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Dos Santos Proença J, Baad-Hansen L, do Vale Braido GV, Campi LB, de Godoi Gonçalves DA. Clinical features of chronic primary pain in individuals presenting painful temporomandibular disorder and comorbidities. J Oral Rehabil 2024; 51:255-265. [PMID: 37727030 DOI: 10.1111/joor.13598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/16/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND The diagnosis of chronic primary pain (CPP), according to the recently released International Classification of Disease (ICD-11) criteria, refers to conditions with complex aetiologies. CPP is characterized by specific clinical features such as generalized sensory hypersensitivity and widespread pain, and is associated with functional disability and emotional distress. OBJECTIVE This study investigated clinical features of CPP in individuals with painful temporomandibular disorders (TMD) and comorbidities (fibromyalgia, migraine and/or tension-type headache). METHODS This cross-sectional study was conducted with a sample of 129 individuals. Painful TMD, fibromyalgia and primary headaches were evaluated based on well-established international criteria. Generalized sensory hypersensitivity was assessed using psychophysical tests. Symptoms of anxiety and depression were assessed by the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. The Central Sensitization Inventory was applied to assess central sensitization-related symptoms and the Pittsburg Sleep Quality Index to evaluate the quality of sleep. The presence of widespread pain was assessed using a body map. The sample was stratified into three groups: control (n = 25), TMD-painful TMD only (n = 35) and TMD + Cm-painful TMD and comorbidities (n = 69). Statistical analysis was performed using one-way ANOVA, chi-squared test and ANCOVA, considering gender as a covariate (α = .05). RESULTS Compared to controls, individuals presenting painful TMD and comorbidities showed lower pressure pain thresholds in all evaluated areas (p ≤ .012) and a higher number of painful areas in the body (p = .001). They presented more symptoms of anxiety (p = .040) and depression (p = .018), and a higher score in the Central Sensitization Inventory (p ≤ .006) than the other groups. CONCLUSION Individuals with painful TMD and comorbidities presented more clinical features of CPP compared to those affected by TMD only.
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Affiliation(s)
- Juliana Dos Santos Proença
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
| | - Lene Baad-Hansen
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | | | - Letícia Bueno Campi
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, Brazil
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Buchbender M, Keplinger L, Kesting MR, Adler W, Schmitt CM. A clinical trial: Aqualizer ™ therapy and its effects on myopathies or temporomandibular dysfunctions. Part I: Objective parameters. Cranio 2024; 42:1-9. [PMID: 33590803 DOI: 10.1080/08869634.2021.1885886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Symptoms of temporomandibular dysfunction (TMD) may include pain in the muscles or restrictions opening the mouth. The aim of this study was to assess the effects of initial Aqualizer™ therapy. METHODS Group 1 received initial Aqualizer™ therapy before definitive hard splint; Group 2 received no initial therapy. Patients with arthrosis, partial/total prosthesis or undergoing splint therapy were excluded. Objective (temporomandibular joint palpation, temporomandibular joint auscultation, palpation of the chewing muscles, and mobility of the lower jaw) parameters were evaluated. The level of statistical significance was 5% (p < 0.05). RESULTS In 53 patients (Group 1 n = 25; Group 2 n = 28), a significant improvement (p < 0.001) was found in Group 1 in pain on palpation (masseter muscle, temporal muscle, post-mandibular region, lateral pterygoid muscle, and suboccipital region), but no significant differences in jaw mobility were found. CONCLUSION Aqualizer™ therapy produces significant improvement of primary symptoms.
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Affiliation(s)
- Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Lukas Keplinger
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Marco R Kesting
- Head of the Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen Nuremberg, Erlangen, Germany
| | - Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
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Piekartz HV, van der Meer H, Olivo SA. Craniofacial disorders and headaches. A narrative review. Musculoskelet Sci Pract 2023; 66:102815. [PMID: 37419842 DOI: 10.1016/j.msksp.2023.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Craniofacial- and headache disorders are common co-morbid disorders. The aim of this review is to provide an overview of the research discussing craniofacial pain, especially temporomandibular disorders, and its relationship and impact on headaches, as well as suggestions for diagnostic assessment tools and physical therapeutic management strategies. METHOD A narrative structured review was performed. A search was conducted in MEDLINE using terms related to craniofacial pain and headaches. Additionally, papers regarding this topic were also extracted from the authors' personal libraries. Any study design (i.e., RCT, observational studies, systematic review, narrative review) that reported the concepts of interest was included, using Covidence. Results were narratively synthesized and described. RESULTS From an epidemiological perspective, craniofacial pain and headaches are strongly related and often co-existing. This may be due to the neuroanatomical connection with the trigeminal cervical complex, or due to shared predisposing factors such as age, gender, and psychosocial factors. Pain drawings, questionnaires, and physical tests can be used to determine the cause of pain, as well as other perpetuating factors in patients with headaches and craniofacial pain. The evidence supports different forms of exercise and a combination of hands-on and hands-off strategies aimed at both the craniofacial pain as well as the headache. CONCLUSION Headaches may be caused or aggravated by different disorders in the craniofacial region. Proper use of terminology and classification may help in understanding these complaints. Future research should look into the specific craniofacial areas and how headaches may arise from problems from those regions. (249 words).
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Affiliation(s)
- Harry von Piekartz
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Cranial Facial Therapy Academy (CRAFTA), Hamburg, Germany.
| | - Hedwig van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, the Netherlands; SOMT University of Physiotherapy, Amersfoort, Netherlands
| | - Susan Armijo Olivo
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Faculty of Rehabilitation Medicine, Faculty of Medicine and Dentistry Rehabilitation Research Center, University of Alberta, Edmonton, Canada
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Böthun A, Häggman-Henrikson B, Stålnacke BM, Wänman A, Nordh E, Lampa E, Hellström F. Clinical signs in the jaw and neck region following whiplash trauma-A 2-year follow-up. Eur J Pain 2023. [PMID: 36806817 DOI: 10.1002/ejp.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/30/2023] [Accepted: 02/19/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective. METHODS In total, 84 cases (48 women) diagnosed with neck distortion after a car accident and 116 controls (68 women) were examined within 1 month, and 49 cases (27 women) and 71 controls (41 women) were re-examined 2 years later. Outcome measures were pain on palpation of jaw and neck muscles and maximal jaw opening. Analysis was performed using mixed-models. RESULTS Cases and women were at higher risk for pain on palpation of jaw muscles (OR:7.7; p < 0.001 and OR:3.2; p = 0.010 respectively) and neck muscles (OR:12.7; p < 0.001 and OR:2.9; p = 0.020 respectively) but with no significant effect of time. Cases and women also had lower maximal jaw opening (-3.1; p = 0.001 and -3.3; p = 0.001 respectively). There was no significant time effect, but a significant interaction between cases and time (2.2; p = 0.004). CONCLUSION Individuals with a whiplash trauma present a higher risk for pain on palpation in jaw and neck muscles both in a short- and long-term perspective, but show normal jaw movements. No time effect suggests that cases do not spontaneously improve nor get worse. Investigating pain on palpation in the jaw and neck muscles after whiplash trauma can identify individuals at risk for developing long-term orofacial pain and dysfunction. SIGNIFICANCE Orofacial pain is often reported after whiplash trauma but most previous studies concerning orofacial pain in whiplash populations have been questionnaire studies. Cases with a previous whiplash trauma and women, in general, had higher risk for pain on palpation in the jaw and neck region. Investigating pain on palpation after a whiplash trauma can help to identify individuals at risk of developing long-lasting pain in the orofacial region.
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Affiliation(s)
- Alicia Böthun
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Birgitta Häggman-Henrikson
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.,Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Britt-Marie Stålnacke
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
| | - Anders Wänman
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Erik Nordh
- Department of Clinical Science, Neurosciences, Div Clinical Neurophysiology, Umeå University, Umeå, Sweden
| | - Ewa Lampa
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Hellström
- Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden.,Department of Occupational Health Science and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Lövgren A, Visscher CM, Lobbezoo F, Yekkalam N, Vallin S, Wänman A, Häggman-Henrikson B. The association between myofascial orofacial pain with and without referral and widespread pain. Acta Odontol Scand 2022; 80:481-486. [PMID: 35776512 DOI: 10.1080/00016357.2022.2036363] [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
OBJECTIVES Pain referral on palpation has been suggested to be a clinical sign of central sensitization potentially associated with widespread pain conditions. Our aim was to evaluate if myofascial pain with referral is a better predictor for widespread pain when compared to no pain or local myofascial pain. MATERIALS AND METHODS Individuals at the Public Dental services in Västerbotten, Sweden, were randomly invited based on their answers to three screening questions for temporomandibular disorders (TMD). In total, 300 individuals (202 women, 20-69 yrs) were recruited, and examined according to the Diagnostic Criteria for TMD (DC/TMD) after completion of a body pain drawing. Widespread pain was considered present when seven or more pain sites were reported on the widespread pain index. A binary logistic regression model, adjusted for the effect of age and gender were used to evaluate the association between myofascial orofacial pain and widespread pain. RESULTS Widespread pain was reported by 31.3% of the study sample. There was a 57.3% overlap with myofascial pain. Widespread pain was associated to myofascial orofacial pain with and myofascial orofacial pain (OR 4.83 95% CI 2.62-9.05 and OR 11.62 95% CI 5.18-27.88, respectively). CONCLUSION These findings reinforce the existing knowledge on the overlap between painful TMD and other chronic pain conditions.
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Affiliation(s)
- Anna Lövgren
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Corine M Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Negin Yekkalam
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Simon Vallin
- Northern Register Centre, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Anders Wänman
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Birgitta Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden.,Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
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LÍBERA JD, NAKANO BMB, GUIOTTI AM, RODRIGUES JVS, BRANDINI DA, DEVIDES EGDF, VOLCE AHDS, TURCIO KHL. Dores musculares cervicais em pacientes com DTM e suas correlações. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.04822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Resumo Introdução As disfunções temporomandibulares apresentam uma variedade de sinais e sintomas que afetam a articulação temporomandibular, músculos da mastigação e estruturas relacionadas e muitos pacientes apresentam queixas cervicais. Objetivo Verificar a correlação de dor à palpação dos músculos da mastigação (masseter, temporal anterior, pterigoideos lateral e medial) e digástrico, com a queixa de dor no pescoço; verificar a correlação de dor à palpação nos músculos da mastigação e digástrico, com dor à palpação no esternocleidomastoideo e trapézio, e se a força de correlação é diferente entre eles. Material e método Foram avaliados 232 prontuários da clínica odontológica das Disfunções Temporomandibulares da Faculdade de Odontologia de Araçatuba, do período de 2011 a 2013. Os dados coletados foram submetidos à análise estatística, com alfa (α) = 0.01 para todos os casos, exceto digástrico quando associado ao trapézio (α) = 0.05. Resultado A maioria dos pacientes era do sexo feminino. Houve correlação positiva entre dor à palpação nos músculos temporal, masseter, pterigoideo lateral, esternocleidomastoideo e trapézio, e queixa de dor no pescoço. Também houve correlação positiva entre a dor em todos os músculos da mastigação (masseter, temporal, pterigoideo lateral e medial) e digástrico e a dor no esternocleidomastoideo. Bem como a correlação de presença de dor nos músculos masseter, temporal, pterigoideo lateral e digástrico com dor no trapézio. A correlação de dor foi mais forte para o músculo esternocleidomastoideo, exceto para o pterigoideo lateral. Conclusão Existe correlação positiva entre a queixa de dor à palpação nos músculos da mastigação, exceto pterigiodeo medial, e os músculos cervicais (esternocleidomastoideo e trapézio). A força de correlação entre a dor do masseter e temporal anterior com o esternocleidomastoideo é mais forte do que com o trapézio.
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Prevalence of temporomandibular disorder in adult patients with chronic pain. Scand J Pain 2020; 21:41-47. [DOI: 10.1515/sjpain-2020-0077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/04/2020] [Indexed: 12/20/2022]
Abstract
Abstract
Objectives
Chronic pain patients often suffer in multiple locations. In health care, examinations of bodily pain usually do not include questions about temporomandibular disorders (TMD); hence TMD symptoms and potential comorbidities are not regularly assessed. Therefore, the primary aim was to evaluate the prevalence of TMD in patients referred to a pain rehabilitation clinic, and the secondary aim was to evaluate possible factors associated with TMD symptoms.
Methods
Consecutive chronic pain patients referred to the Pain Rehabilitation Clinic at the Umeå University Hospital in Sweden were included. TMD symptoms were assessed using three valid screening questions – 3Q/TMD. Pain sites, emotional distress, kinesiophobia, and demographics were obtained from the Swedish Quality Registry for Pain Rehabilitation.
Results
In total, 188 (144 women) chronic pain patients (mean age 41.8 years) were included. Of these, 123 (96 women) answered affirmatively to at least one of the 3Q/TMD. The relative risk of TMD symptoms among the patients with chronic pain, in comparison to the general population, was 7.1 (95% CI 5.9–8.4). Age was the only independent variable associated with TMD among the patients (p = 0.018).
Conclusions
The prevalence of TMD symptoms was higher in a chronic pain population compared to the general population. The 3Q/TMD questionnaire could be a suitable screening tool at pain rehabilitation clinics to identify patients for further examination of involvement of pain in the trigeminal region. Our results reinforce the clinical importance of paying attention to concurrent widespread pain and local TMD symptoms.
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Development and internal validation of prediction models for persistence of self-reported orofacial pain in the follow-up of patients with myofascial pain. Clin Oral Investig 2020; 25:2583-2594. [PMID: 32914270 PMCID: PMC8060172 DOI: 10.1007/s00784-020-03570-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/03/2020] [Indexed: 11/11/2022]
Abstract
Objectives To identify predictors in patient profiles, and to develop, internally validate, and calibrate prediction models for the persistence of self-reported orofacial pain at the 6-month and 12-month follow-up in patients with myofascial pain. Materials and methods A cohort of 63 adult patients with moderate to severe chronic myofascial pain was included. Patient and disease characteristics at baseline were recorded as potential predictors. Patients` presence or absence of improvement of orofacial pain at follow-up was considered the outcome. Binary logistic regression analyses were used to develop the models. The performance and clinical values of the models were determined. Results Forty-three percent and 30% of the patients had persistence of orofacial pain at 6-month and 12-month follow-up, respectively. Pain elsewhere, depression, parafunctional activities, and mandibular function impairment (MFI) were significantly associated with persistence of the pain at 6-month follow-up, whereas depression, parafunctional activities, and MFI were significantly associated with persistence of the pain at 12-month follow-up. Both of the models showed good calibration and discrimination, with shrunken area under the curve (AUC) values of 0.73 and 0.76, respectively. The clinical added predictive values for ruling in the risk of the persistence were 0.30 and 0.31, respectively, and those for ruling it out were 0.25 and 0.20, respectively. Conclusions Potential predictors for prediction of the persistence of self-reported orofacial pain at follow-up were identified. The calibration, discrimination, and clinical values of the models were acceptable. Clinical relevance The models may assist clinicians in decision-making regarding the improvement of orofacial pain of individual patients during follow-up in clinical settings.
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Braido GVDV, Campi LB, Jordani PC, Fernandes G, GonÇalves DADG. Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents. J Appl Oral Sci 2020; 28:e20190608. [PMID: 32901693 PMCID: PMC7480668 DOI: 10.1590/1678-7757-2019-0608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 07/07/2020] [Indexed: 11/25/2022] Open
Abstract
Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification.
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Affiliation(s)
- Guilherme Vinícius do Vale Braido
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Leticia Bueno Campi
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Paula Cristina Jordani
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
| | - Giovana Fernandes
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia, Departamento de Materiais Dentários e Prótese, Araraquara, São Paulo, Brasil
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Puerta MY, Galhardoni R, Teixeira MJ, de Siqueira JTT, de Siqueira SRDT. Chronic facial pain: different comorbidities and characteristics between neuropathic and nonneuropathic conditions. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:273-282. [PMID: 32561251 DOI: 10.1016/j.oooo.2020.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between comorbidities and chronic diseases and neuropathic and nonneuropathic orofacial pain diagnoses to suggest subclassifications of disease. STUDY DESIGN This was a cross-sectional, retrospective, case-control study. We evaluated 174 patients with orofacial pain and 132 controls by using a systematic protocol that consisted of medical history and demographic, pain, and orofacial characteristics. Patients were grouped according to their diagnosis-neuropathic or non-neuropathic pain; medical comorbidities; and exclusion criteria. Analyses included Z-score normalization, χ2 test, Fisher's exact test, 1-way analysis of variance (ANOVA), Student t test, Pearson's correlation coefficient, 2-step clustering, and logistic regression at 95% confidence level. RESULTS Functional chronic diseases were prevalent and correlated with pain and orofacial features. Three groups were identified in the cluster analysis: neuropathic facial pain, other orofacial pain syndromes, and fibromyalgia/temporomandibular disorders (TMDs). Logistic regression showed that hypothyroidism and gastritis were predictors for nonneuropathic orofacial conditions. Psychiatric diseases and gastritis were more prevalent among patients with generalized pain syndromes and TMDs and less prevalent among patients with neuropathic pain. CONCLUSIONS Functional comorbidities were associated with orofacial and dental features and may correspond to multimorbidity states in patients with chronic orofacial pain. The findings support the hypothesis that nonneuropathic orofacial pain syndromes could be functional disorders.
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Affiliation(s)
- Mariana Y Puerta
- Student, Neurology Department, Medical School, University of São Paulo, São Paulo, Brazil
| | - Ricardo Galhardoni
- School of Arts, Science and Humanities Department, University of São Paulo, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Chairman of Neurosurgery, Neurology Department, Medical School, University of São Paulo, São Paulo, Brazil
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SIQUEIRA SRDTD, TEIXEIRA MJ, SIQUEIRA JTTD. The Orofacial Pain Clinic Questionnaire (EDOF-HC) in the evaluation and diagnosis of orofacial pain. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:321-330. [DOI: 10.1590/0004-282x20200003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 01/03/2023]
Abstract
ABSTRACT Background: Diagnostic tools are necessary for the anamnesis and examination of orofacial pain, in order to fulfill diagnostic criteria and to screen potential causes of pain. Objective: To evaluate the Orofacial Pain Clinic Questionnaire (EDOF-HC) in the assessment and diagnosis of orofacial pain. Methods: Overall, 142 patients were evaluated and classified according to the criteria of the International Headache Society and International Association for the Study of Pain. All of them were evaluated with the EDOF-HC questionnaire, which consists of the orofacial and medical history, as well as the orofacial examination. Data were statistically analyzed with chi-square test and Bonferroni correction, one-way ANOVA with Tukey post hoc test, the two-step cluster and decision tree methods. Results: There were diferences in pain descriptors, pain in maximum mouth opening, number of trigger points, and history of previous surgery between the groups, which were classified into trigeminal neuralgia, burning mouth syndrome, temporomandibular disorders and trigeminal posttraumatic neuropathic pain with classification analysis. Conclusions: The EDOF-HC is a clinical supportive tool for the assessment of orofacial pain. The instrument may be used to support data collection from anamnesis and examination of patients according to the diagnostic criteria of most common orofacial conditions. It is also useful in the investigation of local and systemic abnormalities and contributes for the diagnosis of conditions that depend on exclusion criteria.
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Dimitrijevic Carlsson A, Wahlund K, Kindgren E, Skogh T, Starkhammar Johansson C, Alstergren P. Orofacial pain in juvenile idiopathic arthritis is associated with stress as well as psychosocial and functional limitations. Pediatr Rheumatol Online J 2019; 17:83. [PMID: 31856854 PMCID: PMC6921529 DOI: 10.1186/s12969-019-0385-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate relations between psychosocial factors, signs and symptoms of orofacial pain and jaw dysfunction in patients with juvenile idiopathic arthritis (JIA). METHODS Forty-five patients with JIA (median age 12 years) and 16 healthy matched controls (median age 13 years) were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered the DC/TMD questionnaires regarding psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophizing, pain locations and jaw function). RESULTS JIA patients with orofacial pain had higher degree of stress, depression, catastrophizing and jaw dysfunction compared to subjects without. In turn, these factors were associated with orofacial pain intensity. Also, patients with orofacial pain had higher systemic inflammatory activity. CONCLUSIONS Orofacial pain in patients with JIA is associated with stress, psychological distress, jaw dysfunction and loss of daily living activities. Pain intensity seems to be the major pain aspect related to these factors. In addition, systemic inflammatory activity appears to be an important factor contributing to orofacial pain in JIA.
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Affiliation(s)
- Alexandra Dimitrijevic Carlsson
- Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden. .,Center for Oral Rehabilitation in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. .,Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden.
| | - Kerstin Wahlund
- 0000 0004 0636 5406grid.413799.1Department of Stomatognathic Physiology, Kalmar County Hospital, Kalmar, Sweden
| | - Erik Kindgren
- Department of Pediatrics, Västervik Hospital, Västervik, Sweden ,0000 0001 2162 9922grid.5640.7Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden ,grid.416029.8Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
| | - Thomas Skogh
- 0000 0001 2162 9922grid.5640.7Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Carin Starkhammar Johansson
- 0000 0001 2162 9922grid.5640.7Center for Oral Rehabilitation in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per Alstergren
- 0000 0000 9961 9487grid.32995.34Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden ,Scandinavian Center for Orofacial Neurosciences, Malmö, Sweden ,0000 0004 0623 9987grid.411843.bSkåne University Hospital, Specialized Pain Rehabilitation, Lund, Sweden ,0000 0000 9961 9487grid.32995.34Orofacial Pain Unit, Malmö University, Malmö, Sweden
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13
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Kotsiubinskaya JV, Mikhailov VA, Mazo GE, Ashnokova IA. [Myofascial pain syndrome in the dysfunction of the temporomandibular joint]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:21-26. [PMID: 31851167 DOI: 10.17116/jnevro201911911121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM Selection of the clinical characteristics of pain syndrome in the orofacial region in temporomandibular joint pain dysfunction syndrome (TMJ PDS). MATERIAL AND METHODS One hundred and two patients with TMJ PDS were examined using the Verbal Descriptive Pain Rating Scale of the orofacial area. The Clinical Index of TMJ dysfunction (CID) by Helkimo M. was used for objectification of the level of musculo-tonic disorders in the area of the chewing muscles. The psychopathological status of patients with TMJ PDS was assessed with HRDS and SCL-90-R. RESULTS A significant proportion of patients with TMJ PDS, in addition to algic symptoms, have hypertonus of the facial muscles, the nature and severity of which require not only a special diagnostic assessment, but also follow-up treatment. The analysis of data allowed us to identify three clinical groups of patients: with isolated (muscular-tonic), neurological symptoms; with mixed (combination of muscular-tonic and somatoform manifestations) neurological and psychopathological symptoms and with somatoform symptoms. CONCLUSION Patients with TMJ PDS are clinically heterogeneous and require clinical differentiation, distinguishing the common group of patients with muscular dysfunction accompanied by pain and emotional response to it (anxiety and minor depressive symptoms) and the group of patients with a somatoform disorder (and manifestations as general anxiety).
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Affiliation(s)
- J V Kotsiubinskaya
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - V A Mikhailov
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - G E Mazo
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - I A Ashnokova
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
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Osiewicz M, Manfredini D, Biesiada G, Czepiel J, Garlicki A, Aarab G, Pytko-Polończyk J, Lobbezoo F. Prevalence of Function-Dependent Temporomandibular Joint and Masticatory Muscle Pain, and Predictors of Temporomandibular Disorders among Patients with Lyme Disease. J Clin Med 2019; 8:jcm8070929. [PMID: 31261623 PMCID: PMC6679175 DOI: 10.3390/jcm8070929] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/25/2019] [Accepted: 06/27/2019] [Indexed: 01/10/2023] Open
Abstract
The aim was to determine the occurrence of temporomandibular disorders (TMDs) in patients with Lyme disease (LD), and to estimate the contribution of factors that may identify TMD among LD patients. In seventy-six (N = 76) adult patients with LD (mean age 57.6 ± 14.6 years) and 54 healthy non-Lyme volunteers with a mean age of 56.4 ± 13.5 years, possible function (i.e., non-pain) diagnoses were established using the Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Pain diagnoses were established by means of the function-dependent dynamic and static tests. The two groups did not significantly differ in the frequency of disc displacements diagnoses and function-dependent pain diagnoses. LD showed a significantly higher frequency (p < 0.001) of osteoarthrosis than the control group. For the prediction of pain diagnoses in LD patients, the single regression analyses pointed out an association with age, sleep bruxism (SB), and awake bruxism (AB). Two predictors (i.e., SB (p = 0.002) and AB (p = 0.017)) were statistically significant in the final multiple variable model. The frequency of TMD in patients with LD based on function-dependent tests was not significantly different from that in the control group. This investigation suggests that the contribution of bruxism to the differentiation between patients with Lyme and TMD is high.
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Affiliation(s)
- Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland.
| | | | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre forDentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Jolanta Pytko-Polończyk
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre forDentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
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15
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Thymi M, Shimada A, Lobbezoo F, Svensson P. Clinical jaw-muscle symptoms in a group of probable sleep bruxers. J Dent 2019; 85:81-87. [DOI: 10.1016/j.jdent.2019.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 12/30/2022] Open
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16
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Baad‐Hansen L, Thymi M, Lobbezoo F, Svensson P. To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review. J Oral Rehabil 2019; 46:845-861. [DOI: 10.1111/joor.12821] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/09/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Lene Baad‐Hansen
- Section of Oro‐facial Pain and Jaw Function, Department of Dentistry Aarhus University Aarhus Denmark
- Scandinavian Center for Oro‐facial Neurosciences (SCON)
| | - Magdalini Thymi
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam Amsterdam The Netherlands
- Vrije Uiversiteit Amsterdam Amsterdam The Netherlands
| | - Frank Lobbezoo
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam Amsterdam The Netherlands
- Vrije Uiversiteit Amsterdam Amsterdam The Netherlands
| | - Peter Svensson
- Section of Oro‐facial Pain and Jaw Function, Department of Dentistry Aarhus University Aarhus Denmark
- Scandinavian Center for Oro‐facial Neurosciences (SCON)
- Department of Dental Medicine Karolinska Institutet Huddinge Sweden
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17
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Lövgren A, Visscher CM, Alstergren P, Lobbezoo F, Häggman-Henrikson B, Wänman A. The outcome of a temporomandibular joint compression test for the diagnosis of arthralgia is confounded by concurrent myalgia. Clin Oral Investig 2019; 24:97-102. [DOI: 10.1007/s00784-019-02891-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/02/2019] [Indexed: 01/10/2023]
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18
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Osiewicz M, Manfredini D, Biesiada G, Czepiel J, Garlicki A, Pytko-Polończyk J, Lobbezoo F. Differences between palpation and static/dynamic tests to diagnose painful temporomandibular disorders in patients with Lyme disease. Clin Oral Investig 2019; 23:4411-4416. [PMID: 30982182 DOI: 10.1007/s00784-019-02890-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 04/02/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests. MATERIALS AND METHODS Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed. RESULTS RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor. CONCLUSION A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present. CLINICAL RELEVANCE Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.
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Affiliation(s)
- Magdalena Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
| | | | - Grażyna Biesiada
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Czepiel
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Aleksander Garlicki
- Department of Infectious and Tropical Diseases, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jolanta Pytko-Polończyk
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Antinuclear antibody and rheumatoid factor positivity in temporomandibular disorders. Head Face Med 2018; 14:26. [PMID: 30466447 PMCID: PMC6249715 DOI: 10.1186/s13005-018-0183-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/12/2018] [Indexed: 12/12/2022] Open
Abstract
Background To investigate the differences in clinical characteristics and long-term treatment outcomes according to antinuclear antibody(ANA) and rheumatoid factor(RF) positivity and the correlation between pain-related and hematological indices in temporomandibular disorders(TMD) patients. Methods Clinical examinations were done following the Research Diagnostic Criteria for TMD in 257 patients. Comprehensive screening along with psychological and hematological evaluations (ANA, RF, complete blood cell count, C-reactive protein[CRP] and erythrocyte sedimentation rate[ESR]) were conducted. Clinical characteristics and treatment outcomes were statistically compared between ANA/RF positive and negative groups. Results Thirty-nine patients showed ANA/RF positivity. Male patients had smaller comfortable mouth opening(CMO)(p = 0.033) and maximum mouth opening(MMO)(p = 0.016) ranges with more painful neck muscles on palpation when RF/ANA positive. Pain duration, intensity, disability days and psychological distress levels were also higher in RF/ANA positive male patients. Significant correlation was shown in ESR with pain duration(p < 0.05) and numeric rating scale(NRS) before treatment(p < 0.05), CRP with NRS before treatment(p < 0.01), and red blood cell (RBC) with pain intensity(p < 0.05), NRS before treatment(p < 0.01), CMO(p < 0.01), pain on palpation of cervical muscles(p < 0.01), CMO(p < 0.05), and MMO(p < 0.05) 6 months after treatment. Conclusions These results may point towards a nonspecific autoimmune disposition in a subgroup of TMD patients. RF and ANA could be considered as a screening test for the detection of autoimmune phenomena in TMD.
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20
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Delwel S, Scherder EJA, de Baat C, Binnekade TT, van der Wouden JC, Hertogh CMPM, Maier AB, Perez RSGM, Lobbezoo F. Orofacial pain and its potential oral causes in older people with mild cognitive impairment or dementia. J Oral Rehabil 2018; 46:23-32. [PMID: 30281826 PMCID: PMC7380060 DOI: 10.1111/joor.12724] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/24/2018] [Accepted: 09/26/2018] [Indexed: 12/24/2022]
Abstract
Background The number of people with dementia and natural dentition is growing. As dementia progresses, the degree of self‐care decreases and the risk of oral health problems and orofacial pain increases. Objectives To examine and compare the presence of orofacial pain and its potential causes in older people with Mild Cognitive Impairment (MCI) or dementia. Methods In this cross‐sectional observational study, the presence of orofacial pain and its potential causes was studied in 348 participants with MCI or dementia with all levels of cognitive impairment in two outpatient memory clinics and ten nursing homes. Results Orofacial pain was reported by 25.7% of the 179 participants who were considered to present a reliable pain self‐report (Mini‐Mental State Examination score ≥14 points), while it could not be determined in people with more severe cognitive impairment. The oral health examination of the 348 participants indicated that potential painful conditions, such as coronal caries, root caries, tooth root remnants or ulcers were present in 50.3%. There was a significant correlation between the level of cognitive impairment and the number of teeth, r = 0.185, P = 0.003, teeth with coronal caries, r = −0.238, P < 0.001, and the number of tooth root remnants, r = −0.229, P = 0.004, after adjusting for age. Conclusions This study indicated that orofacial pain and its potential causes were frequently present in participants with MCI or dementia. Therefore, a regular oral examination by (oral) healthcare providers in people with MCI or dementia remains imperative, even if no pain is reported.
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Affiliation(s)
- Suzanne Delwel
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Erik J A Scherder
- Department of Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cees de Baat
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tarik T Binnekade
- Department of Clinical Neuropsychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johannes C van der Wouden
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Cees M P M Hertogh
- Department of General Practice & Elderly Care Medicine, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Roberto S G M Perez
- Department of Anesthesiology, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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21
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Lövgren A, Österlund C, Ilgunas A, Lampa E, Hellström F. A high prevalence of TMD is related to somatic awareness and pain intensity among healthy dental students. Acta Odontol Scand 2018; 76:387-393. [PMID: 29457522 DOI: 10.1080/00016357.2018.1440322] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Dental students have been identified as a group with high risks of developing both temporomandibular disorders (TMD) and psychosocial conditions. Our primary aim was to evaluate the cross-sectional prevalence of TMD diagnoses, as defined in the Diagnostic Criteria (DC)/TMD, among dental students. The secondary aim was to evaluate the prevalence and association of behavioural and psychosocial factors in relation to DC/TMD diagnoses. MATERIALS AND METHODS The study was conducted among undergraduate dental students during the second semester of their third year at the Department of Odontology, Medical Faculty, Umeå University, Sweden. Three consecutive cohorts were recruited during August in 2013, 2014, 2015. In total, 54 students were included and examined according the DC/TMD procedure. RESULTS AND CONCLUSIONS The prevalence of any DC/TMD diagnosis was 30%. The most prevalent TMD diagnosis was myalgia. Individuals with a TMD-pain diagnosis (i.e. myalgia or arthralgia) reported significantly higher pain intensity levels according to the Graded Chronic Pain Scale (GCPS) as compared to individuals without TMD-pain (Fisher's exact test p < .001, two-sided). In addition, individuals with any TMD scored significantly higher jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20, p < .001) and oral parafunctions according to the Oral Behavior Checklist (OBC, p = .005) as compared to individuals without TMD. The psychosocial factors evaluated did not differ between individual with or without a TMD diagnosis. The majority of the dental students reported symptoms that are already identified as risk factors for developing TMD and pain conditions. However, longitudinal data are needed to evaluate how this evolves over time.
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Affiliation(s)
- Anna Lövgren
- Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Catharina Österlund
- Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Aurelija Ilgunas
- Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Ewa Lampa
- Clinical Oral Physiology, Department of Odontology Faculty of Medicine, University of Umeå, Umeå, Sweden
| | - Fredrik Hellström
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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22
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Contreras EFR, Fernandes G, Ongaro PCJ, Campi LB, Gonçalves DAG. Systemic diseases and other painful conditions in patients with temporomandibular disorders and migraine. Braz Oral Res 2018; 32:e77. [DOI: 10.1590/1807-3107bor-2018.vol32.0077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 02/21/2018] [Indexed: 02/17/2023] Open
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23
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Osiewicz M, Manfredini D, Loster B, van Selms M, Lobbezoo F. Comparison of the outcomes of dynamic/static tests and palpation tests in TMD-pain patients. J Oral Rehabil 2018; 45:185-190. [DOI: 10.1111/joor.12600] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2017] [Indexed: 11/27/2022]
Affiliation(s)
- M.A. Osiewicz
- Department of Integrated Dentistry; Dental Institute; Faculty of Medicine; Jagiellonian University Medical College; Krakow Poland
| | - D. Manfredini
- School of Dentistry; University of Siena; Siena Italy
| | - B.W. Loster
- Department of Orthodontics; Dental Institute; Faculty of Medicine; Jagiellonian University Medical College; Krakow Poland
| | - M.K.A. van Selms
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
| | - F. Lobbezoo
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
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24
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Visscher CM, van Wesemael-Suijkerbuijk EA, Lobbezoo F. Is the experience of pain in patients with temporomandibular disorder associated with the presence of comorbidity? Eur J Oral Sci 2016; 124:459-464. [DOI: 10.1111/eos.12295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Corine M. Visscher
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; MOVE Research Institute Amsterdam; Amsterdam the Netherlands
| | - Erin A. van Wesemael-Suijkerbuijk
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; MOVE Research Institute Amsterdam; Amsterdam the Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; MOVE Research Institute Amsterdam; Amsterdam the Netherlands
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25
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Harper DE, Schrepf A, Clauw DJ. Pain Mechanisms and Centralized Pain in Temporomandibular Disorders. J Dent Res 2016; 95:1102-8. [PMID: 27422858 DOI: 10.1177/0022034516657070] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Until recently, most clinicians and scientists believed that the experience of pain is perceptually proportional to the amount of incoming peripheral nociceptive drive due to injury or inflammation in the area perceived to be painful. However, many cases of chronic pain have defied this logic, leaving clinicians perplexed as to how patients are experiencing pain with no obvious signs of injury in the periphery. Conversely, there are patients who have a peripheral injury and/or inflammation but little or no pain. What makes some individuals experience intense pain with minimal peripheral nociceptive stimulation and others experience minimal pain with serious injury? It is increasingly well accepted in the scientific community that pain can be generated and maintained or, through other mechanisms, suppressed by changes in the central nervous system, creating a complete mismatch between peripheral nociceptive drive and perceived pain. In fact, there is no known chronic pain condition where the observed extent of peripheral damage reproducibly engenders the same level of pain across individuals. Temporomandibular disorders (TMDs) are no exception. This review focuses on the idea that TMD patients range on a continuum-from those whose pain is generated peripherally to those whose pain is centralized (i.e., generated, exacerbated, and/or maintained by central nervous system mechanisms). This article uses other centralized chronic pain conditions as a guide, and it suggests that the mechanistic variability in TMD pain etiology has prevented us from adequately treating many individuals who are diagnosed with the condition. As the field moves forward, it will be imperative to understand each person's pain from its own mechanistic standpoint, which will enable clinicians to deliver personalized medicine to TMD patients and eventually provide relief in even the most recalcitrant cases.
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Affiliation(s)
- D E Harper
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - A Schrepf
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - D J Clauw
- Chronic Pain and Fatigue Research Center, Department of Anesthesiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
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26
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Chiarotto A, Clijsen R, Fernandez-de-las-Penas C, Barbero M. Prevalence of Myofascial Trigger Points in Spinal Disorders: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil 2016; 97:316-37. [DOI: 10.1016/j.apmr.2015.09.021] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 10/22/2022]
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27
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Kietrys DM, Palombaro KM, Mannheimer JS. Dry needling for management of pain in the upper quarter and craniofacial region. Curr Pain Headache Rep 2015; 18:437. [PMID: 24912453 DOI: 10.1007/s11916-014-0437-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Dry needling is a therapeutic intervention that has been growing in popularity. It is primarily used with patients that have pain of myofascial origin. This review provides background about dry needling, myofascial pain, and craniofacial pain. We summarize the evidence regarding the effectiveness of dry needling. For patients with upper quarter myofascial pain, a 2013 systematic review and meta-analysis of 12 randomized controlled studies reported that dry needling is effective in reducing pain (especially immediately after treatment) in patients with upper quarter pain. There have been fewer studies of patients with craniofacial pain and myofascial pain in other regions, but most of these studies report findings to suggest the dry needling may be helpful in reducing pain and improving other pain related variables such as the pain pressure threshold. More rigorous randomized controlled trials are clearly needed to more fully elucidate the effectiveness of dry needling.
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Affiliation(s)
- David M Kietrys
- Department of Rehabilitation and Movement Sciences, Rutgers, The State University of New Jersey, School of Health Related Professions, Stratford, NJ, USA,
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