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Medina Flores D, Barragán Nuñez MI, Müller de Quevedo H, Bonjardim LR, Rodrigues Conti PC. Real time evaluation of awake bruxism behaviors in young asymptomatic students and its impact on the masticatory muscles. J Prosthet Dent 2023:S0022-3913(23)00174-9. [PMID: 37069016 DOI: 10.1016/j.prosdent.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 04/19/2023]
Abstract
STATEMENT OF PROBLEM The relationship of awake bruxism with pain is still unclear. PURPOSE The purpose of this clinical study was to evaluate awake bruxism behavior for 1 week in healthy young adults with ecological momentary assessment, assess its relationship with masticatory muscle tenderness, and the participation of endogenous analgesia. MATERIAL AND METHODS A total of 150 healthy participants were provided with a smartphone application that sent 10 alerts at random intervals every day. The participants were instructed to report in real time which of the following awake bruxism behaviors best represented their current condition: relaxed jaw muscles, tooth contact, tooth clenching, tooth grinding, or jaw bracing. At baseline, participants underwent recordings of the pressure pain threshold and conditioned pain modulation of the masticatory muscles. Pressure pain threshold recording was also repeated on the last day of the study. A t test was used to compare the first and the last pressure pain threshold recording after 1 week with an ecological momentary assessment evaluation. The Pearson correlation test was performed to evaluate the correlation between variables (α=.05). RESULTS Overall compliance was 75.9%. The average frequency of relaxed jaw muscles was 54.5%, tooth contact 29.4%, jaw bracing 5.8%, tooth clenching 9.7%, and tooth grinding 0.6%. The average frequency of a distinct awake bruxism behavior was 45.5%. A statistically significant increase in pressure pain threshold values was found (P=.001; P=.001; P=.045 for right and left anterior temporalis and left masseter, respectively). No significant correlation was found between the frequency of awake bruxism behaviors, the pressure pain threshold, and conditioned pain modulation (P>.05). CONCLUSIONS The most prevalent behavior was tooth contact (29.4%). No relationship was found between awake bruxism behaviors and masticatory muscle tenderness or endogenous analgesia.
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Affiliation(s)
- Dyanne Medina Flores
- PhD student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru, SP, Brazil.
| | - Maria Isabel Barragán Nuñez
- Post graduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru, SP, Brazil
| | - Henrique Müller de Quevedo
- Post graduate student, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru, SP, Brazil
| | - Leonardo Rigoldi Bonjardim
- Associate Professor, Section of Head and Face Physiology. Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru, SP, Brazil
| | - Paulo César Rodrigues Conti
- Associate Professor, Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (FOB/USP), Bauru, SP, Brazil
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Moloney N, Rabey M, Hush J, Sanders D, Dube T, Marcuzzi A. Is low intensity exercise sufficient to induce exercise-induced pain threshold modulation in people with persistent pain? Musculoskelet Sci Pract 2022; 62:102643. [PMID: 35963040 DOI: 10.1016/j.msksp.2022.102643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES We investigated whether a 12-min walk test (12MWT) yielded exercise-induced pain threshold modulation (EIPM) within people with persistent pain and whether baseline self-report and pain sensitivity measures differed according to these responses. DESIGN Cross-sectional study. METHODS Two cohorts (tertiary/community) (n = 88) with persistent pain underwent pressure pain threshold (PPT) testing before and after a 12MWT to determine exercise-induced pain threshold modulation responses. Baseline self-report (pain severity, pain distribution, psychological distress, sleep) and baseline widespread pain sensitivity (WPS) (high/low) were recorded. Within and between-group differences were analysed using paired t-tests and repeated measure analyses of covariance. Individual EIPM responses were categorised as hyperalgesic, no change and hypoalgesic responses. Differences in baseline self-report and pain sensitivity measures between EIPM categories were investigated. RESULTS No significant within- or between-group differences in PPT following the 12MWT were detected (p > 0.05). Individual responses showed that up to 30% of the community and 44% of the tertiary cohort demonstrated >20% change in PPT (in either direction). Significant differences were shown in pain distribution (p = 0.002) and baseline WPS (p = 0.001) between people with hyperalgesic, no change, hypoalgesic responses. People with 4-5 pain regions were more likely hyperalgesic (χ2 = 9.0, p = 0.003); people with low baseline WPS were more likely to demonstrate no change (p = 0.002). CONCLUSION Low or self-selected intensity exercise was insufficient to induce exercise-induced pain modulation at group level. Individual responses were variable with pain distribution and baseline WPS differing between responses. Future research could evaluate responses and associated factors in larger samples with high baseline pain sensitivity specifically.
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Affiliation(s)
- Niamh Moloney
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Department of Exercise Sciences, Faculty of Science, University of Auckland, New Zealand; THRIVE Physiotherapy, Channel Islands, Guernsey.
| | - Martin Rabey
- THRIVE Physiotherapy, Channel Islands, Guernsey; School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Julia Hush
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Duncan Sanders
- Pain Management Research Centre, The University of Sydney, NSW, Australia
| | - Tumelo Dube
- Pain Management Research Centre, The University of Sydney, NSW, Australia
| | - Anna Marcuzzi
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Sensory recovery and oral health-related quality of life following tongue reconstruction using non-innervated radial forearm free flaps. Oral Oncol 2021; 121:105471. [PMID: 34352555 DOI: 10.1016/j.oraloncology.2021.105471] [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: 05/13/2021] [Revised: 06/29/2021] [Accepted: 07/22/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This study aimed to monitor the recovery of somatosensory function and oral health-related quality of life after tongue reconstruction using a non-innervated radial forearm free flap (RFFF). METHODS Twenty patients (9 men, age: 42-67 years) underwent tongue reconstruction with non-innervated RFFFs, and twenty age- and sex-matched controls were included in this study. Quantitative sensory testing (QST), including cold, warm, and mechanical detection thresholds (CDT, WDT, MDT); cold, heat, and mechanical pain thresholds (CPT, HPT, MPT); and static two-point, sharp/blunt, and direction discrimination (S2-PD, S/BD, DD) were determined 9 months and 18 months after surgery on the surgical (9 M, 18 M) and contralateral sides (9Mc, 18Mc). Oral Health Impact Profile-49 (OHIP-49) was used to determine the oral-related quality of life of participants. RESULTS All parameters showed significantly lower sensitivity at 9 M and 18 M (p < 0.001) compared to those for the controls and the contralateral side, except for DD (p = 0.101). In addition, the parameters showed a significant decrease in sensitivity for 9Mc and 18Mc (p ≤ 0.043) compared to those for the controls, except for MPT, HPT, S/SD, and DD (p ≥ 0.453). Findings on WDT, MPT, S2-PD, and DD (p ≤ 0.046) indicated significantly higher somatosensory function at 18 M than that at 9 M. MDT and MPT (p ≤ 0.038) showed significantly higher sensitivity at 18Mc than at 9Mc. Scores for all dimensions of OHIP-49 were significantly higher in patients (decrease in quality of life, p ≤ 0.002) than in controls, except for physical discomfort (p = 0.51). However, the scores were significantly higher at 18 M than at 9 M (p ≤ 0.011), except for handicap (p = 0.36). Postoperative chemotherapy was significantly correlated with impaired thermal sensitivity of the flaps (WDT, p = 0.049). CONCLUSION The present findings showed significant impairment in somatosensory function on both the surgical and contralateral sides of patients with RFFFs. However, a significant increase in somatosensory function was observed on both sides over time. Somatosensory disturbances observed after surgery were associated with poor oral health-related quality of life.
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Giudice AL, Brewer I, Leonardi R, Roberts N, Bagnato G. Pain threshold and temporomandibular function in systemic sclerosis: comparison with psoriatic arthritis. Clin Rheumatol 2018; 37:1861-1867. [PMID: 29445986 DOI: 10.1007/s10067-018-4028-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/26/2018] [Accepted: 02/06/2018] [Indexed: 01/20/2023]
Abstract
The aim of the study was to evaluate whether a reduced pain threshold is associated with increased temporomandibular dysfunction in systemic sclerosis (SSc) compared to psoriatic arthritis (PsA) and healthy controls. Ninety subjects participated in the study (30 SSc, 30 PsA, and 30 healthy controls). The Helkimo index was used to evaluate temporomandibular dysfunction. Digital palpation was performed at the temporomandibular joint (TMJ) surface and at the superficial masseter muscle (SMM) and pain intensity was recorded on a visual analog scale (VAS), while pain pressure threshold (PPT) was measured at the same sites through a pressure algometer. PPT scores were lower in SSc patients compared to PsA patients and controls. In addition, the average Helkimo index score, measuring the degree of TMJ dysfunction, was higher in SSc compared to PsA and controls. A significant inverse correlation was observed between every PPT score, and both Helkimo index and VAS palpation in SSc and PsA. Both the range of motion and all the other pain-related subdomains of the Helkimo index score (pain on movement, pain palpation TMJ and pain palpation muscle) were significantly worse in SSc compared to PsA, while no significant differences were observed in the TMJ function subdomain. In SSc patients, the skin score was directly associated with the range of motion subdomain of the Helkimo index. Our results confirm that TMJ function is impaired in SSc; further longitudinal studies are needed to assess the role of pain threshold in the assessment of limitations in TMJ function and to identify an objective marker of therapeutic response.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Medical-Surgical Specialties, Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy. .,Department of Biomedical and Dental Sciences and Morphofunctional Imaging - Section of Orthodontics, School of Dentistry, Policlinico Universitario "G. Martino", University of Messina, Via Consolare Valeria, 98123, Messina, Italy.
| | - Idona Brewer
- Department of Medicine, Division of Rheumatology, University of Louisville School of Medicine, 401 E. Chestnut St. Suite 690, Louisville, KY, 40202, USA
| | - Rosalia Leonardi
- Department of Medical-Surgical Specialties, Department of Orthodontics, Policlinico Universitario "Vittorio Emanuele", University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Neal Roberts
- Department of Medicine, Division of Rheumatology, University of Louisville School of Medicine, 401 E. Chestnut St. Suite 690, Louisville, KY, 40202, USA
| | - Gianluca Bagnato
- Division of Rheumatology, Department of Clinical and Experimental Medicine, Policlinico Universitario "G. Martino", University of Messina, Via Consolare Valeria, 98125, Messina, Italy
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Agbaje J, De Laat A, Constantinus P, Svensson P, Baad-Hansen L. Agreement between quantitative and qualitative sensory testing of changes in oro-facial somatosensory sensitivity. J Oral Rehabil 2016; 44:30-42. [DOI: 10.1111/joor.12455] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 11/29/2022]
Affiliation(s)
- J. Agbaje
- OMFS-IMPATH Research Group; Department of Imaging and Pathology; KU Leuven; Leuven Belgium
| | - A. De Laat
- Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - P. Constantinus
- OMFS-IMPATH Research Group; Department of Imaging and Pathology; KU Leuven; Leuven Belgium
- Oral and Maxillofacial Surgery; Leuven University Hospitals; Leuven Belgium
| | - P. Svensson
- Section of Orofacial Pain and Jaw Function; Department of Dentistry; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Karolinska Institutet; Huddinge Sweden
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - L. Baad-Hansen
- Section of Orofacial Pain and Jaw Function; Department of Dentistry; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Karolinska Institutet; Huddinge Sweden
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Kothari SF, Baad-Hansen L, Hansen LB, Bang N, Sørensen LH, Eskildsen HW, Svensson P. Pain profiling of patients with temporomandibular joint arthralgia and osteoarthritis diagnosed with different imaging techniques. J Headache Pain 2016; 17:61. [PMID: 27349657 PMCID: PMC4923011 DOI: 10.1186/s10194-016-0653-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 06/17/2016] [Indexed: 11/20/2022] Open
Abstract
Background Clinical differentiation between pain mechanisms of temporomandibular joint (TMJ) arthralgia and osteoarthritis (OA) is challenging. The aims were to compare somatosensory function at the TMJs and conditioned pain modulation (CPM) effects between TMJ arthralgia and OA patients diagnosed clinically and based on different imaging techniques and age- and gender-matched healthy controls (n = 41). Methods Patients (n = 58) underwent standard clinical examination and three different TMJ imaging modalities. After each examination, they were classified into arthralgia or OA based on the findings. TMJ region somatosensory testing was performed in all participants. Z-scores were calculated for patients based on healthy reference data. CPM was tested by comparing pressure pain thresholds (PPTs) at TMJ and thenar (control) before, during and after the application of painful and nonpainful cold stimuli. Data were analyzed using analyses of variance. Results Somatosensory abnormalities were commonly detected in both patient groups. Assessment of somatosensory function at the TMJ revealed that arthralgia patients were less sensitive to warmth, cold and tactile stimuli than OA patients (P < 0.048). OA patients showed pressure hyperalgesia compared with arthralgia patients (P = 0.025). There was a significant CPM effect at both test sites during painful cold application in all groups (P < 0.001). There was no significant difference in the relative CPM effect between groups except for clinically diagnosed arthralgia patients showing reduced CPM effect compared with controls (P = 0.047). Conclusions Pain profiles including somatosensory function differed between TMJ arthralgia and OA patients although CPM effects were similar in patients and controls. Thus, different TMJ pain conditions may share common pain mechanisms but the present study for the first time also indicated that differential pain mechanisms could be involved. Electronic supplementary material The online version of this article (doi:10.1186/s10194-016-0653-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Simple Futarmal Kothari
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark. .,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University Hospital, Aarhus, Denmark.
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University Hospital, Aarhus, Denmark
| | | | - Niels Bang
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University Hospital, Aarhus, Denmark.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Somatosensory assessment and conditioned pain modulation in temporomandibular disorders pain patients. Pain 2015; 156:2545-2555. [DOI: 10.1097/j.pain.0000000000000325] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Quantitative sensory testing (QST), a set of noninvasive methods used to assess sensory and pain perception, has been used for three decades. The precision of the instruments and the uninvasiveness encouraged many QST-based trials. The developments made have benefited multiple disciplines. QST relies on analysis of an individual's response to external stimuli, reflecting the integrity of the PNS and the sensory pathway. The sensory pathway cannot be assessed in isolation from the affective and cognitive characteristics of patients or testers. Many variables potentially affect the reliability and reproducibility of QST, which after all, is designed for the testing of individuals by other individuals. Several decades of QST research have yielded exciting contributions, but the future of QST cannot be fully known.
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Affiliation(s)
- Carlos J Roldan
- Department of Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Emergency Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- Department of Emergency Medicine Memorial Hermann Hospital, Houston, TX 77030, USA
- Department of Emergency Medicine Lyndon B Johnson Hospital, Houston, TX 77026, USA
| | - Salahadin Abdi
- Department of Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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