
- Liana Rahmayani
- Graduate School of Mathematics and Applied Science, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia.,Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Mustanir Yahya
- Department of Chemistry, Faculty of Mathematics and Natural Science, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Cut Soraya
- Faculty of Dentistry, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Saumi Syahreza
- Department of Physics, Faculty of Mathematics and Natural Science, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
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25
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Alcaraz MJ, Ferrándiz ML. Relevance of Nrf2 and heme oxygenase-1 in articular diseases. Free Radic Biol Med 2020; 157:83-93. [PMID: 31830562 DOI: 10.1016/j.freeradbiomed.2019.12.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/04/2019] [Accepted: 12/07/2019] [Indexed: 02/08/2023]
Abstract
Joint conditions pose an important public health problem as they are a leading cause of pain, functional limitation and physical disability. Oxidative stress is related to the pathogenesis of many chronic diseases affecting the joints such as rheumatoid arthritis and osteoarthritis. Cells have developed adaptive protection mechanisms to maintain homeostasis such as nuclear factor erythroid 2 (NF-E2)-related factor 2 (Nrf2) which regulates the transcription of many genes involved in redox balance, detoxification, metabolism and inflammation. Activation of Nrf2 results in the synthesis of heme oxygenase-1 (HO-1) leading to the formation of a number of bioactive metabolites, mainly CO, biliverdin and bilirubin. Ample evidence supports the notion that Nrf2 and HO-1 can confer protection against oxidative stress and inflammatory and immune responses in joint tissues. As a consequence, this pathway may control the activation and metabolism of articular cells to play a regulatory role in joint destruction thus offering new opportunities for better treatments. Further studies are necessary to identify improved strategies to regulate Nrf2 and HO-1 activation in order to enable the development of drugs with therapeutic applications in joint diseases.
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Affiliation(s)
- Maria José Alcaraz
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Av. Vicent A. Estellés s/n, 46100, Burjasot, Valencia, Spain.
| | - María Luisa Ferrándiz
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM), Universitat Politècnica de València, Universitat de València, Av. Vicent A. Estellés s/n, 46100, Burjasot, Valencia, Spain
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Incorvati C, Romeo A, Fabrizi A, Defila L, Vanti C, Gatto MRA, Marchetti C, Pillastrini P. Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial. BMJ Open 2020; 10:e038438. [PMID: 32792449 PMCID: PMC7430414 DOI: 10.1136/bmjopen-2020-038438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Temporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion. METHODS AND ANALYSIS All consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER NCT03726060.
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Affiliation(s)
- Cristina Incorvati
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Oral and Maxillofacial Surgery, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Antonio Romeo
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Phisical Therapy, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Adele Fabrizi
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Oral and Maxillofacial Surgery, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Luca Defila
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Oral and Maxillofacial Surgery, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Phisical Therapy, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Maria Rosaria Antonella Gatto
- Department of Biomedical and Neuromotor Sciences(DIBINEM) Medical Statistics, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Oral and Maxillofacial Surgery, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM) Phisical Therapy, Alma Mater Studiorum University of Bologna, Bologna, Emilia-Romagna, Italy
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SIQUEIRA SRDTD, TEIXEIRA MJ, SIQUEIRA JTTD. The Orofacial Pain Clinic Questionnaire (EDOF-HC) in the evaluation and diagnosis of orofacial pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:321-330. [DOI: 10.1590/0004-282x20200003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
Abstract
ABSTRACT Background: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. Objective: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. Methods: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. Results: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. Conclusions: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.
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Chronic orofacial pain. J Neural Transm (Vienna) 2020; 127:575-588. [DOI: 10.1007/s00702-020-02157-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/03/2020] [Indexed: 02/06/2023]
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Dimitroulis G. Management of temporomandibular joint disorders: A surgeon's perspective. Aust Dent J 2019; 63 Suppl 1:S79-S90. [PMID: 29574810 DOI: 10.1111/adj.12593] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Disorders of the Temporomandibular joint (TMJ) may clinically present with jaw pain and restricted mouth opening that may limit a patient's access to comprehensive dental care. The aim of this article is to provide a general overview of the current treatment strategies available in the management of disorders of the TMJ. Both conservative and surgical treatment options will be discussed as there is no one treatment for temporomandibular disorders (TMD) which encompasses a wide range of diagnoses. A multidisciplinary team approach to management is essential in the fundamental care of all TMD patients so that treatment can be specifically tailored to individual patient needs.
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Affiliation(s)
- G Dimitroulis
- Maxillofacial Surgery Unit, Department of Surgery, St.Vincent's Hospital, The University of Melbourne, Melbourne, Vic., Australia
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Pinho T, Paço M, Simões D, Chaves P, Almeida V, Rocha J, Moreira L, Duarte J. Common Knowledge About Temporomandibular Disorders and Associated Factors With Its Symptoms: Evidence From a Portuguese Population-Based Survey. JOURNAL OF OROFACIAL SCIENCES 2019. [DOI: 10.4103/jofs.jofs_142_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Racich MJ. Occlusion, temporomandibular disorders, and orofacial pain: An evidence-based overview and update with recommendations. J Prosthet Dent 2018; 120:678-685. [DOI: 10.1016/j.prosdent.2018.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/13/2022]
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Speciali JG. Migraine and temporomadibular disorders. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:211-212. [PMID: 29742239 DOI: 10.1590/0004-282x20180034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 06/08/2023]
Affiliation(s)
- José G Speciali
- Faculdade de Medicina de Ribeirão Preto, Neurologia, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Chaves HV, do Val DR, Ribeiro KA, Lemos JC, Souza RB, Gomes FIF, da Cunha RMS, de Paulo Teixeira Pinto V, Filho GC, de Souza MHLP, Bezerra MM, de Castro Brito GA. Heme oxygenase-1/biliverdin/carbon monoxide pathway downregulates hypernociception in rats by a mechanism dependent on cGMP/ATP-sensitive K + channels. Inflamm Res 2018; 67:407-422. [PMID: 29362850 DOI: 10.1007/s00011-018-1133-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 12/14/2017] [Accepted: 01/17/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE AND DESIGN To investigate the role of heme oxygenase-1 (HO-1), carbon monoxide (CO), and biliverdin (BVD) in the zymosan-induced TMJ arthritis in rats. MATERIALS AND METHODS Mechanical threshold was assessed before and 4 h after TMJ arthritis induction in rats. Cell influx, myeloperoxidase activity, and histological changes were measured in the TMJ lavages and tissues. Trigeminal ganglion and periarticular tissues were used for HO-1, TNF-α, and IL-1β mRNA time course expression and immunohistochemical analyses. Hemin (0.1, 0.3, or 1 mg kg-1), DMDC (0.025, 0.25, or 2.5 µmol kg-1), biliverdin (1, 3, or 10 mg kg-1), or ZnPP-IX (1, 3 or 9 mg kg-1) were injected (s.c.) 60 min before zymosan. ODQ (12.5 µmol kg-1; s.c.) or glibenclamide (10 mg kg-1; i.p.) was administered 1 h and 30 min prior to DMDC (2.5 µmol kg-1; s.c), respectively. RESULTS Hemin (1 mg kg-1), DMDC (2.5 µmol kg-1), and BVD (10 mg kg-1) reduced hypernociception and leukocyte migration, which ZnPP (3 mg kg-1) enhanced. The effects of DMDC were counteracted by ODQ and glibenclamide. The HO-1, TNF-α, and IL-1β mRNA expression and immunolabelling increased. CONCLUSIONS HO-1/BVD/CO pathway activation provides anti-nociceptive and anti-inflammatory effects on the zymosan-induced TMJ hypernociception in rats.
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Affiliation(s)
- Hellíada Vasconcelos Chaves
- Faculty of Dentistry of Sobral, Federal University of Ceará, Avenida Comandante Maurocélio Rocha Pontes, 100, Derby, Sobral, CEP: 62.042-280, Brazil.
| | - Danielle Rocha do Val
- Federal University of Pernambuco, North Eastern Biotechnology Network, Recife, Brazil
| | - Kátia Alves Ribeiro
- Master of Biotechnology Degree Programme, Federal University of Ceará, Sobral, Brazil
| | | | - Ricardo Basto Souza
- Master of Biotechnology Degree Programme, Federal University of Ceará, Sobral, Brazil
| | - Francisco Isaac Fernandes Gomes
- Faculty of Dentistry of Sobral, Federal University of Ceará, Avenida Comandante Maurocélio Rocha Pontes, 100, Derby, Sobral, CEP: 62.042-280, Brazil
| | | | | | | | | | | | - Gerly Anne de Castro Brito
- Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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The semi-synthetic molecule [4″,5″] dihydro-obovatin isolated from Tephrosia Toxicaria pers reduces zymosan-induced temporomandibular joint inflammatory hypernociception in rats. Med Chem Res 2018. [DOI: 10.1007/s00044-017-2123-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2017; 118:281-346. [DOI: 10.1016/j.prosdent.2017.04.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/27/2017] [Accepted: 04/27/2017] [Indexed: 01/19/2023]
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di Paolo C, Pompa G, Arangio P, di Nunno A, Di Carlo S, Rosella D, Papi P, Cascone P. Evaluation of Temporomandibular Disorders before and after Orthognathic Surgery: Therapeutic Considerations on a Sample of 76 Patients. J Int Soc Prev Community Dent 2017; 7:125-129. [PMID: 28462182 PMCID: PMC5390577 DOI: 10.4103/jispcd.jispcd_443_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 03/01/2017] [Indexed: 11/27/2022] Open
Abstract
Objectives: Temporomandibular disorders may be associated with dental and facial malformations. The aim of this study is to record the prevalence of TMDs in patients scheduled for orthognathic surgery, reporting the development of TMDs and symptoms during the entire period of the treatment, and demonstrating the benefits of a team effort on this population. Materials and Methods: Assessment of temporomandibular status was performed using the RDC/TMD criteria at T0 (prior to orthodontic therapy), T1 (3 months after the surgery), and T2 post-therapeutic cycle (6 to 12 months postoperatively). A total of 76 participants were included in the study; all the patients underwent surgical treatment: 12 had bilateral sagittal split osteotomy, 6 with condylar position devices; 64 had Le Fort I + bilateral sagittal split osteotomy, and 15 with condylar position devices. Results were evaluated with a paired-sample t-test and segmentation analysis. Results: Forty-seven patients were affected by TMDs. At T0, 25 patients experienced TMJ pain, 27 had muscular pain, 31 suffered headaches, 42 had disc dislocation with reduction, and 5 were affected by disc dislocation without reduction. Thirty-five patients had occlusal signs of parafunctions, 8 reported tinnitus, and 7 dizziness. At T1, TMJ pain changed from 33.3% to 4.44%, muscular pain changed from 35.5% to 11.1%, headaches improved from 40% to 6.67%, and disc dislocation from 55.2% to 17.7%. Segmentation analysis highlighted improvement after therapy; 57 patients were considered recovered, 14 improved, none were considered stable, whereas 5 patients demonstrated some worsening, 3 of whom had not presented disc dislocation before surgery. At T2, 71 patients were considered completely recovered or improved. Conclusions: Our data indicates beyond any doubt that both functional status and pain levels related to TMDs can be significantly improved with a multi-disciplinary approach. We concluded that surgeon's intervention need to be modified in the presence of presurgical TMDs.
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Affiliation(s)
- Carlo di Paolo
- Gnathology Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Pompa
- Implant Prosthetic Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Paolo Arangio
- Cranio Maxillofacial Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Anna di Nunno
- Gnathology Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Implant Prosthetic Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Daniele Rosella
- Implant Prosthetic Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Piero Papi
- Implant Prosthetic Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
| | - Piero Cascone
- Cranio Maxillofacial Unit, Department of Oral and Maxillo Facial Science, "Sapienza" University of Rome, Rome, Italy
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