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Schmidt SM, Venezian GC, Custodio W, Menezes CCD, Vedovello SAS, Degan VV. Temporomandibular disorder symptoms in the university context. Cranio 2024; 42:525-531. [PMID: 34933662 DOI: 10.1080/08869634.2021.2015556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess the impact of the university context of different academic fields and class times and the sociodemographic context on the symptoms of temporomandibular disorder (TMD). METHODS A total of 2912 university students, divided into 26 undergraduate courses distributed in the fields of biology and exact and human sciences in the day and night participated in this study. The symptoms of orofacial pain and TMD were assessed using a self-explanatory questionnaire for screening, as recommended by the American Academy of Orofacial Pain. The data were analyzed using frequency distribution tables and multiple logistic regression at a 5% significance level. RESULTS There was a significant association between the female sex and the attended class time. Women and undergraduates of night courses were 1.60 times more likely to present symptoms related to TMD compared to women studying during the day. CONCLUSION It was concluded that, within the university context, women and undergraduate students enrolled in night courses were more likely to present with TMD symptoms.
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Affiliation(s)
- Sigmar Miguel Schmidt
- Department of Orthodontics, University Center of Hermínio Ometto Fundation-FHO, Araras, Brazil
| | | | - William Custodio
- Department of Orthodontics, University Center of Hermínio Ometto Fundation-FHO, Araras, Brazil
| | | | | | - Viviane Veroni Degan
- Department of Orthodontics, University Center of Hermínio Ometto Fundation-FHO, Araras, Brazil
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Soman C, Faisal AT, Alsaeygh MM, Al Saffan AD, Salma RG. Driving Stress-Induced Effects on the Orofacial Region and Its Functions and Health Behaviors in Riyadh: A Cross-Sectional Survey. Healthcare (Basel) 2024; 12:1538. [PMID: 39120241 PMCID: PMC11311540 DOI: 10.3390/healthcare12151538] [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: 05/31/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
Driving stress is a multifaceted phenomenon, and the experience of driving invokes stress. Driving causes the activation of stress-response mechanisms, leading to short-term and long-term stress responses resulting in physiological and behavioral changes. The aim of this study was to evaluate driving stress-initiated effects on orofacial functions and health behaviors in the Riyadh population. A cross-sectional survey was conducted in Riyadh using a pre-validated set of questionnaires for habitual information, a driving stress assessment using a driving-behavior inventory, and an assessment of parafunctional habits and effects on orofacial functions. The results indicate that nearly 50% of the sample spends more than two hours commuting, and more than 50% of the sample has inadequate sleep and insufficient exercise. Oral parafunctional habits like nail biting (p = 0.039) and lip or object biting (p = 0.029) had a significant correlation with aggressive driving behaviors, whereas the grinding of teeth (p = 0.011), the clenching of jaws (p = 0.048), lip or object biting (p = 0.018), and pain in mastication (p = 0.036) had a positive correlation with driving dislikes. Driving stress can be detrimental to one's health and not only impacts health behaviors but also induces oral parafunctional habits and adversely affects orofacial regions and functions. Acute driving stress responses may be transient. However, prolonged driving stress can be maladaptive and can increase the risk of chronic diseases including chronic temporomandibular joint disorders and parafunctional habit-related changes in the oral cavity.
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Affiliation(s)
- Cristalle Soman
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
| | - Aya Tarek Faisal
- College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
| | | | | | - Ra’ed Ghaleb Salma
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh 11681, Saudi Arabia
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Anna C, Frank L, Eleonora C, Alessandro B, Luca L, Matteo P, Daniele M. Effects of orthodontic aligners on the ecological report of awake bruxism. J Oral Rehabil 2024. [PMID: 39030849 DOI: 10.1111/joor.13810] [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: 01/17/2024] [Revised: 06/25/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND The demand for orthodontic treatment with aligners has recently increased, but their effects on awake bruxism (AB) behaviours have to be evaluated yet. OBJECTIVES This investigation assessed if aligners can affect oral behaviours (i.e. tooth contact, teeth clenching, teeth grinding and mandible bracing) that are related with the AB spectrum. METHODS The investigation was performed in a sample of 32 consecutively recruited healthy adult patients who required orthodontic treatment. The study protocol involved three different sessions of 1-week monitoring without aligners, with passive aligners and with active aligners, respectively. All patients underwent an orthodontic treatment with aligners and used a smartphone-based application for a real-time report (i.e. ecological momentary assessment [EMA]) of their AB behaviours. Recording time was set from 8.00 to 12.30 and from 14.30 to 22.00. Analysis of variance (ANOVA) was used to compare the average reported frequency for each activity within and between the different sessions. The coefficient of variation (CV) was assessed to evaluate daily fluctuations within the 7 days monitoring periods. RESULTS The average reported frequency of the relaxed condition was 64.9%, 63.0% and 60.0% during the sessions without aligners, with passive aligners and with active aligners, respectively. ANOVA showed no significant differences in any of the AB behaviours within (i.e. between 7 days of evaluation) and between the monitoring sessions (i.e. before orthodontic treatment, with passive aligners, with active aligners). No sex differences were detected, except for the 'tooth contact' report that showed a higher frequency in females. CONCLUSION The impact of our results in the orthodontic field is not negligible; clinicians can find support for the hypothesis that from a global point of view, wearing or not wearing aligners (passive and/or active) does not influence the frequency of AB behaviours at the short term.
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Affiliation(s)
- Colonna Anna
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Lobbezoo Frank
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Capelli Eleonora
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Bracci Alessandro
- Department of Neurosciences, School of Dentistry, University of Padova, Padova, Italy
| | - Lombardo Luca
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Pollis Matteo
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
| | - Manfredini Daniele
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
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Leão AG, Lalue-Sanches M, Hoyuela CPS, Sanches MJ, de Moraes LOC. What has a year of social isolation due to the COVID-19 pandemic influenced oral parafunctional habits and temporomandibular disorders? A case-control study. J Oral Rehabil 2024. [PMID: 39020479 DOI: 10.1111/joor.13805] [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: 05/14/2023] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE Few studies investigated the influence of oral parafunctional habits during the COVID-19 pandemic. Since some studies have demonstrated that signs and symptoms of temporomandibular disorder (TMD), as well as psychological alterations, increased during the COVID-19 pandemic lockdown, the aim of this study was to investigate whether social isolation is a situation that increases the prevalence of oral parafunctional habits. METHODS This was an observational case-control study. An online survey with questions about TMD symptoms (Diagnostic Criteria Symptom Questionnaire) and oral parafunctional habits (Oral Behaviours Checklist [OBC]) was administered to Brazilian residents at two different times (2020 and 2021). The participants were divided according to social isolation practices into study groups (GI: 2020, n = 507; GIII: 2021, n = 282) and control groups (GII: 2020, n = 98; GIV: 2021, n = 202). RESULT In each group, we evaluated the association of the frequency of oral parafunctional habits with the symptoms of TMD, and we observed that individuals with a greater presence of painful TMD present a greater number of oral parafunctional habits. Despite the literature showing that individuals who practiced social isolation developed more oral parafunctional habits, when analysing the association of the OBC questions in Groups GI × GII and GIII × GIV, only 'sustained talking' (p = .0022) and 'hold telephone between your hand and shoulders' (p = .0124) showed a significant difference in GI × GII. Kendall's coefficient of concordance revealed that there was a very strong concordance (GI × GII 0.9515 (p = .0087) and GIII × GIV 0.9655 (p = .0074)) between the ranks of the analysed oral parafunctional habits in all groups. CONCLUSION We can state that Individuals who practiced social isolation did not present more oral parafunctional habits than individuals who did not.
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Affiliation(s)
- Amanda Grossi Leão
- Department of Pathology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Monique Lalue-Sanches
- Department of Pathology, Universidade Federal de São Paulo, Sao Paulo, Brazil
- Faculty of Odontology, Universidade Metodista de São Paulo, Sao Bernardo do Campo, Brazil
| | | | - Marcelo José Sanches
- Department of Pathology, Universidade Federal de São Paulo, Sao Paulo, Brazil
- Faculty of Odontology, Universidade Metodista de São Paulo, Sao Bernardo do Campo, Brazil
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AlSahman L, AlBagieh H, AlSahman R. Is There a Relationship between Salivary Cortisol and Temporomandibular Disorder: A Systematic Review. Diagnostics (Basel) 2024; 14:1435. [PMID: 39001325 PMCID: PMC11241310 DOI: 10.3390/diagnostics14131435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/29/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. METHOD Six databases-PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library-were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was "Do salivary cortisol levels correlate with TMD in individuals aged 18-40?" The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. RESULT A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case-control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. CONCLUSIONS The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding.
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Affiliation(s)
- Lujain AlSahman
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Hamad AlBagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Roba AlSahman
- Faculty of Dentistry, Royal College of Surgeons, D02YN77 Dublin, Ireland;
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Melchior MDO, Magri LV, Victoria Díaz-Serrano K, Leite-Panissi CRA, Gherardi-Donato ECS. How do the mindfulness and sensory-behavioural-emotional aspects influence the painful experience related to temporomandibular disorder? J Oral Rehabil 2024; 51:1175-1183. [PMID: 38532257 DOI: 10.1111/joor.13690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/14/2024] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Chronic pain is persistent or recurrent pain lasting longer than 3 months. The experience of temporomandibular disorder (TMD)-related pain is modulated by emotional and social factors, with mindfulness encapsulating these aspects. OBJECTIVE To investigate the association between cognitive-behavioural-emotional characteristics, mindfulness and the painful experience in women with chronic pain-related TMD. METHODS A cross-sectional study was conducted, including 90 women aged between 18 and 61 years old, diagnosed with chronic pain-related TMD according to the Diagnostic Criteria for Temporomandibular Disorder, considering both temporomandibular joint and muscle pain. Specific instruments were employed to assess cognitive-behavioural-emotional aspects. The Mindful Attention Awareness Scale and the Five Facets of Mindfulness Questionnaire scales evaluated the level and construct of mindfulness. The relationship between variables was analysed using bivariate association tests (.05 > p < .20), followed by multiple regression tests (p < .05). RESULTS The heightened experience of pain correlated with increasing age, a low level of education, the attribution of the locus of control by chance, and lower levels of mindfulness (p < .05). The heightened experience of pain was negatively influenced by mindfulness levels (p < .05). On the other hand, the painful experience was mainly influenced by facets describing negative formulation, distraction, non-reactivity and non-judgement (p < .05). CONCLUSION Demographic, cognitive-behavioural-emotional data and levels of mindfulness and its facets presented different influence weights on the painful experience. These findings provide support for future studies focusing on mindfulness strategies, education and pain management in women with chronic pain-related TMD.
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Affiliation(s)
- Melissa de Oliveira Melchior
- Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Laís Valencise Magri
- Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Cairns BE, He N. β 2-adrenergic receptor activation decreases the mechanical sensitivity of rat masticatory muscle afferent fibres. J Oral Rehabil 2024. [PMID: 38894554 DOI: 10.1111/joor.13787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Activation of β2 adrenergic receptors reduces cutaneous mechanical pain thresholds in rats. While β2 adrenergic receptor activation may contribute to mechanisms that underlie temporomandibular joint pain, its effect on masticatory muscle pain sensitivity is uncertain. OBJECTIVES The current study sought to determine the extent to which β adrenergic receptors are expressed by masticatory muscle afferent fibres, and to assess the effect of local activation of these receptors on the mechanical sensitivity of masticatory muscle afferent fibres in rats. METHODS Trigeminal ganglion neurons that innervate the rat (n = 12) masseter muscle and lower lip were identified by tissue injection of fluorescent dyes and were then stained with antibodies against β1 or β2 adrenergic receptors. Extracellular recordings from 60 trigeminal ganglion neurons that innervate the masticatory muscle were undertaken in a second group of anaesthetised rats of both sexes (n = 37) to assess afferent mechanical activation thresholds. Thresholds were assessed before and after injection of the β adrenergic receptor agonists into masticatory muscle. RESULTS β1 and β2 adrenergic receptor expression was greater in labial skin than in masticatory muscle ganglion neurons (p < .05, one-way ANOVA, Holm-Sidak test). There was a higher expression of β2 adrenergic receptors in masticatory muscle ganglion neurons in males than in females. The mixed β agonist isoproterenol increased afferent mechanical activation threshold in male but not female rats (p < .05, Mann-Whitney test). In male rats, salbutamol, a β2 selective agonist, also increased afferent mechanical activation threshold but hydralazine, a vasodilator, did not (p < .05, Mann-Whitney test). CONCLUSION Activation of β2 adrenergic receptors decreases the mechanical sensitivity of masticatory muscle afferent fibres in a sex-related manner.
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Affiliation(s)
- Brian E Cairns
- Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan He
- Department of Anesthesia, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Luo D, Yang H, Yuan M, Wang D, Qiu C, Zhou R, Gao Y, Xu R, Yang J, Xu Z. Anatomical factors influencing temporomandibular joint clicking in young adults: temporomandibular joint structure disorder or lateral pterygoid muscle dysfunction? Front Bioeng Biotechnol 2024; 12:1337267. [PMID: 38860136 PMCID: PMC11163039 DOI: 10.3389/fbioe.2024.1337267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
Objective: This study aimed to investigate the selected anatomical factors that can potentially influence temporomandibular joint (TMJ) clicking in young adults by assessing TMJ structures and lateral pterygoid muscle (LPM) function using magnetic resonance imaging (MRI). Methods: The patients were divided into four groups: the healthy control group; the clicking on mouth opening group; the clicking on mouth closing group; and the clicking on mouth opening and closing group. Additionally, we used clinical palpation to evaluate the masticatory muscles' functional state and employed MRI using the OCOR-T1WI-FSE-CLOSED, OSAG-PDW-FSE-CLOSED, and OSAG-PDW-FSE-OPEN sequences to analyze the texture of the lateral pterygoid muscle (LPM). Results: The proportion of any articular disc or condylar morphology class did not differ significantly between the TMJ clicking and HC groups. The articular disc position did not differ significantly between the TMJ clicking and HC groups. In the TMJ clicking group, the presence of masticatory muscle dysfunction differed significantly between the clicking and non-clicking sides. Moreover, the LPM accounted for the highest proportion among masticatory muscles with tenderness in all TMJ clicking subgroups (77.78%-100%). Therefore, in the TMJ clicking group, the LPM texture was less defined, more uniform in gray scale, and more similar to local texture (p < 0.0001). Conclusion: The occurrence of TMJ clicking in young adults is unrelated to the TMJ structure but related to the function of masticatory muscles, particularly the LPM.
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Affiliation(s)
- Dan Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
| | - Hua Yang
- Department of Stomatology, People’s Hospital of Lanling County, Linyi, Shandong, China
| | - Mujie Yuan
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
| | - Dashan Wang
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Cheng Qiu
- Department of Orthopaedic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Qingdao, Shandong, China
| | - Ruizhi Zhou
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yudong Gao
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
| | - Ruijie Xu
- School of Electronic Information, Qingdao University, Qingdao, Shandong, China
| | - Jianjun Yang
- Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
| | - Zexian Xu
- School of Stomatology of Qingdao University, Qingdao, Shandong, China
- Dental Digital Medicine and 3D Printing Engineering Laboratory of Qingdao University, Qingdao, Shandong, China
- Department of Oral Implantology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Ramishvili M, Gobadze G, Menabde G, Zurmukhtashvili M, Dugashvili G, Marks L. The influence of COVID-19 on temporo-mandibular disorders. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38637909 DOI: 10.1111/scd.13002] [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: 01/10/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/20/2024]
Abstract
Temporomandibular disorders are multi-factorial conditions affected by psychological, biomechanical, and neuromuscular factors. Stress and anxiety experienced during the pandemic are capable of influencing and aggravating temporomandibular disorders and orofacial pain. The study aimed to analyze whether the coronavirus infection can directly affect these diseases. All participants were asked to complete the Pain Screener and Patients Health Questionnaire and were assigned to Group I: healthy participants and Group 2: participants with existing complaints. In group II participants filled the questionnaires twice the Temporomandibular Disorders Symptom Questionnaire and Graded Chronic Pain Scale. The first time to self-report the severity of chronic pain before COVID-19 (T1 timeline) and the second time- to self-report the level of pain after COVID-19 infection (T2 timeline). Totally 150 participants were included in the study. In group II the difference between T1 and T2 timeline was significant for the level of average pain (p = 0.022) and highest facial pain (p = 0.043); Difference in level of interference of daily activities (p > 0.05), recreational activities (p > 0.05) and ability to work (p > 0.05) was statistically not significant. Graded chronic pain status was the same "Grade I" for T1 and T2 timeline. There was no statistically significant difference in stress level between group I and II.
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Affiliation(s)
- Marika Ramishvili
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Gia Gobadze
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Giorgi Menabde
- Faculty of Medicine, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | | | | | - Luc Marks
- Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Special Care in Dentistry, Department of Cranio-Maxillofacial Surgery, Antwerp University Hospital, Edegem, Belgium
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Zlendić M, Vrbanović E, Tomljanović M, Gall Trošelj K, Đerfi KV, Alajbeg IZ. Association of oral behaviours and psychological factors with selected genotypes in pain-related TMD. Oral Dis 2024; 30:1702-1715. [PMID: 37036392 DOI: 10.1111/odi.14583] [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: 01/30/2023] [Revised: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES To investigate frequency of single nucleotide polymorphisms (SNPs) in pain-related temporomandibular disorders (TMDp) and to determine whether specific SNPs, psychological, psychosomatic and behavioural characteristics are predictive for pain existence and intensity (low pain intensity (LPI)/high pain intensity (HPI)). METHODS Genomic DNA was extracted from buccal mucosa swabs (85 TMDp;85 controls) for evaluating frequency of selected SNPs: catechol-O-methyltransferase (rs4680, rs4818), opiorphin (rs1387964), alpha subunit of voltage-gated sodium channel Nav1.1 (rs6432860) and voltage-gated sodium channel Nav1.9 (rs33985936). Participants completed questionnaires on somatosensory amplification, anxiety and depression symptoms and oral behaviours (OB). RESULTS Sleep-related OB frequency was higher in TMDp patients compared to controls (p = 0.008). Compared to LPI, HPI patients had higher depression (p = 0.020) and anxiety scores (p = 0.017). TMDp group showed higher frequency of CC genotype (rs1387964) than controls (12.9% vs. 3.5%, p = 0.025). Following adjustments for age, sex and sleep-related OB, the significance of the recessive model (CC vs. TC + TT) between TMDp patients and controls was retained (OR = 5.783; 95%CI: 1.454-23.004). Frequency of GG genotype (rs4680 and rs4818) was higher in HPI compared to LPI patients (40% vs. 11.4%, p = 0.006; 24% vs. 3%; p = 0.012, respectively). The difference remained significant after adjusting for age, sex, depression, anxiety and sleep-related OB (rs4680: OR = 3.621; 95%CI: 1.580-8.297; rs4818: OR = 4.919, 95%CI: 1.641-14.746). CONCLUSION This study has demonstrated that rs1387964 CC genotype was associated with TMDp while rs4680 GG and rs4818 GG genotypes contributed to HPI.
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Affiliation(s)
- Marko Zlendić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Tomljanović
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Koraljka Gall Trošelj
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Kristina Vuković Đerfi
- Laboratory for Personalized Medicine, Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Warzocha J, Gadomska-Krasny J, Mrowiec J. Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) from 2018 to 2022. Healthcare (Basel) 2024; 12:575. [PMID: 38470686 PMCID: PMC10931313 DOI: 10.3390/healthcare12050575] [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: 01/15/2024] [Revised: 02/17/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024] Open
Abstract
This study aims to conduct a systematic analysis of literature published between 1 January 2018 and 1 September 2022, exploring factors influencing the progression or development of temporomandibular disorders (TMD), diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three electronic databases were reviewed to identify papers that examined TMD factors using DC/TMD or RDC/TMD. Inclusion criteria encompassed original research published in English between 1 January 2018 and 1 October 2022, online, and complete DC/TMD or RDC/TMD studies on human participants aged 18 or older. Two authors independently assessed the risk of bias using The Joanna Briggs Institute (JBI) Analytical cross-sectional studies' Critical Appraisal Tool. Of 1478 articles, 11 were included. The studies revealed strong associations between TMD and factors such as female, poor sleep quality, depression, oral parafunction, anxiety, somatization, and anatomical features. However, variables such as education, living conditions, socioeconomic status, marital status, chronic pain, and stress did not exhibit statistically significant correlations. Based on the obtained data, it can be concluded that the causes of TMD are largely related to psychological factors, which supports the biopsychosocial theory of the disorder.
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Affiliation(s)
- Joanna Warzocha
- Faculty of Medicine, Lazarski University, Świeradowska 43, 02-662 Warszawa, Poland
| | | | - Joanna Mrowiec
- SCS Astermed-Centrum Ortodontyczno-Implantologiczne, Świętego Bonifacego 92, 02-940 Warszawa, Poland
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12
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Abdellatif D, Iandolo A, Pisano M, Fornara R, Sangiovanni G, Amato M. The incidence of dental fractures in the Italian population during the COVID-19 pandemic: An observational study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:146-153. [PMID: 38463480 PMCID: PMC10923222 DOI: 10.4103/jcde.jcde_241_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/10/2023] [Accepted: 12/05/2023] [Indexed: 03/12/2024]
Abstract
Background The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several governments worldwide have taken several drastic measures to try to stop the spread of the virus, including a very strict lockdown that has caused a sudden and, in many cases, negative change in people's daily lives. In the literature, several studies have shown how the pandemic has significantly impaired many people's mental health, causing short- and long-term stress, anxiety, and sleep disturbances. Introduction This study aims to analyze the correlation between the stress caused by the COVID-19 pandemic and the parafunctions of the temporomandibular joint and masticatory muscles, which in turn, have led to an increase in the incidence of fractures and dental injuries. The ultimate goal is to understand the best choice the dentist must make in the preventive and therapeutic fields. Materials and Methods A questionnaire called "Incidence of tooth fractures during the COVID-19 pandemic" was prepared using the Google® Forms platform. This questionnaire consists of 13 questions. This electronic questionnaire was addressed to all dentists in the Campania Region (ITA) and disseminated through social networks such as WhatsApp® or Facebook® or E-mail. Results A total of 730 dentists completed the survey. Of these, 450 (61.7%) stated that the number of patients reporting muscle and joint pain in the morning had increased during the COVID-19 pandemic. 414 (56.7%) dentists noted an increase in parafunction and 392 (53.6%) an increase in dental fractures during the pandemic period. Discussion and Conclusions As can be seen from the study results, an important correlation was found between the stress resulting from the COVID-19 pandemic and dental fractures. The dental elements treated endodontically, depending on the extent of the damage, require restoration, which is also the best preventive strategy in the case of dental fractures.
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Affiliation(s)
- Dina Abdellatif
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Roberto Fornara
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | - Massimo Amato
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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13
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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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14
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Cioffi I. Biological and psychological factors affecting the sensory and jaw motor responses to orthodontic tooth movement. Orthod Craniofac Res 2023; 26 Suppl 1:55-63. [PMID: 37395347 DOI: 10.1111/ocr.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/03/2023] [Accepted: 06/17/2023] [Indexed: 07/04/2023]
Abstract
Orthodontic tooth movement (OTM) is associated with an inflammatory response, tooth pain (i.e. orthodontic pain) and changes in dental occlusion. Clinical realms and research evidence suggest that the sensory and jaw motor responses to OTM vary significantly among individuals. While some adjust well to orthodontic procedures, others may not and can experience significant pain or not adjust to occlusal changes. This is of concern, as clinicians cannot anticipate an individual's sensorimotor response to OTM. Converging evidence shows that some psychological states and traits significantly affect the sensorimotor response to OTM and may considerably affect an individual's adaptation to orthodontic or other dental procedures. We performed a topical review to synthesize the available knowledge about the behavioural mechanisms regulating the sensorimotor response to OTM, with the intent of informing orthodontic practitioners and researchers about specific psychological states and traits that should be considered while planning orthodontic treatment. We report on studies focusing on the role of anxiety, pain catastrophising, and somatosensory amplification (i.e. bodily hypervigilance), on sensory and jaw motor responses. Psychological states and traits can significantly affect sensory and jaw motor responses and a patient's adaptation to orthodontic procedures, although large interindividual variability exists. Clinicians can use validated instruments (checklists or questionnaires) to collect information about patients' psychological traits, which can assist in identifying those individuals who may not adjust well to orthodontic procedures. The information included in this manuscript also assists researchers investigating the effect of orthodontic procedures and or/appliances on orthodontic pain.
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Affiliation(s)
- I Cioffi
- Faculty of Dentistry, Centre for Multimodal Sensorimotor and Pain Research, University of Toronto, Toronto, Ontario, Canada
- Discipline of Orthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- University of Toronto Centre for the Study of Pain, Toronto, Ontario, Canada
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15
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Iglesias-Peón M, Mesa-Jiménez J, Fernández-DE-Las-Peñas C, García Iglesias N, Iglesias Peón CM, Rodrigues-DE-Souza DP, Alburquerque-Sendín F. Test-retest reliability of the isometric contraction test (IC test) of the masticatory muscles in subjects with and without temporomandibular muscle disorders. J Appl Oral Sci 2023; 31:e20230045. [PMID: 37909525 PMCID: PMC10609633 DOI: 10.1590/1678-7757-2023-0045] [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: 02/09/2023] [Revised: 06/24/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Recently, the DC/TMD has become an essential tool for the diagnosis of temporomandibular disorders (TMD). However, as they fail to include functional activities, new assessment proposals have emerged, such as the isometric contraction test (IC test) of the masticatory muscles, which uses muscle contractions to identify muscular TMD. This study aimed to determine the test-retest reliability of the IC test. METHODS A total of 64 participants (40 women and 24 men) completed the IC test administered by two different physical therapists on two non-consecutive days. Cohen's kappa (k), PABAK, and percent agreement (PA) between days were estimated. RESULTS The IC test showed good to excellent test-retest reliability values (k>0.77; PABAK>0.90), both globally and individually for the muscles evaluated, and PA>90%, therefore above the thresholds for clinical applicability. However, the global assessment of myofascial pain and the evaluation of the medial pterygoid muscle showed slightly lower reliability values. CONCLUSION The IC test is reliable for the assessment of subjects with muscular TMD, both in terms of the global assessment and the evaluation of each muscle, which supports its clinical applicability. Care should be taken when assessing myofascial pain globally and when evaluating the medial pterygoid in all types of pain.
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Affiliation(s)
- Marcos Iglesias-Peón
- Osteopatía y Fisioterapia Guadalajara, Guadalajara, España
- Universidad de Córdoba, Programa de Doctorado en Biomedicina, Córdoba, España
| | - Juan Mesa-Jiménez
- Universidad CEU San Pablo, Departamento de Fisioterapia, Madrid, España
| | - César Fernández-DE-Las-Peñas
- Universidad Rey Juan Carlos, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Alcorcón, Madrid, España
| | | | | | | | - Francisco Alburquerque-Sendín
- Universidad de Córdoba, Facultad de Medicina y Enfermería, Departamento de Enfermería, Farmacología y Fisioterapia, Córdoba, España
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España
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16
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Yap AU, Dewi NL, Pragustine Y, Marpaung C. Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress. Clin Oral Investig 2023; 27:5083-5093. [PMID: 37395863 DOI: 10.1007/s00784-023-05129-5] [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: 12/08/2022] [Accepted: 06/20/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. MATERIALS AND METHODS Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). RESULTS Among the 507 participants (mean age 22.2 ± 1.5 years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). CONCLUSIONS Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. CLINICAL RELEVANCE Oral parafunction appears to be a dysfunctional coping response to psychological distress.
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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, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Ni Luh Dewi
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Yenny Pragustine
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia.
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17
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Vrbanović E, Zlendić M, Trošelj KG, Tomljanović M, Vuković Đerfi K, Alajbeg IZ. Association of Oxidative-Stress-Related Gene Polymorphisms with Pain-Related Temporomandibular Disorders and Oral Behavioural Habits. Antioxidants (Basel) 2023; 12:1195. [PMID: 37371925 DOI: 10.3390/antiox12061195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
The frequency of selected polymorphisms, one in each gene coding for proteins with antioxidative properties (CAT(rs1001179), SOD2(rs4880), GPX1(rs1050450), and NQO1(rs689452)), was compared between patients suffering from pain-related temporomandibular disorders (TMDp; n = 85) and control subjects (CTR; n = 85). The same was evaluated when participants were divided with respect to oral behavioural habits frequency into high-frequency parafunction (HFP; n = 98) and low-frequency parafunction (LFP; n = 72) groups. Another aim was to investigate whether polymorphisms in these genes can be associated with participants' psychological and psychosomatic characteristics. Polymorphisms were genotyped using the genomic DNA extracted from buccal mucosa swabs and real-time TaqMan genotyping assays. No differences in genotype distribution between TMDp patients and control subjects were found. Still, TMDp patients who were homozygous for minor allele A, related to the GPX1 polymorphism rs1050450, reported significantly more waking-state oral behaviours than GA + GG genotype carriers (score: 30 vs. 23, p = 0.019). The frequency of genotype AA for rs1050450 polymorphism was higher in HFP than in LFP participants (14.3% vs. 4.2%, p = 0.030). The most important predictors of waking-state oral behaviours were depression, anxiety, AA genotype (rs1050450), and female sex. The explored gene polymorphisms were not found to be significant risk factors for either TMDp or sleep-related oral behaviours. The association of waking-state oral behaviours with selected gene polymorphisms additionally supports previous assumptions that daytime bruxism is more closely linked to various stress manifestations, which might also be reflected through the variability related to the cellular antioxidative activity.
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Affiliation(s)
- Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Marko Zlendić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Koraljka Gall Trošelj
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Marko Tomljanović
- Laboratory for Epigenomics, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Kristina Vuković Đerfi
- Laboratory for Personalized Medicine, Division of Molecular Medicine, Ruđer Bošković Institute, 10000 Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, 10000 Zagreb, Croatia
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18
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Nilsson IM, Ekberg E, Michelotti A, Al-Khotani A, Alstergren P, Conti PCR, Durham J, Goulet JP, Hirsch C, Kalaykova S, 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 C, Wahlund K, Rongo R. Diagnostic criteria for temporomandibular disorders-INfORM recommendations: Comprehensive and short-form adaptations for children. J Oral Rehabil 2023; 50:99-112. [PMID: 36373958 DOI: 10.1111/joor.13390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 08/19/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) are used worldwide in adults. Until now, no adaptation for use in children has been proposed. OBJECTIVE The aim of this study was to present comprehensive and short-form adaptations of Axis I and Axis II of the DC/TMD for adults that are appropriate for use with children in clinical and research settings. METHODS Global Delphi studies with experts in TMDs and in pain psychology identified ways of adapting the DC/TMD for children. RESULTS The proposed adaptation is suitable for children aged 6-9 years. Proposed changes in Axis I include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for children, (ii) adding a general health questionnaire for children and one for their parents, (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire and (iv) modifying the clinical examination protocol. Proposed changes in Axis II include (i) for the Graded Chronic Pain Scale, to be developmentally appropriate for children, (ii) adding anxiety and depression assessments that have been validated in children and (iii) adding three constructs (stress, catastrophising and sleep disorders) to assess psychosocial functioning in children. CONCLUSION The recommended DC/TMD, including Axis I and Axis II, for children aged 6-9 years, is appropriate for use in clinical and research settings. This adapted the first version for children includes changes in Axis I and Axis II changes requiring reliability and validity testing in international settings. Official translations to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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Affiliation(s)
- 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
| | - EwaCarin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ambrosina Michelotti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
| | - Amal Al-Khotani
- Dental Department, East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia.,Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.,Dental Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Paulo Cesar Rodrigues Conti
- Department 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
- Newcastle School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Christian Hirsch
- Clinic of Pediatric Dentistry, University of Leipzig, Leipzig, Germany
| | - Stanimira Kalaykova
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Flavia P Kapos
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Christopher D King
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Center for Understanding Pediatric Pain (CUPP), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Osamu Komiyama
- Department of Oral Function and Fixed Prosthodontics, 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, Malmö, 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, New York, USA
| | - Tonya M Palermo
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Christopher C Peck
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Chris Penlington
- Newcastle 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, New York, USA
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, School of Dentistry and Oral Health, Aarhus, Denmark
| | - Corine 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 Orofacial Pain and Jaw Function, Kalmar County Hospital, Kalmar, Sweden
| | - Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy
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Asquini G, Devecchi V, Borromeo G, Viscuso D, Morato F, Locatelli M, Falla D. Predictors of pain reduction following a program of manual therapies for patients with temporomandibular disorders: A prospective observational study. Musculoskelet Sci Pract 2022; 62:102634. [PMID: 35939919 DOI: 10.1016/j.msksp.2022.102634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/04/2022] [Accepted: 07/22/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Clinical guidelines recommend conservative treatment for the management of temporomandibular disorders (TMD), and manual therapy (MT) is commonly applied to reduce pain and improve function. OBJECTIVES To identify predictors of pain reduction and functional improvement following a program of manual therapies (MTP) in patients with TMD and develop a first screening tool that could be used in clinical practice to facilitate decision-making. DESIGN A cohort of 102 adults with a diagnosis of TMD were treated with four weekly sessions within a MTP applied to craniomandibular structures. Candidate predictors were demographic variables, general health variables, psychosocial features, TMD characteristics and related clinical tests. A reduction of pain intensity by at least 30% after the MTP was considered a good outcome. Logistic regression was adopted to develop the predictive model and its performance was assessed considering the explained variance, calibration, and discrimination. Internal validation of the prediction models was further evaluated in 500 bootstrapped samples. RESULTS Patients experiencing pain intensity greater than 2/10 during mouth opening, positive expectations of outcome following a MTP, pain localized in the craniocervical region, and a low Central Sensitization Inventory score obtained a good outcome following the MTP. Predictive performance of the identified physical and psychological variables was characterized by high explained variance (R2 = 58%) and discrimination (AUC = 89%) after internal validation. A preliminary screening clinical tool was developed and presented as a nomogram. CONCLUSIONS The high discrimination of the prediction model revealed promising findings, although these need to be externally validated in future research. TRIAL REGISTRATION NUMBER NCT03990662.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham Birmingham, B15 2TT, UK; Italian Stomatologic Institute, Craniomandibular Physiotherapy Service, Via Pace 21, 20122, Milan, Italy
| | - Valter Devecchi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham Birmingham, B15 2TT, UK
| | - Giulia Borromeo
- Italian Stomatologic Institute, Craniomandibular Physiotherapy Service, Via Pace 21, 20122, Milan, Italy
| | - Domenico Viscuso
- Italian Stomatologic Institute, Craniomandibular Physiotherapy Service, Via Pace 21, 20122, Milan, Italy; University of Cagliari, Department of Surgical Sciences, Dental Service, Via Università 40 Cagliari, Italy
| | - Federico Morato
- Italian Stomatologic Institute, Craniomandibular Physiotherapy Service, Via Pace 21, 20122, Milan, Italy
| | - Matteo Locatelli
- IRCCS San Raffaele Scientific Institute, Via Olgettina Milano 60, 20132, Milano, Italy
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham Birmingham, B15 2TT, UK.
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20
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Cairns BE. The contribution of autonomic mechanisms to pain in temporomandibular disorders: A narrative review. J Oral Rehabil 2022; 49:1115-1126. [PMID: 36098708 DOI: 10.1111/joor.13370] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are diagnosed based on symptom presentation and, like other functional pain disorders, often lack definitive pathology. There is a strong association between elevated stress levels and the severity of TMD-related pain, which suggests that alterations in autonomic tone may contribute to this pain condition. OBJECTIVES This narrative review examines the association between altered autonomic function and pain in TMD. METHODS Relevant articles were identified by searching PubMed and through the reference list of those studies. RESULTS TMD sufferers report an increased incidence of orthostatic hypotension. As in other chronic musculoskeletal pain conditions, TMD is associated with increased sympathetic tone, diminished baroreceptor reflex sensitivity and decreased parasympathetic tone. It remains to be determined whether ongoing pain drives these autonomic changes and/or is exacerbated by them. To examine whether increased sympathetic tone contributes to TMD-related pain through β2 adrenergic receptor activation, clinical trials with the beta blocker propranolol have been undertaken. Although evidence from small studies suggested propranolol reduced TMD-related pain, a larger clinical trial did not find a significant effect of propranolol treatment. This is consistent with human experimental pain studies that were unable to demonstrate an effect of β2 adrenergic receptor activation or inhibition on masticatory muscle pain. In preclinical models of temporomandibular joint arthritis, β2 adrenergic receptor activation appears to contribute to inflammation and nociception, whereas in masticatory muscle, α1 adrenergic receptor activation has been found to induce mechanical sensitization. Some agents used to treat TMD, such as botulinum neurotoxin A, antidepressants and α2 adrenergic receptor agonists, may interact with the autonomic nervous system as part of their analgesic mechanism. CONCLUSION Even if dysautonomia turns out to be a consequence rather than a causative factor of painful TMD, the study of its role has opened up a greater understanding of the pathogenesis of this condition.
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Affiliation(s)
- Brian E Cairns
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
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21
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Iglesias-Peón M, Mesa-Jiménez J, Fernández-de-las-Peñas C, Rojas-García J, Rodrigues-de-Souza DP, Alburquerque-Sendín F. Validity of the Isometric Contraction Test of the Masticatory Muscles for Diagnosis of Muscular Temporomandibular Disorders. Diagnostics (Basel) 2022; 12:diagnostics12081861. [PMID: 36010212 PMCID: PMC9406470 DOI: 10.3390/diagnostics12081861] [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: 06/23/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, the Diagnostic Criteria for Temporomandibular Pain Disorders (DC/TMD) has been questioned, mainly because of the dependence on the muscular pressure needed to be applied during the clinical examination. Therefore, it is necessary to establish improvements in diagnostic strategies for DC/TMD of axis I. The aim of this study was to determine the validity of the Isometric Contraction Test of the masticatory muscles (ICTest) to diagnose DC/TMD of axis I. Forty (n = 40) patients with muscular TMD (myalgia in any of its subtypes), as well as forty age and sex matched controls, participated. They were diagnosed according to DC/TMD of axis I and performed the ICTest in a single session. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and positive (LR+) and negative likelihood ratios (LR−) of the ICTest compared with the DC/TMD of axis I were calculated. The ICTest showed a specificity of 95% for the diagnosis of myalgia, and between 94.9% and 96.8% for all subtypes in relation to the DC/TMD of axis I. For sensitivity, lower values were obtained, that is, 90.0% for myalgia, and losing sensitivity depending on the type of myalgia. The LR+ was over 10 for all diagnoses, with the exception of myofascial pain with referral, which was lower. When addressing the LR−, the myofascial diagnosis was the only one below 0.2. According to the results, the ICTest could be considered a valid procedure to diagnose subjects with muscular TMD in a clinical setting.
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Affiliation(s)
- Marcos Iglesias-Peón
- Osteopatía y Fisioterapia Guadalajara, 19005 Guadalajara, Spain; (M.I.-P.); (J.R.-G.)
- Doctoral Program in Biomedicine, University of Córdoba, 14004 Córdoba, Spain
| | - Juan Mesa-Jiménez
- Department of Physical Therapy, Universidad San Pablo CEU, Boadilla del Monte, 28668 Madrid, Spain;
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain;
| | - Jorge Rojas-García
- Osteopatía y Fisioterapia Guadalajara, 19005 Guadalajara, Spain; (M.I.-P.); (J.R.-G.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain;
- Correspondence: ; Tel.: +34-957-218-241
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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22
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Saccomanno S, Saran S, De Luca M, Mastrapasqua RF, Raffaelli L, Levrini L. The Influence of SARS-CoV-2 Pandemic on TMJ Disorders, OSAS and BMI. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127154. [PMID: 35742398 PMCID: PMC9222869 DOI: 10.3390/ijerph19127154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/25/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022]
Abstract
The pandemic of the 21st century had a significant influence on the lives of the world population in a negative way. This situation determined a change of lifestyle; it caused the necessity of social isolation for a great number of people. In fact, people tended to avoid crowded environments, social events, to reduce medical checks and sports activities, favoring sedentary life because of fear of the virus. This social attitude brought a high level of stress that worsened many health conditions. This study has the aim of evaluating the possible influence of the pandemic on temporomandibular joint (TMJ) disorders, obstructive sleep apnea syndrome (OSAS) and body mass index (BMI). An anonymized survey, available in two languages (Italian and English), was given to 208 patients from different private dental practices. In this questionnaire, the patients shared experiences about their life during the pandemic. The article highlighted that during this health emergency, there was an increase in body weight in the considered sample. This brought a worsening of OSAS in 65% of patients with a previous diagnosis. Eventually, an increase in TMJ disorders and orofacial pain was reported.
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Affiliation(s)
- Sabina Saccomanno
- Department of Health, Life and Environmental Science, University of L’Aquila, Piazza Salvatore Tommasi, 67100 L’Aquila, Italy
- Correspondence: ; Tel.: +39-339-41-53-290
| | - Stefano Saran
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy; (S.S.); (L.L.)
| | - Martina De Luca
- Dental School, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.D.L.); (L.R.)
| | | | - Luca Raffaelli
- Dental School, Catholic University of the Sacred Heart, 00168 Rome, Italy; (M.D.L.); (L.R.)
| | - Luca Levrini
- Department of Human Sciences, Innovation and Territory, School of Dentistry, Postgraduate of Orthodontics, University of Insubria, 21100 Varese, Italy; (S.S.); (L.L.)
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23
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Mocci E, Goto T, Chen J, Ament S, Traub RJ, Dorsey SG. Early and Late Transcriptional Changes in Blood, Neural, and Colon Tissues in Rat Models of Stress-Induced and Comorbid Pain Hypersensitivity Reveal Regulatory Roles in Neurological Disease. FRONTIERS IN PAIN RESEARCH 2022; 3:886042. [PMID: 35655748 PMCID: PMC9152010 DOI: 10.3389/fpain.2022.886042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Irritable bowel syndrome (IBS) and temporomandibular disorder (TMD) are two chronic pain conditions that frequently overlap in the same individual, more commonly in women. Stress is a significant risk factor, exacerbating or triggering one or both conditions. However, the mechanisms underlying IBS–TMD co-morbidity are mostly unknown. Aim To detect both specific and common stress-induced visceral hypersensitivity (SIH) and comorbid TMD–IBS pain hypersensitivity (CPH) genetic signatures over time. Method Twenty-four female rats were randomly assigned to one of three experimental groups: naïve, SIH, and CPH (orofacial pain plus stress). RNA was extracted from blood, colon, spinal cord, and dorsal root ganglion 1 or 7 weeks after the stress paradigm. We combined differential gene expression and co-expression network analyses to define both SIH and CPH expression profiles across tissues and time. Results The transcriptomic profile in blood and colon showed increased expression of genes enriched in inflammatory and neurological biological processes in CPH compared to SIH rats, both at 1 and 7 weeks after stress. In lumbosacral spinal tissue, both SIH and CPH rats compared to naïve revealed decreased expression of genes related to synaptic activity and increased expression of genes enriched in “angiogenesis,” “Neurotrophin,” and “PI3K-Akt” pathways. Compared to SIH, CPH rats showed increased expression of angiogenesis-related genes 1 week after exposure to stress, while 7 weeks post-stress the expression of these genes was higher in SIH rats. In dorsal root ganglia (DRG), CPH rats showed decreased expression of immune response genes at week 1 and inhibition of nerve myelination genes at 7 weeks compared to naïve. For all tissues, we observed higher expression of genes involved in ATP production in SIH compared to CPH at 1 week and this was reversed 7 weeks after the induction of stress. Conclusion Our study highlights an increased inflammatory response in CPH compared to SIH rats in the blood and colon. DRG and spinal transcriptomic profiles of both CPH and SIH rats showed inhibition of synaptic activity along with activation of angiogenesis. Targeting these biological processes may lead to a more profound understanding of the mechanisms underlying IBS–TMD comorbidities and new diagnostic and therapeutic strategies.
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Affiliation(s)
- Evelina Mocci
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
- Institute for Genome Sciences, University of Maryland School of Medicine, University of Maryland Baltimore, Baltimore, MD, United States
| | - Taichi Goto
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
| | - Jie Chen
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
| | - Seth Ament
- Institute for Genome Sciences, University of Maryland School of Medicine, University of Maryland Baltimore, Baltimore, MD, United States
| | - Richard J. Traub
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
| | - Susan G. Dorsey
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, University of Maryland Baltimore, Baltimore, MD, United States
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
- *Correspondence: Susan G. Dorsey
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24
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Lewandowska A, Mańka-Malara K, Kostrzewa-Janicka J. Sagittal Condylar Inclination and Transversal Condylar Inclination in Different Skeletal Classes. J Clin Med 2022; 11:jcm11092664. [PMID: 35566792 PMCID: PMC9104711 DOI: 10.3390/jcm11092664] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 01/27/2023] Open
Abstract
Background: During prosthodontic treatment, the averaged values of the transversal condylar inclination (TCI) and the sagittal condylar inclination (SCI) are used for articulator settings. This study evaluated different parameters of measurable mandibular movements according to skeletal classes. Methods: Seventy-five patients (mean age 30.8 ± 5.49) had a condylography using the Cadiax Compact device (Gamma Dental, Klosterneuburg, Austria) and cephalometric analysis performed. Statistical analysis was performed using R statistical software. Results: There was no statistical evidence to state that the value of SCI angle is different in I compared to II Skeletal Class. There were no statistically significant differences when comparing the I vs. III and II vs. III Skeletal Class. The lowest mean SCI angle values were found in subjects with Skeletal Class III. There were statistically significant differences in left-sided TCI between Class I and II. There was a statistically significant linear relationship between ANB angle value and SCI value. Conclusions: Due to the wide individual variation in SCI and TCI values, it is advisable to use individual measurable parameters of mandibular movements during prosthetic reconstructions. The statistically significant relationship between SCI and ANB angle can be used to individualize the articulating parameters, especially in significant skeletal disproportions.
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25
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Vrbanović E, Zlendić M, Alajbeg IZ. Association of oral behaviours' frequency with psychological profile, somatosensory amplification, presence of pain and self-reported pain intensity. Acta Odontol Scand 2022; 80:522-528. [PMID: 35254961 DOI: 10.1080/00016357.2022.2042380] [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: 11/01/2022]
Abstract
OBJECTIVE To investigate the association of the frequency of oral behaviours with psychological (anxiety, depression) and psychosomatic factors (somatosensory amplification) as well as with pain presence (Temporomandibular disorders-pain (TMDp) patients and control (CTR) participants) and pain intensity (no_low pain intensity (nLPI)/high pain intensity (HPI)). MATERIAL AND METHODS Fifty-four TMDp patients (48 females and 6 males; 29.13 ± 10.46 years) and 46 controls (29 females and 17 males; 28.54 ± 9.71 years) were administered Oral Behaviours Checklist (OBC), Generalized Anxiety Disorder-7 Scale, Patient Health Questionnaire-9 for depression and Somatosensory Amplification Scale. Data were analysed with respect to the presence of TMD pain and to pain intensity. Mann-Whitney test and Spearman's rank correlation were used for analyses. RESULTS No significant differences in examined variables between TMDp patients and CTR individuals were found. The frequency of oral behaviors (OBC total score and sleep-related oral behaviours) as well as anxiety, depression and somatosensory amplification scores were higher in HPI group when compared to nLPI group (p < .05). In univariate correlations, oral behaviours were positively correlated with somatosensory amplification (p = .001), anxiety (p < .05), depression (p < .05), female sex (p < .05) and pain intensity (p < .05) but not with pain presence. Multiple linear regression models showed that predictors for the higher frequency of oral behaviours were anxiety and female sex. CONCLUSIONS Oral behaviours were associated with pain intensity but not with pain presence and were primarily influenced by anxiety and female sex, suggesting that therapeutic approach should consider both, reducing pain intensity and management of the impact of psychological factors.Trial registration: ClinicalTrials.gov NCT04694274. Registered on 01/04/2021.
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Affiliation(s)
- Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Zlendić
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Iva Z. Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
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26
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Headache Because of Problems with Teeth, Mouth, Jaws, or Dentures in Chronic Temporomandibular Disorder Patients: A Case–Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053052. [PMID: 35270743 PMCID: PMC8910597 DOI: 10.3390/ijerph19053052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to characterize self-reported headaches because of problems with the teeth, mouth, jaws, or dentures (HATMJD) in chronic patients with temporomandibular disorders (TMDs) in order to compare their results with those of TMD patients without such headaches and to investigate the associations of HATMJD with depression, anxiety, physical symptoms, oral behaviors, and sleep quality. We conducted a case–control study on consecutive chronic TMD patients referred to the University Medical Center of Ljubljana, Slovenia. A self-reported HATMJD was extracted from item #12 in the 49-item version of the Oral Health Impact Profile questionnaire. Axis II instruments of the Diagnostic Criteria for TMD (i.e., for screening of depression, anxiety, specific comorbid functional disorders, and oral behaviors) and the Pittsburgh Sleep Quality Index were used in this study. In total, 177 TMD patients (77.4% women; mean age: 36.3 years) participated in this study; 109 (61.6%) patients were classified as TMD patients with HATMJD. TMD patients with at least mild depressive and anxiety symptoms, with at least low somatic symptom severity, and a high number of parafunctional behaviors had more HATMJD. Parafunctional behavior and sleep quality were the most prominent predictive factors of the occurrence of HATMJD. TMD patients with HATMJD have more psychosocial dysfunction, a higher frequency of oral behaviors, and poorer sleep quality than TMD patients without such headaches.
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27
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Winocur-Arias O, Winocur E, Shalev-Antsel T, Reiter S, Shifra L, Emodi-Perlman A, Friedman-Rubin P. Painful Temporomandibular Disorders, Bruxism and Oral Parafunctions before and during the COVID-19 Pandemic Era: A Sex Comparison among Dental Patients. J Clin Med 2022; 11:jcm11030589. [PMID: 35160041 PMCID: PMC8837112 DOI: 10.3390/jcm11030589] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/12/2022] Open
Abstract
Aim: To evaluate the effect of the current coronavirus pandemic on the prevalence of bruxism, oral parafunctions and painful Temporo-Mandibular Disorders (TMDs) and to evaluate the influence of the pandemic on both sexes. Methods: This retrospective study included 288 dental patients who underwent complete anamnesis and examination according to the Diagnostic Criteria for TMD. The study evaluated two patient populations according to the date of examination: (a) pre-COVID-19 pandemic era (108 patients); (b) COVID 19 pandemic era, where 180 patients were examined during the pandemic. Results: A significant increase in parafunction activity was found in both men and women (p < 0.001) during the COVID-19 pandemic. Awake bruxism (AB) and sleep bruxism (SB) was more prevalent during the COVID-19 pandemic solely in women (AB-p < 0.001; SB-p = 0.014). Conclusions: Men and women were affected by the ongoing stress due to the COVID-19 pandemic, yet women showed a higher influence as compared to men. The long-term exposure to elevated levels of anxiety and stress may aggravate or trigger stomatognathic detrimental conditions. Dentists should be aware and regularly monitor their patients regarding the possible existence and consequences of bruxism and TMD.
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Affiliation(s)
- Orit Winocur-Arias
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (O.W.-A.); (R.S.)
| | - Efraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Tamar Shalev-Antsel
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Shoshana Reiter
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (O.W.-A.); (R.S.)
| | - Levartovsky Shifra
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
- Correspondence:
| | - Pessia Friedman-Rubin
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6139001, Israel; (E.W.); (T.S.-A.); (L.S.); (P.F.-R.)
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28
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Louca Jounger S, Christidis N, Hedenberg-Magnusson B, List T, Svensson P, Schalling M, Ernberg M. Polymorphisms in the HTR2A and HTR3A Genes Contribute to Pain in TMD Myalgia. FRONTIERS IN ORAL HEALTH 2022; 2:647924. [PMID: 35047998 PMCID: PMC8757775 DOI: 10.3389/froh.2021.647924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background: The aim of this study was to investigate if single nucleotide polymorphisms (SNPs) related to monoaminergic neurotransmission, in particular the serotonergic pathway, contribute to pain perception in patients with temporomandibular disorder (TMD) myalgia and if there is a correlation to jaw function as well as psychosocial factors such as stress, anxiety and depression. Materials and Methods: One hundred and seventeen individuals with TMD myalgia were included. A venous blood or saliva sample was taken for genetic analyses and genotyped regarding HTR2A (rs9316233) HTR3A (rs1062613), HTR3B (rs1176744), SERT (5-HTTLPR) and COMT (rs4680). A clinical examination according to Diagnostic Criteria for TMD (DC/TMD) was performed and axis II data (psychosocial factors) were compared between participants with different genotypes for each gene using Kruskall–Wallis test. The characteristic pain intensity (CPI) was tested for correlations to scores for the Perceived Stress Scale, Generalized Anxiety Disorder, and Patient Health Questionnaires using Spearman's rank correlation test with Bonferroni correction for multiple testing. To further explore data factor analysis was performed to identify latent factors associated to the outcome variables. Results: Participants carrying at least one copy of the rare allele of the HTR2A (rs9316233) and HTR3A (rs1062613) had higher CPI compared with the participants with the homozygous common genotype (P = 0.042 and P = 0.024, respectively). Correlation analyses showed several significant positive correlations between CPI on one hand, and self-reported psychosocial distress and jaw function on the other hand for several genotypes that mostly were weak to moderate. The factor analysis identified two latent variables. One was positively correlated to the HTR3B gene, jaw function and self-reported parafunctions, and the other was positively correlated to psychological distress and negatively correlated to SERT. Conclusion: Taken together, the polymorphism rs1062613 in the HTR3A gene contributes to pain intensity in TMD myalgia. This together with positive interactions between pain variables and psychological factors in genotypes strengthens that pain and psychological distress are related. Further research is needed to explore this as well as the influence of gene-to-gene interactions on pain and psychological distress.
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Affiliation(s)
- Sofia Louca Jounger
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Britt Hedenberg-Magnusson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Department of Orofacial Pain and Jaw Function, Folktandvården Eastmaninstitutet, Stockholm, Sweden
| | - Thomas List
- Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Peter Svensson
- Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, University of Aarhus, Aarhus, Denmark
| | - Martin Schalling
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Malin Ernberg
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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29
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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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Lee KS, Jha N, Kim YJ. Risk factor assessments of temporomandibular disorders via machine learning. Sci Rep 2021; 11:19802. [PMID: 34611188 PMCID: PMC8492627 DOI: 10.1038/s41598-021-98837-5] [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: 04/23/2021] [Accepted: 09/15/2021] [Indexed: 02/08/2023] Open
Abstract
This study aimed to use artificial intelligence to determine whether biological and psychosocial factors, such as stress, socioeconomic status, and working conditions, were major risk factors for temporomandibular disorders (TMDs). Data were retrieved from the fourth Korea National Health and Nutritional Examination Survey (2009), with information concerning 4744 participants' TMDs, demographic factors, socioeconomic status, working conditions, and health-related determinants. Based on variable importance observed from the random forest, the top 20 determinants of self-reported TMDs were body mass index (BMI), household income (monthly), sleep (daily), obesity (subjective), health (subjective), working conditions (control, hygiene, respect, risks, and workload), occupation, education, region (metropolitan), residence type (apartment), stress, smoking status, marital status, and sex. The top 20 determinants of temporomandibular disorders determined via a doctor's diagnosis were BMI, age, household income (monthly), sleep (daily), obesity (subjective), working conditions (control, hygiene, risks, and workload), household income (subjective), subjective health, education, smoking status, residence type (apartment), region (metropolitan), sex, marital status, and allergic rhinitis. This study supports the hypothesis, highlighting the importance of obesity, general health, stress, socioeconomic status, and working conditions in the management of TMDs.
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Affiliation(s)
- Kwang-Sig Lee
- grid.222754.40000 0001 0840 2678AI Center, Korea University College of Medicine, Seoul, Korea
| | - Nayansi Jha
- grid.267370.70000 0004 0533 4667Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 Korea
| | - Yoon-Ji Kim
- grid.267370.70000 0004 0533 4667Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505 Korea
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31
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Tang Z, Zhou J, Long H, Gao Y, Wang Q, Li X, Wang Y, Lai W, Jian F. Molecular mechanism in trigeminal nerve and treatment methods related to orthodontic pain. J Oral Rehabil 2021; 49:125-137. [PMID: 34586644 DOI: 10.1111/joor.13263] [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: 03/29/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Orthodontic treatment is the main treatment approach for malocclusion. Orthodontic pain is an inevitable undesirable adverse reaction during orthodontic treatment. It is reported orthodontic pain has become one of the most common reason that patients withdraw from orthodontic treatment. Therefore, understanding the underlying mechanism and finding treatment of orthodontic pain are in urgent need. AIMS This article aims to sort out the mechanisms and treatments of orthodontic pain, hoping to provide some ideas for future orthodontic pain relief. MATERIALS Tooth movement will cause local inflammation. Certain inflammatory factors and cytokines stimulating the trigeminal nerve and further generating pain perception, as well as drugs and molecular targeted therapy blocking nerve conduction pathways, will be reviewed in this article. METHOD We review and summaries current studies related to molecular mechanisms and treatment approaches in orthodontic pain control. RESULTS Orthodontics pain related influencing factors and molecular mechanisms has been introduced. Commonly used clinical methods in orthodontic pain control has been evaluated. DISCUSSION With the clarification of more molecular mechanisms, the direction of orthodontic pain treatment will shift to targeted drugs.
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Affiliation(s)
- Ziwei Tang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiawei Zhou
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yanzi Gao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qingxuan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaolong Li
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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32
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Golanska P, Saczuk K, Domarecka M, Kuć J, Lukomska-Szymanska M. Temporomandibular Myofascial Pain Syndrome-Aetiology and Biopsychosocial Modulation. A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7807. [PMID: 34360099 PMCID: PMC8345811 DOI: 10.3390/ijerph18157807] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treatment of MPS should be deliberated holistically as it is a complex disorder.
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Affiliation(s)
- Paulina Golanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Klara Saczuk
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Monika Domarecka
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
| | - Joanna Kuć
- Department of Prosthodontics, Medical University of Bialystok, 24 A M. Sklodowskiej-Curie St., 15-276 Bialystok, Poland;
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland; (P.G.); (K.S.); (M.D.)
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33
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Barbosa C, Manso MC, Reis T, Soares T, Gavinha S, Ohrbach R. Are oral overuse behaviours associated with painful temporomandibular disorders? A cross-sectional study in Portuguese university students. J Oral Rehabil 2021; 48:1099-1108. [PMID: 34273189 DOI: 10.1111/joor.13226] [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: 05/24/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Many different types of oral overuse behaviours occur frequently in adult populations with painful temporomandibular disorders (TMDs). Less is known regarding these behaviours and their associations with TMDs in university students. OBJECTIVES Test the association between frequency of different oral overuse behaviours evaluated by the Oral Behaviour Checklist (OBC) and the severity of painful TMDs. METHODS In this cross-sectional study, 1381 students from 19 universities in the Oporto District, Portugal, completed the Research Diagnostic Criteria for TMD (RDC/TMD) Personal History Questionnaire and the OBC, and they received an RDC/TMD clinical examination. The OBC sum score (ranging from 0 to 84 points) was classified as normal (0 ≤ 16 points), low overuse (17 ≤ 24) or high overuse (≥25). Painful TMD subtypes (myalgia, arthralgia or combined) were identified. Associations were tested using multivariable binary logistic regression models (α = .05), adjusted for age and sex, and referencing the normal parafunction group. RESULTS University students with high overuse were more likely to have a painful TMD: myalgia (OR = 1.9, 95% CL: 1.3-3.0); arthralgia (OR = 2.2; 95% CL: 1.4-3.4), combined (OR = 5.0; 95% CL: 3.1-8.1). Students with low overuse were more likely to have only the combined painful TMD (OR = 2.4; 95% CL: 1.4-4.0) but not the individual painful disorders. Of the 21 different behaviours, 13 were reported at least 50% of the time. CONCLUSIONS In this university student sample, oral overuse behaviours are widespread, and their overall extent exhibited a dose-response relationship with respect to severity of painful TMDs based on pain and chronicity. Only some behaviours were independently associated with painful TMDs, suggesting the value of further OBC instrument development.
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Affiliation(s)
- Cláudia Barbosa
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Maria Conceição Manso
- Faculty of Health Sciences, FP-I3ID (FP-ENAS), University Fernando Pessoa, Porto, Portugal.,LAQV-REQUIMTE, University of Porto, Porto, Portugal
| | - Tiago Reis
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Tânia Soares
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Sandra Gavinha
- Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA
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Ramanan D, Palla S, Bennani H, Polonowita A, Farella M. Oral behaviours and wake-time masseter activity in patients with masticatory muscle pain. J Oral Rehabil 2021; 48:979-988. [PMID: 34185872 DOI: 10.1111/joor.13219] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Little is known about wake-time masseter activity of patients with masticatory muscle pain in real-life settings. OBJECTIVES The aims of this study were (1) to assess wake-time masseter activity of women with masticatory muscle pain (MMP) and compare it with that of pain-free women; and (2) to investigate the association between objectively measured masseter contractions and self-reported oral behaviours. METHODS Adult women (N = 27) diagnosed with MMP were age-matched with pain-free women (N = 26). The electromyographic (EMG) activity of the masseter muscle when awake was recorded unilaterally for two consecutive days. The number of contraction episodes and relative contraction time (%) were calculated using cut-off thresholds of 3%, 5% and 10% of maximum voluntary contraction (MVC). Self-reported daytime oral activity was assessed using the Oral Behaviours Checklist (OBC, items 3-21). Data were analysed using univariate tests and mixed-model analyses. RESULTS The number of contraction episodes was similar between groups for all detection thresholds, but the relative contraction time at the lower detection thresholds (i.e. 3% MVC and 5% MVC) was significantly longer (1.5-fold) in the MMP than in the pain-free group. The OBC scores were significantly higher in the women with MMP than in controls, but no positive association could be found between EMG variables and OBC scores. CONCLUSION Women with MMP engage in low-level masseter muscle contractions, which last longer than those of pain-free controls. There was no relationship between self-reported oral behaviours and masseter activity when awake. These findings support the notion that prolonged low-level clenching when awake may play a role in the pathophysiology of MMP.
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Affiliation(s)
- D Ramanan
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - S Palla
- University of Zurich, Zurich, Switzerland
| | - H Bennani
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - A Polonowita
- Discipline of Oral Medicine, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - M Farella
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.,Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Association between Stress at Work and Temporomandibular Disorders: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2055513. [PMID: 34307651 PMCID: PMC8249225 DOI: 10.1155/2021/2055513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/26/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
Temporomandibular disorders (TMD) have been traditionally associated with psychosocial factors; however, occupational stress as a factor related to TMD has not been adequately assessed in the literature. The aim was to investigate the association between stress at work and TMD on adult paid workers. An electronic search included PubMed, Scopus, Web of Science, Embase, and LILACS databases. Manual searches in the included articles' reference and gray literature were performed. There were no restrictions regarding language or publication period. The inclusion criteria comprised observational studies with paid workers of any category, of both sexes, above 18 years old, assessing occupational stress/stress or distress and TMD as diagnosis or isolated signs and symptoms. Methodological quality was evaluated using Joanna Briggs tools. We narratively assessed the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We collected 12 studies. 50% reported a positive association between stress and TMD diagnostic across various job categories. On the other hand, TMJ sounds (a TMD sign) and work stress were associated only in a musicians' population. However, the shortage of eligible articles and the methodological limitations provided a very low certainty of the evidence; only 4 of the studies used validated tools for both stress and TMD (2 reporting positive association). The association between stress and TMD is inconclusive by the available data. In the future, we expect more robust epidemiologic studies addressing these relevant aspects.
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36
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Shaffer SM, Emerson AJ, Burr M, Einhorn L, Naze GS. Quality of life in painful temporomandibular disorders onset: a systematic review of outcome measure clinimetrics and predictive properties. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1914955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Alicia J. Emerson
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Meghan Burr
- Exercise Science Department, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | | | - Garrett S. Naze
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
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37
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Gikić M, Vrbanović E, Zlendić M, Alajbeg IZ. Treatment responses in chronic temporomandibular patients depending on the treatment modalities and frequency of parafunctional behaviour. J Oral Rehabil 2021; 48:785-797. [PMID: 33797785 DOI: 10.1111/joor.13173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES (i) To evaluate the effect of three different interventions on treatment outcomes and (ii) to determine how the frequency of oral parafunction influences the effectiveness of the different therapeutic modalities. METHODS Forty-five participants were randomly assigned into three treatment groups [physical therapy (PT), stabilisation splint (SS) and control therapy (CT)]. According to Oral Behavior Checklist score, participants were divided into "high-frequency parafunction" (HFP) and low-frequency parafunction" (LFP) group. Primary (spontaneous pain and characteristic pain intensity) and secondary outcomes (range of mouth opening, anxiety symptoms, quality of life, perceived stress and global functional limitation) were evaluated during six-month treatment period. RESULTS Participants in PT group showed a significant reduction in characteristic pain intensity (p = .047, η2 = 0.243) when compared to SS and CT group, but significant improvement in spontaneous pain was found in all treatment groups. Patients treated with PT and SS exhibited significantly stronger improvement in pain-free mouth opening than patients in CT group (3rd month: p=.037, η2=0.258; 6th month: p = .005, η2 = 0.383). Within-group analyses showed significant decrease of perceived stress, anxiety symptoms and global functional limitation only in PT group over a six-month treatment period. Participants with HFP presented significantly greater levels of anxiety (3rd month: p = .009, η2 = 0.275; 6th month: p = .041, η2 = 0.176) than participants with LFP. Within-group analyses, however, showed significant improvement of anxiety, but also the decrease of perceived stress and improvement of global limitation for the HFP group but not for the LFP group. CONCLUSION Although no treatment can be marked as superior in terms of spontaneous pain relief, PT was more effective when observing relief of characteristic pain intensity. In HFP group the reduction of anxiety, stress and functional limitation was present regardless of the applied therapy. TRIAL REGISTRATION ClinicalTrials.gov NCT04694274. Registered on 01/04/2021.
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Affiliation(s)
- Marijana Gikić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ema Vrbanović
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Marko Zlendić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia.,Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Iva Z Alajbeg
- Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.,Department of Dentistry, Clinical Hospital Center Zagreb, Zagreb, Croatia
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Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch'ang JH. Bruxism in Acute Neurologic Illness. Curr Pain Headache Rep 2021; 25:41. [PMID: 33837858 DOI: 10.1007/s11916-021-00953-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW While traditionally encountered in ambulatory settings, bruxism occurs in patients with a variety of acute neurologic illnesses including encephalitis, intracerebral hemorrhage, traumatic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke. Untreated bruxism in acute neurologic illness can lead to tooth loss, difficulty in mouth care resulting in recurrent aspiration pneumonia, endotracheal tube dislodgement, and even tongue laceration or amputation. Inpatient clinicians should be aware of the etiologies and management strategies for bruxism secondary to acute neurologic illness. RECENT FINDINGS Management strategies for bruxism are varied and include pharmacologic and non-pharmacologic therapies in addition to onabotulinumtoxinA (BoNT-A). Bruxism impacts patients with a variety of acute neurologic illnesses, and emerging evidence suggests successful and safe treatment strategies.
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Affiliation(s)
- Devin J Burke
- Division of Neurocritical Care, Weill Cornell Medicine, New York Presbyterian, 525 East 68th St, RM F610, New York, NY, 10065, USA
| | - Alison Seitz
- Department of Neurology, Weill Cornell, New York Presbyterian, New York, NY, USA
| | | | - Matthew S Robbins
- Department of Neurology, Weill Cornell, New York Presbyterian, New York, NY, USA
| | - Judy H Ch'ang
- Division of Neurocritical Care, Weill Cornell Medicine, New York Presbyterian, 525 East 68th St, RM F610, New York, NY, 10065, USA.
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39
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Asquini G, Bianchi AE, Borromeo G, Locatelli M, Falla D. The impact of Covid-19-related distress on general health, oral behaviour, psychosocial features, disability and pain intensity in a cohort of Italian patients with temporomandibular disorders. PLoS One 2021; 16:e0245999. [PMID: 33529226 PMCID: PMC7853459 DOI: 10.1371/journal.pone.0245999] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/12/2021] [Indexed: 12/22/2022] Open
Abstract
This study aimed to understand the impact of COVID-19 distress on psychological status, features of central sensitization and facial pain severity in people with temporomandibular disorders (TMDs). In this prospective cohort study, 45 adults (19 chronic, 26 acute/subacute TMD) were recruited prior to the COVID-19 outbreak. Baseline assessment took place before the outbreak while a follow-up was performed immediately after the lockdown period. Multiple variables were investigated including age, gender, perceived life quality, sleep quality, anxiety and depression, coping strategies, central sensitization, pain intensity, pain-related disability and oral behaviour. COVID Stress Scales (CSS) were applied at follow-up to measure the extent of COVID-related distress. CSS were significantly higher in those with chronic TMDs compared to those with acute/subacute TMDs (p<0.05). In people with chronic TMD, the variation in anxiety and depression from baseline to follow-up was significantly correlated with scores on the CSS (r = 0.72; p = 0.002). Variations of the central sensitization inventory (r = 0.57; p = 0.020) and graded chronic pain scale (r = 0.59; p = 0.017) were significantly correlated with scores on the CSS. These initial findings indicate that people with chronic TMD were more susceptible to COVID-19 distress with deterioration of psychological status, worsening features of central sensitization and increased chronic facial pain severity. These findings reinforce the role of stress as a possible amplifier of central sensitization, anxiety, depression, chronic pain and pain-related disability in people with TMDs. Trial Registration: ClinicalTrials.gov ID: NCT03990662.
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Affiliation(s)
- Giacomo Asquini
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Craniomandibular Physiotherapy Service, Italian Stomatologic Institute, Milan, Italy
| | | | - Giulia Borromeo
- Craniomandibular Physiotherapy Service, Italian Stomatologic Institute, Milan, Italy
| | | | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
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40
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Pereira NC, Oltramari PVP, Conti PCR, Bonjardim LR, de Almeida-Pedrin RR, Fernandes TMF, de Almeida MR, Conti ACCF. Frequency of awake bruxism behaviour in orthodontic patients: Randomised clinical trial: Awake bruxism behaviour in orthodontic patients. J Oral Rehabil 2020; 48:422-429. [PMID: 33278836 DOI: 10.1111/joor.13130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The influence of aligners on the activity of the masticatory muscles is still controversial, especially regarding the behaviour associated with awake bruxism (AB). OBJECTIVE To compare the frequency of AB behaviours between patients treated with aligners and fixed appliances. METHODS The sample comprised 38 Class I patients (mean age 22.08 years), divided by simple randomisation into two groups: OA group; orthodontic aligners (n 19) and FA group; fixed appliance (n 19). The frequency of AB was investigated by the ecological momentary assessment using an online device (mentimeter), during 7 following days at different timepoints, before and after appliance placement and in the 2nd, 3rd, 4th and 6th months of orthodontic treatment. These variables were also evaluated: level of anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale, catastrophising related to pain and degree of hypervigilance by the Pain Vigilance and Awareness Questionnaire, and the presence of facial pain evaluated by the DC/TMD. RESULTS There was no difference between groups in the frequency of AB behaviours, with mean of 53.5% for group OA and 51.3% for FA. The most frequent behaviour was slightly touching the teeth, and in FA group, there was a significant reduction in this behaviour soon after appliance placement. The groups did not differ concerning the degree of anxiety, stress, catastrophising, hypervigilance and facial pain. CONCLUSION The orthodontic treatment performed with aligners or fixed appliances did not influence the frequency of AB during the 6 months of treatment. REGISTRY OF CLINICAL TRIALS: (REBEC): RBR-9zytwf.
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Affiliation(s)
- Nayara C Pereira
- Department of Orthodontics, University of North Paraná (UNOPAR), Londrina-PR, Brazil
| | - Paula V P Oltramari
- Department of Orthodontics, University of North Paraná (UNOPAR), Londrina-PR, Brazil
| | - Paulo C R Conti
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru Orofacial Pain Group, Bauru, Brazil
| | - Leonardo R Bonjardim
- Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru Orofacial Pain Group, Bauru, Brazil
| | | | - Thaís M F Fernandes
- Department of Orthodontics, University of North Paraná (UNOPAR), Londrina-PR, Brazil
| | - Marcio R de Almeida
- Department of Orthodontics, University of North Paraná (UNOPAR), Londrina-PR, Brazil
| | - Ana C C F Conti
- Department of Orthodontics, University of North Paraná (UNOPAR), Londrina-PR, Brazil
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Chaurand J, Godínez-Victoria M, Tellez-Girón A, Facio-Umaña JA, Jimenez-Ponce F. Incobotulinum toxin type A for treatment of chronic myofascial pain. J Oral Sci 2020; 63:37-40. [PMID: 33298638 DOI: 10.2334/josnusd.20-0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE This study assessed the effectiveness of incobotulinum toxin type A (IBTx) for chronic myofascial pain affecting the masseter and temporal muscles. METHODS Twenty two patients who received a diagnosis of chronic masseter and temporalis myofascial pain were evaluated by using a visual analog pain scale (VAS), digital pressure algometry, and the SF-36 Health Survey at baseline (T0), before IBTx injection. Patients were again evaluated at 2 months (T1) and 7 months (T2) after IBTx injection. RESULTS VAS scores for pain significantly differed (P = 0.029, Friedman test). Post-hoc tests showed a significant reduction in pain at 2 months (T0-T1) and 7 months (T0-T2) (P = 0.011 and P = 0.028, respectively; Wilcoxon test) but not between 2 and 7 months (P = 0.676; Wilcoxon test). There was no significant difference in pressure algometry values (P = 0.385, Friedman test). Quality of life (QOL) assessment showed a significant difference (P = 0.002, Friedman test). Post-hoc tests showed a significant improvement in QOLat 2 months, but no significant difference at 7 months (P = 0.004 and P = 0.260, Wilcoxon test). CONCLUSION IBTx injection resulted in safe, effective short-term pain relief for patients with chronic facial pain affecting the masseter and temporalis muscles.
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Affiliation(s)
- Jorge Chaurand
- Maxillofacial Surgery Department, National Medical Center "20 de Noviembre" Institute for Social Security and Services for State Workers
| | | | - Aldo Tellez-Girón
- Maxillofacial Surgery Department, National Medical Center "20 de Noviembre" Institute for Social Security and Services for State Workers
| | | | - Fiacro Jimenez-Ponce
- Regulatory and Attention to Hospitals Department, Institute for Social Security and Services for State Workers
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Prasad S, Farella M, Paulin M, Yao S, Zhu Y, van Vuuren LJ. Effect of electrode characteristics on electromyographic activity of the masseter muscle. J Electromyogr Kinesiol 2020; 56:102492. [PMID: 33254005 DOI: 10.1016/j.jelekin.2020.102492] [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: 05/23/2020] [Revised: 10/27/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The study investigated effects of electrode material, inter-electrode distance (IED), and conductive gel on electromyographic (EMG) activity recorded from the masseter muscle. MATERIALS AND METHODS EMG was recorded unilaterally, as ten volunteers performed standardized oral tasks. Ag/AgCl and Ag coated with Au were the gel-based; Ag alloy coated with graphene, pure Ag coated with graphene and silver nanowire embedded electrodes were the gel-free materials tested. Ag/AgCl electrodes were tested at three different IEDs (i.e. 15 mm, 20 mm, 25 mm). An electrode relative performance index (ERPI) was defined and calculated for each of the standardized oral tasks that the volunteers performed. ERPI values obtained for the different oral tasks with different electrode materials and IEDs were compared using two-way repeated-measures ANOVA. RESULTS ERPI values were not significantly influenced by IED. However, for the electrode materials statistically significant differences were found in ERPI values for all oral tasks. Of the gel-free electrode materials tested, pure silver electrodes coated with graphene had the highest ERPI values followed by Ag alloy electrodes coated with graphene and silver nanowire embedded electrodes. CONCLUSIONS Within the limitations of the study, IED between 15 and 25 mm has a negligible effect on masseter muscle EMG. Graphene coated and silver nanowire embedded electrodes show promise as gel-free alternatives.
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Affiliation(s)
- Sabarinath Prasad
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.
| | - Mauro Farella
- Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Michael Paulin
- Department of Zoology, University of Otago, Dunedin, New Zealand
| | - Shanshan Yao
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, United States
| | - Yong Zhu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, United States
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Duffin PS, Smith A, Hawkins JM. Nonodontogenic Odontalgia Referred from the Temporal Tendon: A Case Report. J Endod 2020; 46:1530-1534. [DOI: 10.1016/j.joen.2020.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/08/2020] [Indexed: 12/22/2022]
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Poluha RL, De la Torre Canales G, Bonjardim LR, Conti PCR. Somatosensory and psychosocial profile of patients with painful temporomandibular joint clicking. J Oral Rehabil 2020; 47:1346-1357. [DOI: 10.1111/joor.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Rodrigo Lorenzi Poluha
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Giancarlo De la Torre Canales
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
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Waked JP, Canuto MPLDAM, Gueiros MCSN, Aroucha JMCNL, Farias CG, Caldas ADF. Model for Predicting Temporomandibular Dysfunction: Use of Classification Tree Analysis. Braz Dent J 2020; 31:360-367. [PMID: 32901710 DOI: 10.1590/0103-6440202003279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/17/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to construct a predictive model that uses classification tree statistical analysis to predict the occurrence of temporomandibular disorder, by dividing the sample into groups of high and low risk for the development of the disease. The use of predictive statistical approaches that facilitate the process of recognizing and/or predicting the occurrence of temporomandibular disorder is of interest to the scientific community, for the purpose of providing patients with more adequate solutions in each case. This was a cross-sectional analytical population-based study that involved a sample of 776 individuals who had sought medical or dental attendance at the Family Health Units in Recife, PE, Brazil. The sample was submitted to anamnesis using the instrument Research Diagnostic Criteria for Temporomandibular Disorders. The data were inserted into the software Statistical Package for the Social Sciences 20.0 and analyzed by the Pearson Chi-square test for bivariate analysis, and by the classification tree method for the multivariate analysis. Temporomandibular disorder could be predicted by orofacial pain, age and depression. The high-risk group was composed of individuals with orofacial pain, those between the ages of 25 and 59 years and those who presented depression. The low risk group was composed of individuals without orofacial pain. The authors were able to conclude that the best predictor for temporomandibular disorder was orofacial pain, and that the predictive model proposed by the classification tree could be applied as a tool for simplifying decision making relative to the occurrence of temporomandibular disorder.
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Affiliation(s)
- Jorge P Waked
- Center for Rural Health and Technology, Academic Unit of Biological Sciences, UFCG - Universidade Federal de Campina Grande, Patos, PB, Brazil
| | - Mariana P L de A M Canuto
- Health Science Center, Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Maria Cecilia S N Gueiros
- Health Science Center, Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - João Marcílio C N L Aroucha
- Health Science Center, Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Cleysiane G Farias
- Health Science Center, Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Arnaldo de F Caldas
- Health Science Center, Department of Clinical and Preventive Dentistry, UFPE - Universidade Federal de Pernambuco, Recife, PE, Brazil
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Study of the Effects of Recognition of Stress on Symptoms and Regular Hospital Visits: An Analysis from Japanese National Statistics. Healthcare (Basel) 2020; 8:healthcare8030274. [PMID: 32824079 PMCID: PMC7551782 DOI: 10.3390/healthcare8030274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022] Open
Abstract
Stress is a risk factor for numerous lifestyle diseases, including dental diseases. The purpose of the present study was to investigate how sensitivity to psychological stress relates to subjective symptoms and regular hospital visits using information from the large-scale database of national statistics. Anonymized data from 10,584 respondents aged 30–79 of the Japanese 2013 Comprehensive Survey of Living Conditions were analyzed. Respondents were classified by age into a middle-aged group and an elderly group, and a contingency table analysis, rank correlation analysis, and binomial logistic regression analysis were performed. Contingency table analysis confirmed that eight items were related to the presence of a recognition of stress, including the presence of subjective symptoms (p < 0.001), the presence of regular hospital visits (p < 0.001), symptoms of periodontal disease (p < 0.001), and self-rated health (p < 0.001). Responses for symptoms and diseases requiring regular hospital visits were ranked in order for a stress group and a no stress group, and it was found that other than fatigue symptoms being ranked highly in the stress group, there were no particular differences. Logistic regression analysis results showed significant odds ratios for six items including: self-rated health (3.91, 95% CI, 3.23 to 4.73), lifestyle awareness (1.96, 95% CI, 1.68 to 2.28), and symptoms of periodontal disease (1.71, 95% CI 1.19 to 2.48). The present study showed that susceptibility to psychological stress is related to awareness of subjective symptoms and to regular hospital visits due to disease, suggesting that these have direct and indirect mutual effects.
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Puthukkudiyil JS, Bhutia O, Roychoudhury A, Bhatt K, Yadav R, Bhalla AS. Does Repositioning of Temporomandibular Joint Disc With Bone Anchors Provide Better Clinical Outcomes Than Conventional Disc Plication Procedures for Anterior Disc Displacements Without Reduction in Patients Refractory to Nonsurgical Treatments? J Oral Maxillofac Surg 2020; 78:2160-2168. [PMID: 32777247 DOI: 10.1016/j.joms.2020.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE Although open temporomandibular joint arthroplasty with discopexy is a common treatment for patients with anterior disc displacements without reduction (ADDWo) unresponsive to medical management, there are no studies comparing disc repositioning with bone anchors and conventional discopexy procedure. The purpose of the study was to compare the efficacy between disc repositioning with bone anchors and the conventional discopexy procedure for ADDWo of temporomandibular joint refractory to medical management. PATIENTS AND METHODS A randomized controlled trial was conducted in patients with ADDWo. The primary objective was to compare the improvement in mouth opening (primary outcome variable) between the 2 treatment (primary predictor variable) groups-disc repositioning with bone anchors versus conventional disc plication. Secondary outcome variables were pain measured by visual analog scale, lateral excursions, and position of the disc evaluated by magnetic resonance imaging (MRI). Other variables of interest were age, gender, and duration of symptoms. The parameters were evaluated at preoperative, postoperative day 1, and 1-, 6-, and 12-month postoperative period. Categorical variables were compared with χ2 test and continuous variables with analysis of variance and adjusted for multiple comparisons with Bonferroni test. RESULTS The study sample comprised 14 patients (7 in each group) with MRI-proven ADDWo. Statistically significant differences were found in the improvement of mouth opening between the 2 groups, showing better improvement with bone anchors (14.42 ± 5.96 vs 7.57 ± 7.25 mm; P < .05). The reduction in visual analog scale also showed statistically significant difference with better pain reduction achieved with bone anchor (4.57 ± 1.61 vs 3.28 ± 0.75; P < .05). There was no statistically significant difference in lateral excursions and postoperative position of the disc evaluated by MRI between the groups at the 12-month follow-up period. CONCLUSIONS Disc repositioning with bone anchors provides better clinical outcomes in terms of maximal mouth opening and pain scores compared with conventional disc plication.
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Affiliation(s)
- Jithin Sasikumar Puthukkudiyil
- Senior Resident, Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ongkila Bhutia
- Professor, Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
| | - Ajoy Roychoudhury
- Professor and Head, Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Krushna Bhatt
- Assistant Professor, Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rahul Yadav
- Associate Professor, Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ashu Seith Bhalla
- Professor, Department of Radio Diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Gazal G. Overcoming temporomandibular joint clicking and pain. Cranio 2020; 38:209-211. [DOI: 10.1080/08869634.2020.1769440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Giath Gazal
- College of Dentistry, Taibah University, Al Madina Al Munawara, Kingdom of Saudi Arabia
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α 1 adrenergic receptor activation has a dynamic effect on masticatory muscle afferent fibers. Neuropharmacology 2020; 175:108197. [PMID: 32544482 DOI: 10.1016/j.neuropharm.2020.108197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022]
Abstract
Temporomandibular Disorder (TMD) patients report amplification of pain in the masticatory muscles after psychological trauma or stressful conditions. The mechanisms underlying this phenomenon are yet to be elucidated. This study combined immunohistochemistry with single cell in vivo electrophysiology recordings of masticatory muscle afferent fibers to investigate the role of α1-adrenergic receptors in muscle nociception. It was found that a subset of trigeminal afferent fibers which innervate the masseter and temporal muscles expressed α1a, α1b and α1d receptors, including a smaller number of putative nociceptors which co-expressed TrpV1 receptors. Local injection of the selective α1 adrenergic receptor agonist phenylephrine into masticatory muscle decreased and increased the mechanical activation threshold of slow and fast conducting afferent fibers, respectively. This effect was reversed by co-administration of the α1 selective antagonist terazosin. To rule out the possibility that local ischemia was responsible for the observed effect of phenylephrine on masticatory muscle afferent fibers, additional experiments were conducted where blood flow to the masticatory muscle was reduced by common carotid artery occlusion. This investigation found that muscle blood flow occlusion increased the mechanical activation threshold of the majority of masticatory muscle afferent fibers unrelated to conduction velocity. These findings suggest that under conditions of increased sympathetic tone, such as those related to stress, noradrenaline may sensitize masticatory muscle nociceptors to increase pain and desensitize muscle proprioceptors to alter muscle tone, through activation of α1 receptors.
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Masticatory Muscles Activity in Sport Climbers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041378. [PMID: 32098017 PMCID: PMC7068301 DOI: 10.3390/ijerph17041378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022]
Abstract
Masticatory muscle activity during teeth clenching is associated with changes in many physiological parameters throughout the body. Clenching can improve muscle activity, force production, rate of force development, and joint fixation. Hence, teeth clenching and masticatory muscle activity can be important in competitive sports activities. Sport climbing is becoming increasingly popular and will be included for the first time in the Summer Olympic Games, Tokyo, 2020. However, masticatory muscle activity in sport climbers has not yet been studied. The aim of the presented study is to compare the bioelectrical activity of the masticatory muscles in sport climbers and non-climbers in order to determine the relationship between these muscles and climbing activity. 44 subjects without masticatory system disorders (16 women and 28 men, average age 26.3) were divided into two groups of 22 sport climbers (8 women, 14 men, climbing experience >4 years), while 22 people (8 women, 14 men, with no regular sports activity) were assigned to the control group. Electromyographic examination of temporalis anterior (TA) and masseter muscle (MM) was evaluated in three conditions: during resting mandibular position, during maximum intercuspation clenching, and during maximum voluntary clenching with cotton rolls between teeth. For statistical analysis, the W Shapiro-Wilk test and the Mann-Whitney U test were used. Sport climbers showed significantly higher bioelectrical activities of MM during maximum intercuspation clenching (238.45 μV vs. 83.87 μV, p = 0.002), and during maximum voluntary clenching with cotton rolls between teeth (300.01 μV vs. 101.38 μV, p = 0.001) compared to controls. The differences between groups in relation to the resting bioelectrical activity of the MM muscles, and TA muscles in all conditions were not statistically significant (p > 0.05). Higher bioelectrical activity of masseter muscles during clenching in climbers can be associated with this sports activity. However, the mechanism remains unknown and requires future research.
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