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Nikolaos Z, Marcus G, Dimitrios N, Michail T, Dimitrios MD, Vasileios P. Instrumental Occlusal Analysis in Migraine Patients: A Quantitative Cross Sectional Study. Clin Exp Dent Res 2024; 10:e938. [PMID: 39039942 PMCID: PMC11263750 DOI: 10.1002/cre2.938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/01/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES This study aimed to investigate possible differences of functional occlusal variables between a group of migraine patients (MG) and a control group (CG). MATERIALS AND METHODS Each group included 50 individuals. Instrumental functional analysis and digital occlusal analysis were performed. Variables examined were condylar displacement from a reference position to maximum intercuspation; angular difference between the steepness of the articular eminence and the contra-lateral canine guidance; and angular difference between the steepness of the articular eminence and the ipsilateral central incisor guidance and occlusal plane inclination. Self-reported grinding and occlusal index were also investigated. RESULTS There were statistically significant differences in the extent of retral condylar displacement assessed both clinically [MG: 0.49 mm (SD 0.67 mm), CG: 0.29 mm (SD 0.27 mm), p = 0.012] and digital-mechanically [MG: 1.53 mm (SD 0.95 mm), CG: 0.9 mm (SD 0.66 mm), p = 0.001], the angular difference between the steepness of the articular eminence and the contra-lateral canine guidance [MG: 13.11° (SD 8.33°), CG: 9.47° (SD 7.08°), p = 0.021 and MG: 12.94° (SD 8.71°), CG: 9.44° (SD 8.70°), p = 0.017], and the occlusal plane inclination [MG: 11.16° (SD 4.66°), CG: 9.09° (SD 4.37°), p = 0.024]. Self-reported grinding (MG: 39/50, CG: 12/50, p < 0.001) and occlusal index [MG: 1.92 (SD 0.46), CG: 0.21 (SD 0.66), p < 0.001] were also significantly higher in migraineurs. CONCLUSIONS Articular and occlusal structures could play a role in migraine and thus should be considered in an interdisciplinary approach.
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Affiliation(s)
- Zokaris Nikolaos
- 251 Hellenic Air Force and VA Hospital, Department of ProsthodonticsAthensGreece
| | - Greven Marcus
- Medical University of Vienna, University Clinic of DentistryViennaAustria
| | | | - Tzakis Michail
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
| | - Mitsikostas Dimos Dimitrios
- School of Medicine, First Department of Neurology, Aeginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Psarras Vasileios
- School of Dentistry, Department of Orofacial PainNational and Kapodistrian University of AthensAthensGreece
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Dikilitaş A, Karaaslan F, Evirgen Ş, Ertuğrul AS, Kamburoğlu K. Evaluation of the effects of periodontal status according to 2017 classifications on oral health-related quality of life and quality of life-related to general health: A cross-sectional study. Int J Dent Hyg 2024; 22:672-680. [PMID: 37752817 DOI: 10.1111/idh.12753] [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: 07/16/2021] [Revised: 08/08/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND In patients with periodontal disease, various symptoms are observed along with inflammation. The impact of local and systemic inflammation on periodontal tissue is well-known; however, the impact of periodontal disease on the individual's quality of life is unclear. This study aimed to assess oral health-related and general health-related quality of life in patients undergoing maintenance treatment following treatment for periodontitis (RP-CPH), patients with gingivitis (G) and patients with Stage I periodontitis (SI-P) and to compare this with individuals with clinical periodontal health (IP-CPH). METHOD This study was comprised of cross-sectional periodontal assessment along with questionnaires. Oral health-related quality of life and general health-related quality of life were assessed using, respectively, the Oral Health Impact Profile-14 (OHIP-14) and Short-Form-36 (SF-36) questionnaires. Study participants were classified according to the classification of periodontal and peri-implant diseases and conditions established by the 2017 World Workshop. RESULTS The OHIP-14 total scores for the 166 study participants (age range: 22-57) of the G (11.61 ± 3.21) and SI-P (13.03 ± 3.47) groups were significantly higher than the OHIP-14 total scores of the IP-CPH (1.09 ± 1.58) and RP-CPH (2.95 ± 2.58) groups. SF-36 scores were found to be significantly lower in the SI-P group in all subgroups compared to the G and IP-CPH groups. CONCLUSIONS A correlation was found between early-stage periodontal disease and low levels of OHRQoL and GHRQoL. The health of periodontal tissues may have a positive effect on the quality of life.
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Affiliation(s)
- Ahu Dikilitaş
- Department of Periodontology, Faculty of Dentistry, Uşak University, Uşak, Turkey
| | - Fatih Karaaslan
- Department of Periodontology, Faculty of Dentistry, Uşak University, Uşak, Turkey
| | - Şehrazat Evirgen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Uşak University, Uşak, Turkey
| | - Abdullah Seçkin Ertuğrul
- Department of Periodontology, Faculty of Dentistry, İzmir Katip Çelebi University, İzmir, Turkey
| | - Kıvanç Kamburoğlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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3
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Naderi Y, Karami E, Chamani G, Amizadeh M, Rad M, Shabani M. Temporomandibular treatments are significantly efficient in improving otologic symptoms. BMC Oral Health 2023; 23:913. [PMID: 37996839 PMCID: PMC10666408 DOI: 10.1186/s12903-023-03627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
Symptoms of temporomandibular disorders (TMD) could be present as otologic symptoms like earache and dizziness in some patients. In most cases, these symptoms are not recognized because otolaryngologists fail to diagnose TMD as a source of the problem. This investigation was conducted to evaluate the effect of TMD treatments on the otologic symptoms which after taking history and clinical examinations seemed to be related to TMD. In the present study, the patients who were complaining of otalgia, ear fullness, tinnitus, hearing loss, and dizziness were evaluated by an ear fellow. Forty patients who had no known otologic or other primary causes to explain their symptoms, were referred to the orofacial pain clinic with the possible diagnosis of TMD. If the diagnosis was confirmed by an orofacial pain specialist, a combination of TMD treatments was administered to each case and the patients were followed up. The results showed that following implementation of treatment protocols for TMD, more than 50% of the patients reported complete or partial recovery in the second follow-up (p < 0.05). The most common otologic symptom of the referred cases was earache, and the most common associated complaint was neck pain. All the patients had one or more parafunctional habits. This study showed that TMD treatments were significantly efficient in improving otologic symptoms partially or completely and the authors concluded that for the patients with otolaryngologic unexplained symptoms, an overhaul examination is needed to assess TMD as a possible cause of the patient complaint. It is recommended that in cases with unexplained otologic symptoms, otolaryngologists care more about the neck trigger points (TP) and ask about the patient's parafunctional habits. Otolaryngologists and dentists need to be aware of the risk of developing otologic symptoms caused by these habits or cervical TPs.
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Affiliation(s)
- Yeganeh Naderi
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Elaheh Karami
- Department of Oral Medicine and Orofacial Pain, Kerman School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran
| | - Goli Chamani
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Scandinavian Center for Orofacial Neuroscience (SCON), Karolinska Institute, Huddinge, Sweden.
| | - Maryam Amizadeh
- Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Rad
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Shabani
- Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, 76198-13159, Iran.
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Dahl AF, Bergem AK, Bjørnland T, Olsen-Bergem H. Temporomandibular pain and quality of life assessment in adolescents in a Norwegian cohort. Clin Exp Dent Res 2023. [PMID: 37243420 DOI: 10.1002/cre2.733] [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: 01/03/2023] [Revised: 03/03/2023] [Accepted: 03/17/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE The objective was to examine the prevalence of pain from the face and temporomandibular joint (TMJ) and oral function in adolescents and contribute to more focus on this patient group. METHODS A total of 957 adolescents were included in this study, in age cohorts 18, 16, and 14, scheduled for a dental recall examination. Clinical data were collected as a part of the routine clinical examination. All participants also answered a survey. RESULTS Almost half of the participants had experienced facial pain in the last 3 months, headache being the most prevalent site reported. A significantly higher prevalence was found for females for all pain sites, and facial pain was significantly higher among the oldest. A reduced maximal incisal opening was significantly associated with higher reported facial/jaw pain, with increased mouth opening pain and chewing pain. Fifty-seven percent of the participants reported the use of nonprescription painkillers, highest among females, and in the oldest age cohort, mainly caused by nonfeverish headaches. General health was found to be negatively correlated to facial pain, headache, pain intensity, and duration, pain upon oral function, and oral movement, as well as the use of nonprescriptive drugs. Females in the older age group, experience less quality of life in general, as they felt more worried, anxious, lonely, and sad, compared to males. CONCLUSION Facial- and TMJ pain was higher in females, and higher with increasing age. Almost half of the participants had experienced facial pain in the last 3 months, headache being the most prevalent site reported. General health was found to be negatively correlated to facial pain.
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Affiliation(s)
| | - Anne K Bergem
- Psychiatric Division, The Norwegian Medical Association, Oslo, Norway
| | - Tore Bjørnland
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Heming Olsen-Bergem
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Lee IS, Kim SY. Effectiveness of manual therapy and cervical spine stretching exercises on pain and disability in myofascial temporomandibular disorders accompanied by headaches: a single-center cohort study. BMC Sports Sci Med Rehabil 2023; 15:39. [PMID: 36959659 PMCID: PMC10035158 DOI: 10.1186/s13102-023-00644-0] [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: 12/03/2022] [Accepted: 03/11/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Previous studies have demonstrated a relationship between headaches and temporomandibular disorders (TMDs). Moreover, recent studies have shown functional, anatomical, and neurological associations between the temporomandibular joint (TMJ) and upper cervical spine. This study aimed to investigate the effectiveness of manual therapy and cervical spine stretching exercises for pain and disability in patients with myofascial TMDs accompanied by headaches. METHODS Thirty-four patients recruited from Gyeryong Hospital with headaches and diagnosed with TMDs were randomly assigned to the experimental (n = 17) and control (n = 17) groups. Headache impact was assessed using the Korean Headache Impact Test-6. Masseter myofascial pain was measured using the visual analog scale, and TMJ pressure pain threshold levels were evaluated using an algometer. Neck pain intensity was assessed using the numerical rating scale. Once per week for 10 weeks, the experimental group received cervical spine-focused manual therapy and stretching exercises alongside conservative physical therapy, and the control group received conservative physical therapy alone. Patients were evaluated at baseline and 5 and 10 weeks post-intervention. RESULTS After the intervention, the experimental group exhibited significant reductions in the cervical kyphotic angle, Korean Headache Impact Assessment score, neck pain intensity, TMJ pain pressure threshold, Neck Disability Index score, and Jaw Functional Limitation Scale level compared with the control group (p < 0.01). CONCLUSION Manual therapy and stretching exercises could help resolve TMDs accompanied by headaches through biomechanical changes in the cervical spine. These findings may guide protocols and clinical trials involving manual therapy that align morphological structures.
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Affiliation(s)
- In-Su Lee
- Department of Physical Therapy, Graduate School, Daejeon University, Daejeon, Republic of Korea
| | - Suhn-Yeop Kim
- Department of Physical Therapy, College of Health and Medical Science, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, 34520, Republic of Korea.
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Beddis HP, Davies SJ. Relationships between tooth wear, bruxism and temporomandibular disorders. Br Dent J 2023; 234:422-426. [PMID: 36964364 DOI: 10.1038/s41415-023-5584-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 03/26/2023]
Abstract
This article will provide an overview of the diagnosis of common temporomandibular disorders (TMDs) and bruxism, along with their relevance in management of tooth wear. When assessing and managing a tooth wear case, the teeth should not be considered in isolation, but as part of the articulatory system, which has three inter-related elements: the teeth, the temporomandibular joints and the masticatory muscles. The presence/absence of bruxism and TMD are highly relevant, although there may not be a causal relationship between these. A consideration of TMD and bruxism, together with the potential impact these may have on the patient during and after any management of tooth wear, will form part of patient education and the informed consent process.
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Affiliation(s)
- Hannah P Beddis
- Restorative Department, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK.
| | - Stephen J Davies
- University of Manchester, TMD Clinic, Manchester University Dental School, Higher Cambridge Street, Manchester, M15 6FH, UK
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The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137974. [PMID: 35805650 PMCID: PMC9265370 DOI: 10.3390/ijerph19137974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.
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Yakkaphan P, Smith JG, Chana P, Renton T, Lambru G. Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis. CEPHALALGIA REPORTS 2022. [DOI: 10.1177/25158163221097352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Temporomandibular disorders (TMD) and headaches are prevalent among the global population. Patients often suffer from both conditions, and they are likely to be associated in a bidirectional way. However, the nature of the association remains unclear. Understanding the epidemiological aspects of the relationship between these conditions could have important clinical implications. Objective: To evaluate the prevalence of headaches in TMD patients as well as the prevalence of TMD in patients who suffer from headaches. Method: A systematic literature search was conducted using electronic databases. Studies published in English and those that used an acknowledged diagnostic criteria for TMD and headaches were included. Study quality was assessed using the Newcastle-Ottawa scale and meta-analyses were performed to generate pooled prevalence estimates. Result: Thirty-one studies met the selection criteria for the review; 16 studies evaluated the prevalence of headache in TMD patients and 15 studies evaluated the prevalence of TMD in headache patients. The included studies were of moderate-to-high quality. Meta-analyses revealed moderate-to-large heterogeneities across included studies. Pooled prevalence estimates from meta-analyses indicated similar rates of headaches in TMD patients and of TMD in headache patients (61.58%, 95% CI 45.26–76.66 and 59.42%, 95% CI 51.93–66.60, respectively). Migraines were more commonly observed in TMD patients (40.25%, 95% CI 35.37–45.23) compared to tension-type headaches (18.89%, 95% CI 12.36–26.44). The prevalence of headaches was particularly high in painful-TMD (82.80%, 95% CI 75.41–89.10). Conclusion: Despite large variance in prevalence rates across included studies, this review suggests headache and TMD frequently co-occur, particularly in the case of migraines and muscle related TMD. This association has important clinical, pathophysiological and therapeutic implications.
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Affiliation(s)
- Pankaew Yakkaphan
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London UK
| | - Jared G Smith
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Pav Chana
- Charles Clifford Dental Institute, Sheffield University Teaching Hospitals, Sheffield, UK
| | - Tara Renton
- Faculty of Dentistry, Oral & Craniofacial Science, King’s College London, London UK
| | - Giorgio Lambru
- The Headache Service, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK
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Association between primary headaches and temporomandibular disorders: A systematic review and meta-analysis. J Am Dent Assoc 2021; 153:120-131.e6. [PMID: 34649707 DOI: 10.1016/j.adaj.2021.07.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/02/2021] [Accepted: 07/21/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The primary objective of this systematic review was to answer the following question systematically: Is there any association between primary headaches (PHs) and temporomandibular disorders (TMDs) in adults? TYPES OF STUDIES REVIEWED The protocol was registered with the International Prospective Register of Systematic Reviews. The authors performed the search in 7 main databases and 3 gray literature sources. The included articles had to have adult samples. PHs must have been diagnosed using the International Classification of Headache Disorders, and TMDs must have been diagnosed using Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or International Classification of Orofacial Pain. Risk of bias was evaluated using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument tools. The meta-analysis was performed using Review Manager software, Version 5.4. Certainty of evidence was screened according to Grading of Recommendations Assessment, Development and Evaluation. RESULTS Eight of 2,574 articles reviewed met the inclusion criteria for qualitative analysis and, of these, 6 met the inclusion criteria for quantitative analysis. Odds ratios (ORs) for painful TMD and tension-type headache (OR, 3.16; 95% CI, 1.80 to 5.54 to OR, 13.06; 95% CI, 2.79 to 61.12), migraines (OR, 5.35; 95% CI, 3.04 to 9.40 to OR, 6.22; 95% CI, 3.81 to 10.14), and chronic headaches (OR, 40.40; 95% CI, 8.67 to 188.15 to OR, 95.93; 95% CI, 12.53 to 734.27) were calculated. Articular TMDs without pain were evaluated in only 1 article, in which ORs of 1.78 (95% CI, 0.90 to 3.51) for migraines and 1.04 (95% CI, 0.53 to 2.06) for tension-type headache were reported. Three studies were classified as moderate risk of bias and 5 as low risk of bias. The certainty of evidence varied between very low and low. CONCLUSIONS AND PRACTICAL IMPLICATIONS Recognizing the positive association between painful TMD and PHs can help dentists and physicians treat the pain and avoid it, or recommend the patient to a specialist.
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Ashraf J, Närhi M, Suominen AL, Saxlin T. Association of temporomandibular disorder-related pain with severe headaches-a Bayesian view. Clin Oral Investig 2021; 26:729-738. [PMID: 34224000 PMCID: PMC8791898 DOI: 10.1007/s00784-021-04051-y] [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: 04/30/2021] [Accepted: 06/22/2021] [Indexed: 12/04/2022]
Abstract
Objectives Association of temporomandibular disorders (TMD)-related pain with severe headaches (migraine and tension-type headaches [TTH]) was studied over a follow-up period of 11 years. Materials and methods The data used was from two nationally representative health surveys in Finland—the Health 2000 Survey (baseline) and the Health 2011 Survey (follow-up) (Bioresource Research Impact Factor [BRIF] 8901)—conducted by the Finnish Institute for Health and Welfare (THL). The primary dataset of the current study included a subset of the population undergoing a clinical oral examination, including TMD examination, at baseline, and answering the questions related to severe headaches, both at baseline and at follow-up (n = 530). From the primary dataset, two datasets were created to study the onset of migraine (dataset 1) and TTH (dataset 2) separately. Dataset 1 included participants healthy of migraine, but not other headaches, at baseline (n = 345), and dataset 2 participants healthy of TTH and other headaches, except migraine, at baseline (n = 464). Bayesian logistic regression models with weakly informative priors were utilized to assess the association of muscle-related TMD pain (mTMD) at baseline and temporomandibular joint-related TMD pain (jTMD) at baseline with the presence of migraine and TTH at follow-up. Results Neither of the baseline TMD-related pain variables were associated with the presence of migraine at follow-up (posterior effect estimates-0.12, 95% credible interval [CI] -0.49–0.24, and 0.11, 95% CI -0.38–0.59, for mTMD and jTMD, respectively), whereas mTMD at baseline (posterior effect estimate 0.36, 95% CI 0.02–0.69), but not jTMD at baseline (posterior effect estimate -0.32, 95% CI -0.94–0.25), was associated with the presence of TTH at follow-up. Bayesian sensitivity analyses revealed that the estimates of the regression models were stable, demonstrating sufficient validity and consistency of the estimates. Conclusion These results indicate that diverse mechanisms may exist behind the associations of TMD-related painful conditions with different types of severe headaches. Clinical relevance TMD-related pain is a frequent comorbidity of severe primary headaches. Therapy of severe primary headaches may thus benefit significantly with the incorporation of a multi-disciplinary clinical team.
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Affiliation(s)
- Javed Ashraf
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Matti Närhi
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Department of Public Health and Welfare, the Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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11
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Ashraf J, Närhi M, Suominen AL, Zaproudina N, Saxlin T. Temporomandibular-disorder-related pain as a predictor of severe headaches. Community Dent Oral Epidemiol 2021; 50:206-215. [PMID: 33961319 DOI: 10.1111/cdoe.12654] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The current study aimed to investigate the association of temporomandibular disorders (TMD)-related pain with the presence of migraine or tension-type headaches (TTH) over a follow-up period of 11 years. METHODS Data sets from Finnish national health surveys, the Health 2000 Survey (baseline), and the Health 2011 Survey (follow-up) were utilized. Study participants are undergoing clinical TMD examination at baseline and answering questions related to the presence of migraine and TTH at follow-up were included in the study (n = 530). For analyses, the study sample was divided into two data sets: One with those excluded suffering from migraine at baseline (Data set I, n = 345), and the other excluding those having TTH at baseline (Data set II, n = 464). RESULTS Based on logistic regression modelling, no consistent association between TMD-related pain and the presence of migraine was observed, although jTMD associated with elevated estimates for migraine. However, participants with muscle-related TMD pain (mTMD) at baseline had markedly higher odds for having TTH at follow-up than participants without mTMD at baseline (OR 2.1, 95% CI 1.2-3.8). Joint-related TMD pain (jTMD) at baseline was inversely associated with the presence of TTH at follow-up (OR 0.4, 95% CI 0.1-1.3). CONCLUSION Contrasting patterns of the associations of TMD-related pain with different severe headaches point towards a more thorough and systematic research approach are needed to understand the mechanisms behind these associations.
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Affiliation(s)
- Javed Ashraf
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Matti Närhi
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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12
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Sadrabad MJ, Ameli N, Kianpour M, Ghorbani R, Sohanian S. The relationship of temporomandibular disorders with Class II malocclusion as a risk factor. APOS TRENDS IN ORTHODONTICS 2021. [DOI: 10.25259/apos_153_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The temporomandibular joints (TMJs) play a fundamental role in mastication, deglutition, speech, and even respiration. Thus, temporomandibular disorders (TMDs) can affect the quality of life, especially if they become chronic. Considering the controversy regarding the etiology of the TMDs, this study aimed to assess the relationship of TMDs with dental malocclusion.
Materials and Methods:
Totally, 885 dentate patients between 18 years and 60 years with complete dental records and no condylar ankylosis, history of trauma, bruxism, clenching, or congenital TMJ anomalies participated in this study. Tenderness on palpation, clicking, crepitus, pain, deviation on mouth opening, open bite, deep bite, cross bite, and class of malocclusion (I, II or III) were recorded for all patients.
Results:
Of patients, 60.2% were males and 39.8% were females. Gender had no correlation with TMDs. Patients had a mean age of 34.8 years. Age had no correlation with TMDs. Of TMD symptoms, clicking had the highest frequency (23.3%) followed by deviation on mouth opening (10.6%), pain at the mouth opening (2.9%), tenderness on palpation (1.4%), trismus (1.2%), and crepitus (1.1%). Of patients, 76.7% were Class I, 13.8% were Class II, and 6.2% were Class III. Less than 2% of patients had deep bite, open bite, or cross bite.
Conclusion:
TMDs had a relatively high prevalence (35%) in our study population. Age, gender, and class of malocclusion had no correlation with TMDs; however, Class II malocclusion was slightly more prevalent among TMD patients, which needs to be taken into account by patients and orthodontists.
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Affiliation(s)
- Maryam Jalili Sadrabad
- Department of Oral Medicine, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
| | - Nazila Ameli
- Department of Orthodontics, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
| | - Mahnoosh Kianpour
- Department of Student Research Committee, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
| | - Raheb Ghorbani
- Department of Epidemiology and Statistics, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
- Social Determinants of Health Research Center, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
| | - Shabnam Sohanian
- Department of Oral and Maxillofacial Pathology, Dental School, Semnan University of Medical Sciences, Semnan, Iran,
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Temporomandibular Disorders Slow Down the Regeneration Process of Masticatory Muscles: Transcriptomic Analysis. ACTA ACUST UNITED AC 2021; 57:medicina57040354. [PMID: 33916982 PMCID: PMC8067552 DOI: 10.3390/medicina57040354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Musculoskeletal injuries represent a pathological condition due to limited joint motility and morphological and functional alterations of the muscles. Temporomandibular disorders (TMDs) are pathological conditions due to alterations in the musculoskeletal system. TMDs mainly cause temporomandibular joint and masticatory muscle dysfunctions following trauma, along with various pathologies and inflammatory processes. TMD affects approximately 15% of the population and causes malocclusion problems and common symptoms such as myofascial pain and migraine. The aim of this work was to provide a transcriptomic profile of masticatory muscles obtained from TMD migraine patients compared to control. Materials and Methods: We used Next Generation Sequencing (NGS) technology to evaluate transcriptomes in masseter and temporalis muscle samples. Results: The transcriptomic analysis showed a prevalent downregulation of the genes involved in the myogenesis process. Conclusions: In conclusion, our findings suggest that the muscle regeneration process in TMD migraine patients may be slowed, therefore therapeutic interventions are needed to restore temporomandibular joint function and promote healing processes.
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Mnguni N, Olivier B, Mosselson J, Mudzi W. Prevalence of concurrent headache and temporomandibular disorders: a systematic review protocol. JBI Evid Synth 2020; 19:263-269. [PMID: 32740034 DOI: 10.11124/jbisrir-d-19-00255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to determine the concurrent prevalence of temporomandibular disorders and headaches in patients. INTRODUCTION Temporomandibular disorders affect the temporomandibular joint and associated orofacial structures. It is the second-most common musculoskeletal disorder experienced by adults. Headache is one of the most pervasive neurological disorders and can be an extremely disabling condition. Temporomandibular disorders and headache are known to often occur simultaneously and have a bi-directional relationship due to their close anatomical association. INCLUSION CRITERIA The systematic review will include all studies with adult participants (>18 years) experiencing headaches (migraine, migraine with/without aura, tension-type, cervicogenic, and chronic headache) with symptoms of temporomandibular disorders occurring concurrently. METHODS An initial search of PubMed will be followed by CINAHL, the Cochrane Central Register of Controlled Trials in the Cochrane Library, EBSCO MasterFILE Premier, PEDro, ProQuest Health and Medical Complete, Science Direct, and Scopus. Titles and abstracts of studies will be reviewed, and full text articles will be selected if the inclusion criteria are met. Studies that meet the eligibility criteria will then be assessed by two independent reviewers. Full-text articles will be selected if the inclusion criteria are met. A standardized critical appraisal checklist for studies reporting prevalence data will be used to assess methodological quality and a standardized data extraction tool will be used. The results from the included studies will be analyzed using JBI SUMARI software. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42019139689).
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Affiliation(s)
- Nkazimulo Mnguni
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Benita Olivier
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,The Wits-JBI Centre for Evidenced-Based Practice: A JBI Affiliated Group, Johannesburg, South Africa
| | - Jackie Mosselson
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Witness Mudzi
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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15
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Sekulić S, John MT, Davey C, Rener-Sitar K. Association Between Oral Health-Related and Health-Related Quality of Life. Zdr Varst 2020; 59:65-74. [PMID: 32952705 PMCID: PMC7478079 DOI: 10.2478/sjph-2020-0009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/06/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate the correlation between the four dimensions of Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL) constructs in a dental patient population. METHODS A cross-sectional study carried out at HealthPartners, Minnesota, USA. This study is a secondary data analysis of available adult dental patients' data. The instruments used to assess the OHRQoL and HRQoL constructs were the Oral Health Impact Profile-version with 49 items (OHIP-49) and Patient-Reported Outcome Measures Information System (PROMIS) measures v.1.1 Global Health instruments Patient Reported Outcome Measures (PROMs), respectively. We used Structural Equation Modeling to determine the correlation between OHRQoL and HRQoL. RESULTS Two thousand and seventy-six dental patients participated in the study. OHRQoL and HRQoL scores correlated with 0.56 (95%CI:0.52-0.60). The OHRQoL and Physical Health dimension of HRQoL correlated with 0.55 (95%CI:0.51-0.59). The OHRQoL and Mental Health dimension of HRQoL correlated with 0.51 (95%CI:0.47-0.55). When adjusted for age, gender, and depression, the correlation coefficients changed only slightly and resulted in 0.52 between OHRQoL and HRQoL Physical Health, and 0.47 between OHRQoL and HRQoL Mental Health. Model fit statistics for all analyses were adequate and indicated a good fit. CONCLUSIONS OHRQoL and HRQoL overlap greatly. For dental practitioners, the OHRQoL score is informative for their patients' general health status and vice versa. Study results indicate that effective therapeutic interventions by dentists improve patients' OHRQoL as well as HRQoL.
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Affiliation(s)
- Stella Sekulić
- Department of Prosthetic Dentistry, Dental Division, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000Ljubljana, Slovenia
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, USA
| | - Mike T. John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, USA
| | - Cynthia Davey
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, USA
| | - Ksenija Rener-Sitar
- Department of Prosthetic Dentistry, Dental Division, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000Ljubljana, Slovenia
- Department of Prosthodontics, University Dental Clinics, University Medical Center Ljubljana, Ljubljana, Slovenia
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16
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Bianchi J, de Oliveira Ruellas AC, Gonçalves JR, Paniagua B, Prieto JC, Styner M, Li T, Zhu H, Sugai J, Giannobile W, Benavides E, Soki F, Yatabe M, Ashman L, Walker D, Soroushmehr R, Najarian K, Cevidanes LHS. Osteoarthritis of the Temporomandibular Joint can be diagnosed earlier using biomarkers and machine learning. Sci Rep 2020; 10:8012. [PMID: 32415284 PMCID: PMC7228972 DOI: 10.1038/s41598-020-64942-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/21/2020] [Indexed: 12/26/2022] Open
Abstract
After chronic low back pain, Temporomandibular Joint (TMJ) disorders are the second most common musculoskeletal condition affecting 5 to 12% of the population, with an annual health cost estimated at $4 billion. Chronic disability in TMJ osteoarthritis (OA) increases with aging, and the main goal is to diagnosis before morphological degeneration occurs. Here, we address this challenge using advanced data science to capture, process and analyze 52 clinical, biological and high-resolution CBCT (radiomics) markers from TMJ OA patients and controls. We tested the diagnostic performance of four machine learning models: Logistic Regression, Random Forest, LightGBM, XGBoost. Headaches, Range of mouth opening without pain, Energy, Haralick Correlation, Entropy and interactions of TGF-β1 in Saliva and Headaches, VE-cadherin in Serum and Angiogenin in Saliva, VE-cadherin in Saliva and Headaches, PA1 in Saliva and Headaches, PA1 in Saliva and Range of mouth opening without pain; Gender and Muscle Soreness; Short Run Low Grey Level Emphasis and Headaches, Inverse Difference Moment and Trabecular Separation accurately diagnose early stages of this clinical condition. Our results show the XGBoost + LightGBM model with these features and interactions achieves the accuracy of 0.823, AUC 0.870, and F1-score 0.823 to diagnose the TMJ OA status. Thus, we expect to boost future studies into osteoarthritis patient-specific therapeutic interventions, and thereby improve the health of articular joints.
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Affiliation(s)
- Jonas Bianchi
- University of Michigan, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Ann Arbor, MI, 48109, USA.
- São Paulo State University (UNESP), Department of Pediatric Dentistry, School of Dentistry, Araraquara, SP, 14801-385, Brazil.
| | | | - João Roberto Gonçalves
- São Paulo State University (UNESP), Department of Pediatric Dentistry, School of Dentistry, Araraquara, SP, 14801-385, Brazil
| | | | - Juan Carlos Prieto
- University of North Carolina, Department of Psychiatry and Computer Science, Chapel Hill, NC, 27516, USA
| | - Martin Styner
- University of North Carolina, Department of Psychiatry and Computer Science, Chapel Hill, NC, 27516, USA
| | - Tengfei Li
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, 27516, USA
| | - Hongtu Zhu
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC, 27516, USA
| | - James Sugai
- University of Michigan, Department of Periodontics and Oral Medicine, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - William Giannobile
- University of Michigan, Department of Periodontics and Oral Medicine, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Erika Benavides
- University of Michigan, Department of Periodontics and Oral Medicine, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Fabiana Soki
- University of Michigan, Department of Periodontics and Oral Medicine, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Marilia Yatabe
- University of Michigan, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - Lawrence Ashman
- University of Michigan, Department of Oral and Maxillofacial Surgery and Hospital Dentistry, School of Dentistry, Ann Arbor, MI, 48109, USA
| | - David Walker
- University of North Carolina, Department of Orthodontics, Chapel Hill, NC, 27516, USA
| | - Reza Soroushmehr
- University of Michigan, Center for Integrative Research in Critical Care and Michigan Institute for Data Science, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI, 48109, USA
| | - Kayvan Najarian
- University of Michigan, Center for Integrative Research in Critical Care and Michigan Institute for Data Science, Department of Computational Medicine and Bioinformatics, Ann Arbor, MI, 48109, USA
| | - Lucia Helena Soares Cevidanes
- University of Michigan, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Ann Arbor, MI, 48109, USA
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17
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Prevalence of Temporomandibular Disorder in Turkish University Students: a Questionnaire Study. BALKAN JOURNAL OF DENTAL MEDICINE 2019. [DOI: 10.2478/bjdm-2019-0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Summary
Background/Aim: Temporomandibular dysfunction (TMD) might influence any individual with different signs and symptoms irrespective of gender or age. The aim of this study is to assess the prevalence of TMD in Oral and Dental Health Program students of İstanbul University-Cerrahpaşa.
Material and Methods: This study include a sample of 486 students with age ranging from18 to 24 years. The presence and severity of TMD was evaluated using the Fonseca’s Anamnestic Index (FAI) and its questionnaire. The data were analysed using SPSS Version 22. The chisquare test was used to compare the data from different groups and to determine whether the differences were statistically significant.
Results: The results showed that a total of 47,53% of students had some degree of TMD and females were generally more affected than males. These degrees were as follows: 33,95 % were classified as mild, 11,52 % moderate and 2,05 % severe signs and symptoms. The women exhibited some degree of TMD (51,8%) at a higher frequency than men (40,33%). No significant differences were observed between gender for a same TMD severity degree (p>0.05).
Conclusions: A high prevalence of mild TMD was found in this study population. In addition, tense personalities, headaches, and temporomandibular joint (TMJ) sounds were the most prevalent findings of TMD. The present study suggests that Fonseca’s Anamnestic Index (FAI) has been used in screening for TMD for prevention and management of TMD in a non-patient young population.
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18
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Arbex G, Teixeira VP, Moriyama CM, Andrade de Paula E, Santos EM, Bussadori SK. Temporomandibular disorder and headache in university professors. J Phys Ther Sci 2019; 31:217-222. [PMID: 30936634 PMCID: PMC6428655 DOI: 10.1589/jpts.31.217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/10/2018] [Indexed: 11/29/2022] Open
Abstract
[Purpose] Temporomandibular disorder is a condition with a multifactor etiology that
involves the temporomandibular joint, bones, surrounding muscles and facial pain is the
most common symptom. This study evaluated the possible association between headache and
temporomandibular disorder in university professors. [Participants and Methods]
Twenty-seven professors were recruited and answered the Axis II of the Research Diagnostic
Criteria for Temporomandibular Disorders for the evaluation and diagnosis of
temporomandibular disorder and filled out a “Headache Diary” proposed by the American
Headache Society. [Results] The university professors showed headache and
temporomandibular disorder, but no association was found between the two conditions.
Comparing the gender, the males were most frequently affected, but females had more
intensity of signs and symptoms. There is a lack of data on the population addressed in
the present study. [Conclusion] Indeed, this was the first such study developed with
university professors. It is of considerable importance to develop further studies to
investigate the possible association between headache and temporomandibular disorder.
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Affiliation(s)
- Gabriella Arbex
- School of Dentistry, Metropolitana de Santos University, São Paulo, Brazil
| | | | | | | | | | - Sandra Kalil Bussadori
- School of Dentistry, Metropolitana de Santos University, São Paulo, Brazil.,Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho: Vergueiro Street, 235/249 Liberdade, 01504000, São Paulo, SP, Brazil
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19
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Christidis N, Lindström Ndanshau E, Sandberg A, Tsilingaridis G. Prevalence and treatment strategies regarding temporomandibular disorders in children and adolescents-A systematic review. J Oral Rehabil 2019; 46:291-301. [PMID: 30586192 DOI: 10.1111/joor.12759] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 11/12/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022]
Abstract
AIMS Temporomandibular disorders (TMD) in children/adolescents are very common. Yet, there is a lack of consensus regarding which clinical interventions are appropriate. The aim of this systematic review was to gather and assess the quality of the available literature on the prevalence and evidence-based treatment strategies in children and adolescents suffering from TMD. METHODS A systematic literature review was conducted including articles from 1992 to 2016. A total of 2293 articles were found. Eight were included, six regarding prevalence and two regarding treatment. Simple or multiple conjunctions of different search words: "temporomandibular disorder", "temporomandibular joint disorder", "prevalence", "children" "adolescents", "occlusal appliance", "jaw exercise" and "relaxation" were used on the databases PubMed and Web of Science. Inclusion criteria were (a) scientific articles or randomised controlled clinical trials evaluating prevalence, choice of therapy and treatment outcome for children and/or adolescents with TMD published in Swedish or English and (b) a TMD diagnosis according to the Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. RESULTS Prevalence (ages 10-19 years) varied between 7.3 and 30.4%, and the most common diagnoses were myofascial pain and anterior disc displacement with reduction. Only two articles were found regarding treatment in adolescents (ages 12-18 years). The stabilising occlusal appliance had superior treatment outcome compared to relaxation therapy or brief information. CONCLUSION The general absence of standardised studies concerning children/adolescents with TMD pain states the evident need for further systematic prevalence and treatment evaluations. Considering this, it is not possible to achieve any evidence-based treatment strategies or guidelines for children and adolescents with TMD.
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Affiliation(s)
- Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Elisande Lindström Ndanshau
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Amanda Sandberg
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Georgios Tsilingaridis
- Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Center of Pediatric Oral Health, Stockholm, Sweden
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20
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Hunter EK. Integration of Rehabilitation and Acupuncture in the Treatment of a Professional Musician with Temporomandibular Joint Dysfunction. Acupunct Med 2018; 29:298-301. [DOI: 10.1136/aim.2010.003889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This case study describes the use of acupuncture in a professional musician with myogenic temporomandibular dysfunction. The 3-year history of symptoms was associated with persistent episodic tension-type headaches. Acupuncture was used for trigger point release, primarily of the masticatory muscles, in conjunction with exercise therapy. After 8 weekly acupuncture sessions, the patient's pain had completely resloved, headaches had resolved and the Patient-Specific Functional Scale showed significant improvements.
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21
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Calixtre LB, Oliveira AB, de Sena Rosa LR, Armijo-Olivo S, Visscher CM, Alburquerque-Sendín F. Effectiveness of mobilisation of the upper cervical region and craniocervical flexor training on orofacial pain, mandibular function and headache in women with TMD. A randomised, controlled trial. J Oral Rehabil 2018; 46:109-119. [DOI: 10.1111/joor.12733] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/30/2018] [Accepted: 09/26/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Letícia B. Calixtre
- Laboratory of Clinical and Occupational Kinesiology (LACO); Department of Physical Therapy; Federal University of São Carlos (UFSCar); São Carlos Brazil
| | - Ana Beatriz Oliveira
- Laboratory of Clinical and Occupational Kinesiology (LACO); Department of Physical Therapy; Federal University of São Carlos (UFSCar); São Carlos Brazil
| | - Lianna Ramalho de Sena Rosa
- Laboratory of Clinical and Occupational Kinesiology (LACO); Department of Physical Therapy; Federal University of São Carlos (UFSCar); São Carlos Brazil
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine; University of Alberta; Edmonton Alberta Canada
- Institute of Health Economics; Edmonton Alberta Canada
| | - Corine M. Visscher
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit Amsterdam; Amsterdam The Netherlands
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22
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Vivaldi D, Di Giosia M, Tchivileva IE, Jay GW, Slade GD, Lim PF. Headache attributed to TMD Is Associated With the Presence of Comorbid Bodily Pain: A Case-Control Study. Headache 2018; 58:1593-1600. [DOI: 10.1111/head.13404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 06/24/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Daniela Vivaldi
- Department of Endodontics and Department of Dental Ecology, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | | | - Inna E. Tchivileva
- Department of Endodontics, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | - Gary W. Jay
- Department of Neurology, School of Medicine; UNC-CH; Chapel Hill NC USA
| | - Gary D. Slade
- Department of Dental Ecology, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | - Pei F. Lim
- Department of Endodontics, School of Dentistry; UNC-CH; Chapel Hill NC USA
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23
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Kocaman G, Kahraman N, Köseoğlu BG, Bilgiç B, Matur Z, Ertaş M, Gülşen Y, Baykan Baykal B. Evaluation of OnabotulinumtoxinA Treatment in Patients with Concomitant Chronic Migraine and Temporomandibular Disorders. ACTA ACUST UNITED AC 2018; 55:330-336. [PMID: 30622389 DOI: 10.5152/npa.2017.19257] [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] [Received: 07/18/2016] [Accepted: 12/08/2016] [Indexed: 11/22/2022]
Abstract
Introduction Migraine and temporomandibular disorders (TMD) are both common diseases and TMD are reported as a risk factor in migraine progression. OnabotulinumtoxinA is used in the treatment of chronic migraine (CM), and also has a potential role in TMD treatment. In this study, it is aimed to compare the efficacy of onabotulinumtoxinA treatment in CM patients with and without TMD. Methods In this retrospective study, 30 CM patients (age range: 18-65 years), satisfying the inclusion and follow-up criteria in their medical records were investigated. The PREEMPT injection protocol was taken as reference and onabotulinumtoxinA 155-195 U with fixed-dose has been administered into 31 specific sites within the head/neck muscles in included subjects. Two cycles of treatment were assessed in all patients at the baseline and 12 weeks later. The headache diaries, which were completed routinely one month before, and during 6 months follow-up after the treatment, were assessed. The effect of onabotulinumtoxinA treatment was compared between CM patients with and without TMD/bruxism. Results Of 30 female patients, 17 had concomitant TMD. In week 24, there were significant improvement in the groups with and without TMD regarding to the mean change of frequencies in the days with migraine compared to the initial findings (p<0.001). However, there was no significant difference between the two groups. Conclusions OnabotulinumtoxinA is an effective and safe treatment for CM. Its efficacy appears to be similar in CM patients with and without TM, speculating that the comorbidity of TMD did not play a role for the treatment response.
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Affiliation(s)
- Gülşen Kocaman
- Department of Neurology, Bezmialem Vakıf University, Faculty of Medicine, İstanbul, Turkey
| | - Neşe Kahraman
- Department of Maxillofacial Surgery, İstanbul University, İstanbul Faculty of Dentistry, İstanbul, Turkey
| | - Banu Gürkan Köseoğlu
- Department of Maxillofacial Surgery, İstanbul University, İstanbul Faculty of Dentistry, İstanbul, Turkey
| | - Başar Bilgiç
- Department of Neurology, İstanbul University, İstanbul Medical Faculty, İstanbul, Turkey
| | - Zeliha Matur
- Department of Neurology, İstanbul Bilim University, Faculty of Medicine, İstanbul, Turkey
| | | | - Yeşim Gülşen
- Department of Neurology, İstanbul University, İstanbul Medical Faculty, İstanbul, Turkey
| | - Betül Baykan Baykal
- Department of Neurology, İstanbul University, İstanbul Medical Faculty, İstanbul, Turkey
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24
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Alkhudhairy MW, Al Ramel F, Al Jader G, Al Saegh L, Al Hadad A, Alalwan T, Al Shaikh D, Al Bandar M. A Self-Reported Association between Temporomandibular Joint Disorders, Headaches, and Stress. J Int Soc Prev Community Dent 2018; 8:371-380. [PMID: 30123773 PMCID: PMC6071353 DOI: 10.4103/jispcd.jispcd_177_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/30/2018] [Indexed: 12/15/2022] Open
Abstract
AIMS AND OBJECTIVES Temporomandibular joint disorder (TMD) is an umbrella term for a number of conditions in the area of the joint, temple, and masticatory system. Many of those with TMD also suffer from headaches and anxiety. The aims and objectives of this study were to determine if there exists an association between the Diagnostic Criteria of TMD (DC/TMD) symptom questionnaire and report of headaches as well as stress. MATERIALS AND METHODS A cross-sectional study was implemented via the use of the DC/TMD symptom questionnaire and the perceived stress scale (PSS). This was distributed conveniently among dental students in a multi-dental school setting in Riyadh, Saudi Arabia, and was completed by 152 dental students. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05. RESULTS Those who ticked yes for pain on the TMD pain screener for pain with chewing hard or tough food, pain on mouth opening and lateral excursion, and pain with jaw habits as parafunction were at an odds risk from twice to thrice as likely to experience headaches. Similarly, those with poor coping skills on the PSS were more likely to have headaches (P = 0.002). Likewise, positive answers on the screener and symptom questionnaire were relevant with higher stress scores on the PSS. CONCLUSION This study clarifies and reiterates the intertwined power of both stress and headaches; the former being a role player in TMD progression and the latter its product. TMD is unfortunately on the rise; it should not be brushed off as a nuisance. A multidisciplinary approach in diagnosis and treatment of both TMD and headaches by a team of orofacial pain specialist, neurologist, psychiatrist and/or psychologist, and physical therapists to untangle the deceiving presentation of both conditions would not only provide a more favorable prognosis but also improve cost and time expenditures.
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Affiliation(s)
- May Wathiq Alkhudhairy
- Department of Diagnostic Sciences and Oral Maxillofacial Surgery, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Fatima Al Ramel
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Ghufran Al Jader
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Layla Al Saegh
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Areej Al Hadad
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Tumadhir Alalwan
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Dhuha Al Shaikh
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
| | - Malak Al Bandar
- Dental Interns, Riyadh Elm University (formerly Riyadh Colleges of Dentistry and Pharmacy), Riyadh, Saudi Arabia
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25
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Bruno MAD, Krymchantowski AV. Amitriptyline and intraoral devices for migraine prevention: a randomized comparative trial. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:213-218. [PMID: 29742243 DOI: 10.1590/0004-282x20180023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Nonpharmacological treatments, such as the Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss), are approved for migraine prophylaxis. We aimed at evaluating the effectiveness of the NTI-tss and to compare its efficacy with amitriptyline and with a sham intraoral device in the preventive treatment of migraine. METHODS Consecutive patients with migraine were randomized to receive 25 mg of amitriptyline/day (n = 34), NTI-tss (n = 33) and a non-occlusal splint (n = 30). The headache frequency was evaluated at six and 12 weeks. RESULTS The amitriptyline group showed, respectively, 60% and 64% reduction in attack frequency at six and 12 weeks (P = 0.000). In the NTI-tss and non-occlusal splint groups, reduction was 39% and 30%, respectively, at six weeks and 48% for both groups at 12 weeks. CONCLUSIONS Amitriptyline proved superior to the NTI-tss and the non-occlusal splint. Despite its approval by the United States Food and Drug Administration, the NTI-tss was not superior to a sham device.
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Affiliation(s)
- Marco A D Bruno
- Departamento de Neurologia, Universidade Federal Fluminense, Niterói, RJ, Brasil
| | - Abouch V Krymchantowski
- Centro de Avaliação e Tratamento da Dor de Cabeça do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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26
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Temporal change in headache and its contribution to the risk of developing first-onset temporomandibular disorder in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study. Pain 2017; 158:120-129. [PMID: 27984525 DOI: 10.1097/j.pain.0000000000000737] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
While cross-sectional studies have demonstrated an association between headache and temporomandibular disorder (TMD), whether headache can predict the onset of TMD is unknown. The aims of this study were to evaluate the contribution of headache to the risk of developing TMD and describe patterns of change in headache types over time. An initially TMD-free cohort of 2410 persons with low frequency of headache completed quarterly questionnaires assessing TMD and headache symptoms over a median 3.0-year follow-up period. First-onset TMD was confirmed by clinical examination in 199 participants. Baseline reports of migraine (hazard ratio [HR] = 1.67, 95% confidence interval [CI]: 1.06-2.62) or mixed headache types (HR = 4.11, 95% CI: 1.47-11.46), or headache frequency (HR = 2.13, 95% CI: 1.31-3.48) predicted increased risk of developing TMD. In addition, headache dynamics across the follow-up period before the TMD onset were evaluated in a nested case-control study where 248 incident TMD cases were matched to 191 TMD-free controls. Both headache prevalence and frequency increased across the observation period among those who developed TMD but not among controls. Patients with TMD were more likely to experience worsening in the headache type compared with that by controls, eg, prevalence of definite migraine among TMD cases increased 10-fold. Among all headache types experienced by patients with TMD before the TMD onset, migraine had the highest odds of progression relative to remission (odds ratio = 2.8, 95% CI: 1.6-4.8), whereas for controls this ratio was significant only for the tension-type headache (odds ratio = 2.1, 95% CI: 1.2-3.9). The important clinical implication of these findings is that adequate treatment of migraine may reduce the risk for developing TMD.
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27
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Abstract
Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship.
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Affiliation(s)
- Steven B Graff-Radford
- The Pain Center, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard #1101, Los Angeles, CA 90048, USA; The Program for Headache and Orofacial Pain, Cedars-Sinai Medical Center, Los Angeles, CA, USA; UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Jeremy J Abbott
- West Coast Ear, Nose & Throat Medical Group, 301 South Moorpark Road, Thousand Oaks, CA 91361, USA
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28
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Di Paolo C, D'Urso A, Papi P, Di Sabato F, Rosella D, Pompa G, Polimeni A. Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients. Pain Res Manag 2017; 2017:3203027. [PMID: 28420942 PMCID: PMC5379086 DOI: 10.1155/2017/3203027] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/14/2017] [Indexed: 12/25/2022]
Abstract
Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.
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Affiliation(s)
- Carlo Di Paolo
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Anna D'Urso
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Piero Papi
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Francesco Di Sabato
- Department of Clinical Medicine, Headache Center, “Sapienza” University of Rome, Rome, Italy
| | - Daniele Rosella
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
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29
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Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:288-297. [DOI: 10.1016/j.oooo.2016.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/07/2016] [Accepted: 12/13/2016] [Indexed: 12/31/2022]
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30
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Douglas De Oliveira DW, Lages FS, Guimarães RC, Pereira TS, Botelho AM, Glória JCR, Tavano KTA, Gonçalves PF, Flecha OD. Do TMJ symptoms improve and last across time after treatment with red (660 nm) and infrared (790 nm) low level laser treatment (LLLT)? A survival analysis. Cranio 2017; 35:372-378. [DOI: 10.1080/08869634.2017.1292176] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Frederico Santos Lages
- Faculty of Dentistry, Department of Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Adriana Maria Botelho
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valley, Diamantina, Brazil
| | | | | | | | - Olga Dumont Flecha
- Department of Dentistry, Federal University of Jequitinhonha and Mucuri Valley, Diamantina, Brazil
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31
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Sanders AE, Jain D, Sofer T, Kerr KF, Laurie CC, Shaffer JR, Marazita ML, Kaste LM, Slade GD, Fillingim RB, Ohrbach R, Maixner W, Kocher T, Bernhardt O, Teumer A, Schwahn C, Sipilä K, Lähdesmäki R, Männikkö M, Pesonen P, Järvelin M, Rizzatti-Barbosa CM, Meloto CB, Ribeiro-Dasilva M, Diatchenko L, Serrano P, Smith SB. GWAS Identifies New Loci for Painful Temporomandibular Disorder: Hispanic Community Health Study/Study of Latinos. J Dent Res 2017; 96:277-284. [PMID: 28081371 DOI: 10.1177/0022034516686562] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Temporomandibular disorder (TMD) is a musculoskeletal condition characterized by pain and reduced function in the temporomandibular joint and/or associated masticatory musculature. Prevalence in the United States is 5% and twice as high among women as men. We conducted a discovery genome-wide association study (GWAS) of TMD in 10,153 participants (769 cases, 9,384 controls) of the US Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The most promising single-nucleotide polymorphisms (SNPs) were tested in meta-analysis of 4 independent cohorts. One replication cohort was from the United States, and the others were from Germany, Finland, and Brazil, totaling 1,911 TMD cases and 6,903 controls. A locus near the sarcoglycan alpha ( SGCA), rs4794106, was suggestive in the discovery analysis ( P = 2.6 × 106) and replicated (i.e., 1-tailed P = 0.016) in the Brazilian cohort. In the discovery cohort, sex-stratified analysis identified 2 additional genome-wide significant loci in females. One lying upstream of the relaxin/insulin-like family peptide receptor 2 ( RXP2) (chromosome 13, rs60249166, odds ratio [OR] = 0.65, P = 3.6 × 10-8) was replicated among females in the meta-analysis (1-tailed P = 0.052). The other (chromosome 17, rs1531554, OR = 0.68, P = 2.9 × 10-8) was replicated among females (1-tailed P = 0.002), as well as replicated in meta-analysis of both sexes (1-tailed P = 0.021). A novel locus at genome-wide level of significance (rs73460075, OR = 0.56, P = 3.8 × 10-8) in the intron of the dystrophin gene DMD (X chromosome), and a suggestive locus on chromosome 7 (rs73271865, P = 2.9 × 10-7) upstream of the Sp4 Transcription Factor ( SP4) gene were identified in the discovery cohort, but neither of these was replicated. The SGCA gene encodes SGCA, which is involved in the cellular structure of muscle fibers and, along with DMD, forms part of the dystrophin-glycoprotein complex. Functional annotation suggested that several of these variants reside in loci that regulate processes relevant to TMD pathobiologic processes.
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Affiliation(s)
- A E Sanders
- 1 Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,2 Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Jain
- 3 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - T Sofer
- 3 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - K F Kerr
- 3 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - C C Laurie
- 3 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - J R Shaffer
- 4 Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,5 Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - M L Marazita
- 4 Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,6 Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,7 Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,8 Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,9 Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - L M Kaste
- 10 Department of Pediatric Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - G D Slade
- 11 Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,12 Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - R B Fillingim
- 12 Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA
| | - R Ohrbach
- 13 Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA
| | - W Maixner
- 14 Department of Anesthesiology, Center for Translational Pain Medicine, Duke University, Durham, NC, USA
| | - T Kocher
- 15 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - O Bernhardt
- 15 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - A Teumer
- 16 Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - C Schwahn
- 17 Department of Prosthetic Dentistry, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - K Sipilä
- 18 Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,19 Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland.,20 Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,21 Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - R Lähdesmäki
- 20 Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,22 Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Finland
| | - M Männikkö
- 23 Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,24 Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - P Pesonen
- 20 Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - M Järvelin
- 25 Biocenter Oulu, University of Oulu, Center for Life Course Health Research, University of Oulu, Finland.,26 Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - C M Rizzatti-Barbosa
- 27 Department of Prosthesis and Periodontology, Piracicaba Dental Scholl, University of Campinas, Piracicaba, Brazil
| | - C B Meloto
- 28 The Alan Edwards Centre for Research on Pain, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - M Ribeiro-Dasilva
- 29 University of Florida, College of Dentistry, Gainesville, FL, USA
| | - L Diatchenko
- 30 Alan Edwards Pain Centre, McGill University, Montreal, QC, Canada
| | - P Serrano
- 31 Piracicaba Dental School, State University of Campinas, Department of Prosthesis and Periodontology, Brazil
| | - S B Smith
- 14 Department of Anesthesiology, Center for Translational Pain Medicine, Duke University, Durham, NC, USA
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32
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Abstract
Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities, and may affect the quality of life of the patient. Assessment Evaluations indicate that the recently published Diagnostic Criteria for TMD (DC/TMD) are reliable and valid. These criteria cover the most common types of TMD, which include pain-related disorders (e.g., myalgia, headache attributable to TMD, and arthralgia) as well as disorders associated with the TMJ (primarily disc displacements and degenerative disease). As peripheral mechanisms most likely play a role in the onset of TMD, a detailed muscle examination is recommended. The persistence of pain involves more central factors, such as sensitization of the supraspinal neurons and second-order neurons at the level of the spinal dorsal horn/trigeminal nucleus, imbalanced antinociceptive activity, and strong genetic predisposition, which also is included in DC/TMD. Conclusion The etiology is complex and still not clearly understood, but several biological and psychosocial risk factors for TMD have been identified. Several studies indicate that patients with TMD improve with a combination of noninvasive therapies, including behavior therapy, pharmacotherapy, physical therapy, and occlusal appliances. More stringently designed studies, however, are needed to assess treatment efficacy and how to tailor treatment to the individual patient.
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Affiliation(s)
- Thomas List
- 1 Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,2 Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden.,3 Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Rigmor Højland Jensen
- 4 Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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33
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Bonato LL, Quinelato V, De Felipe Cordeiro PC, De Sousa EB, Tesch R, Casado PL. Association between temporomandibular disorders and pain in other regions of the body. J Oral Rehabil 2016; 44:9-15. [DOI: 10.1111/joor.12457] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 01/14/2023]
Affiliation(s)
- L. L. Bonato
- TMD and Orofacial Pain; School of Medicine of Petropolis; Rio de Janeiro RJ Brazil
- Department of Dentistry; Fluminense Federal University; Niteroi RJ Brazil
| | - V. Quinelato
- Department of Dentistry; Fluminense Federal University; Niteroi RJ Brazil
| | | | - E. B. De Sousa
- Program of Cell and Developmental Biology; Institute of Biomedical Sciences; Rio de Janeiro Federal University; Rio de Janeiro RJ Brazil
- Research Division; National Institute of Traumatology and Orthopedics Jamil Haddad; Rio de Janeiro RJ Brazil
| | - R. Tesch
- School of Medicine of Petropo-lis; Metropolis RJ Brazil
- Brazilian Dental Association - Petropolis and Duque de Caxias; Rio de Janeiro RJ Brazil
- Pontificia Universi-dad Catolica Madre y Maestra; Santo Domingo Dominican Republic
| | - P. L. Casado
- Periodontology Department; Fluminense Federal University; Niteroi RJ Brazil
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34
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Gil-Martínez A, Grande-Alonso M, López-de-Uralde-Villanueva I, López-López A, Fernández-Carnero J, La Touche R. Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement. J Headache Pain 2016; 17:103. [PMID: 27812883 PMCID: PMC5095086 DOI: 10.1186/s10194-016-0690-1] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/14/2016] [Indexed: 01/12/2023] Open
Abstract
Background The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD). Methods A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11). Results A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p < 0.001, d = 1.99; and p < 0.001, d = 1.17), craniomandibular pain and disability (p < 0.001, d = 1.34; and p < 0.001, d = 0.9, respectively), and impact of headache (p < 0.001, d = 1.91; and p < 0.001, d = 0.91, respectively). In addition, significant differences were observed between JP group and MP group for impact of headache (p < 0.001, d = 1.08). Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p < 0.001). In the mixed chronic pain group, neck disability (β = 0.40; p < 0.001) and kinesiophobia (β = 0.30; p = 0.03) were significant covariate (33 % of variance) of craniomandibular pain and disability. Conclusion Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.
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Affiliation(s)
- Alfonso Gil-Martínez
- Hospital La Paz Institute for Health Research, Madrid, Spain. .,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain.
| | - Mónica Grande-Alonso
- Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
| | - Ibai López-de-Uralde-Villanueva
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
| | - Almudena López-López
- Multidisciplinary Group on Pain Research and Management, Excellence Research Program URJC-Santander, Universidad Rey Juan Carlos, Alcorcón, Spain.,Departamento de medicina y cirugía, psicología, medicina preventiva y salud pública e inmunología microbiología médica, Universidad Rey Juan Carlos, Avda. Atenas s/n, 28922, Alcorcón, Spain
| | - Josué Fernández-Carnero
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain.,Multidisciplinary Group on Pain Research and Management, Excellence Research Program URJC-Santander, Universidad Rey Juan Carlos, Alcorcón, Spain.,Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Avda. Atenas s/n, 28922, Alcorcón, Spain
| | - Roy La Touche
- Hospital La Paz Institute for Health Research, Madrid, Spain.,Motion in Brains Research Group, Departamento de Fisioterapia, Centro Superior de Estudios Universitarios, Universidad Autónoma de Madrid, Calle La Salle, 10, 28036, Madrid, Spain
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35
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Vazquez-Delgado E, Schmidt JE, Carlson CR, DeLeeuw R, Okeson JP. Psychological and Sleep Quality Differences between Chronic Daily Headache and Temporomandibular Disorders Patients. Cephalalgia 2016; 24:446-54. [PMID: 15154854 DOI: 10.1111/j.1468-2982.2004.00698.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty-seven patients diagnosed with CDH, according to classification criteria from Silberstein et al., were matched by age and sex with 67 patients who had a primary diagnosis of myofascial pain (MP) and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups: chronic migraine ( n = 35); chronic tension-type headache ( n = 26); ‘other CDH’ ( n = 6). All patients completed a battery of psychological and sleep quality questionnaires. All CDH subgroups showed similar psychological and sleep quality profiles. Pain intensity and duration were controlled in the multivariate analyses (MANCOVA) by treating them as covariates. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences were generally not significant. We did not find significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are often necessary for successful clinical management.
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Affiliation(s)
- E Vazquez-Delgado
- Orofacial Pain Center, College of Dentistry, University of Kentucky, Lexington, Kentucky 40506-0044, USA
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36
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Takeuchi M, Saruta J, Kato M, Sugimoto M, Kamata Y, Shimizu T, To M, Kawata T, Igarashi H, Tsukinoki K. Features of occlusal state in female Japanese patients with migraine: a case-controlled study. Cranio 2016; 34:382-387. [PMID: 27101875 DOI: 10.1080/08869634.2015.1106808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The prevalence rate of migraines is 8.4%; it is mostly diagnosed in women at 20s to 40s, and is known to cause major physical and mental disruption to daily life. This study was conducted on women aged between their 20s and 40s, in order to investigate the possible differences in the features of the occlusal state between a migraine and a non-migraine (control) group. METHODS Age-matched female patients with migraine (n = 60) diagnosed by headache specialists and healthy controls (n = 57) were enrolled. Dental casts were used to evaluate some features. RESULTS The maxillary and mandibular dentition casts from the migraine group showed significantly characteristic findings in their Angle's classification, overjet, and deviation in the anterior tooth midline, compared to the control group. DISCUSSION The results relating occlusal state to both tension-related headaches and migraines, which have different pathogeneses, suggest the possibility of dental intervention to improve the symptoms of primary headaches.
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Affiliation(s)
- Mifumi Takeuchi
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Juri Saruta
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan.,b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Momoko Kato
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Masahiro Sugimoto
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan.,d Institute for Advanced Biosciences , Keio University , Tsuruoka , Japan
| | - Yohei Kamata
- c Department of Comprehensive Dentistry, Yokohama Clinic , Kanagawa Dental University , Yokohama , Japan
| | - Tomoko Shimizu
- c Department of Comprehensive Dentistry, Yokohama Clinic , Kanagawa Dental University , Yokohama , Japan
| | - Masahiro To
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | - Toshitsugu Kawata
- a Department of Oral Science, Division of Orthodontics, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
| | | | - Keiichi Tsukinoki
- b Department of Oral Science, Division of Salivary Gland and Health Medicine, Graduate School of Dentistry , Kanagawa Dental University , Yokosuka , Japan
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Al-Khotani A, Naimi-Akbar A, Albadawi E, Ernberg M, Hedenberg-Magnusson B, Christidis N. Prevalence of diagnosed temporomandibular disorders among Saudi Arabian children and adolescents. J Headache Pain 2016; 17:41. [PMID: 27102118 PMCID: PMC4840132 DOI: 10.1186/s10194-016-0642-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/16/2016] [Indexed: 01/07/2023] Open
Abstract
Background Studies have indicated that the prevalence of symptoms and signs of temporomandibular disorders (TMD) are rare early in childhood, but become more prevalent in adolescents and adulthood. To our knowledge, no study has investigated the prevalence of TMD-diagnoses in children in the general population. The aim was thus to investigate the prevalence of TMD-diagnoses among children and adolescents in the general population using the Research Diagnostic Criteria for TMD (RDC/TMD). Methods The current cross-sectional study consisted of 456 children and adolescents, aged between 10 and 18, randomly enrolled from 10 boy’s- and 10 girl’s- schools in Jeddah. The participants first answered two validated questions about TMD-pain, followed by a clinical examination according to RDC/TMD. Results One hundred twenty-four participants (27.2 %) were diagnosed with at least one TMD-diagnosis. Myofascial pain was the most common diagnosis (15 %) followed by disc displacement with reduction, arthralgia, myofascial pain with limited mouth opening and osteoarthrosis. Children diagnosed with myofascial pain more often reported orofacial pain, headache and tooth clenching (p < 0.05), whereas children with arthralgia more often reported orofacial pain and tooth grinding than those without a TMD-diagnosis (p < 0.05). Only 18 % of the subjects in the TMD group had sought a dentist or physician for their pain. Conclusion TMD was common among children and adolescents in Saudi Arabia. Self-reported orofacial pain and headache as well as bruxism were associated with a TMD-pain diagnosis and disc displacement. A surprisingly low percentage of children and adolescents sought treatment by a dentist or physician for their pains.
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Affiliation(s)
- Amal Al-Khotani
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden. .,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
| | - Aron Naimi-Akbar
- Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden
| | - Emad Albadawi
- Jeddah Dental Speciality Center, Ministry of Health, Jeddah, Saudi Arabia
| | - Malin Ernberg
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Britt Hedenberg-Magnusson
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.,Department of Clinical Oral Physiology at the Eastman Institute, Stockholm Public Dental Health (Folktandvården SLL AB), SE-113 24, Stockholm, Sweden
| | - Nikolaos Christidis
- Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, SE-Box 4064, SE-141 04, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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Kim TY, Shin JS, Lee J, Lee YJ, Kim MR, Ahn YJ, Park KB, Hwang DS, Ha IH. Gender Difference in Associations between Chronic Temporomandibular Disorders and General Quality of Life in Koreans: A Cross-Sectional Study. PLoS One 2015; 10:e0145002. [PMID: 26673219 PMCID: PMC4686021 DOI: 10.1371/journal.pone.0145002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 11/25/2015] [Indexed: 11/25/2022] Open
Abstract
Background Chronic temporomandibular disorder (TMD) is known to have strong correlations with psychological factors and to display gender disparity. However, while chronic TMD is known to affect quality of life, large-scale studies investigating the influence on quality of life by gender are scarce. Methods This cross-sectional study assessed the data of 17,198 participants aged ≥19 years who completed chronic TMD and EuroQol-5 Dimension sections in the 4th Korean National Health and Nutrition Examination Survey (2007–2009). We adjusted for covariates (health behavior, sociodemographic factors) in regression analysis for complex sampling design to calculate regression coefficients and 95% CIs for gender difference in the association between chronic TMD and quality of life. We also evaluated which covariates of somatic health, mental health, health behavior, and sociodemographic factors weakened the relationship between TMD and EQ-5D. Results Prevalence of chronic TMD was 1.6% (men 1.3%, women 1.8%), and chronic TMD persisted to negatively impact quality of life even after adjusting for confounding variables. Low sociodemographic factors and health behavior had a negative effect on quality of life. Somatic health and mental health were most affected by chronic TMD. As for quality of life, women were affected to a greater extent than men by TMD. Women were more affected by osteoarthritis and general mental health (stress, depressive symptoms, and thoughts of suicide), and men by employment. Conclusions These results imply that chronic diseases and psychological factors are important in chronic TMD, and that there may be physiological and pathological gender differences in TMD.
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Affiliation(s)
- Tae-Yoon Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-riong Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Yong-jun Ahn
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Ki Byung Park
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Deok-Sang Hwang
- Department of Korean Medicine Obstetrics & Gynecology, Kyung Hee University, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- * E-mail:
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Tomaz-Morais JF, Lucena LBDS, Mota IA, Pereira AKFDTC, Lucena BTLD, Castro RDD, Alves GÂDS. Temporomandibular disorder is more prevalent among patients with primary headaches in a tertiary outpatient clinic. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:913-7. [PMID: 26517213 DOI: 10.1590/0004-282x20150145] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the prevalence of signs and symptoms of temporomandibular disorders (TMD) in patients with primary headaches attended in a tertiary neurology ambulatory. METHOD Authorized by the Ethics Committee, the present cross-sectional study was conducted with a random sample of patients screened for orofacial pain and primary headaches at a tertiary hospital in Northeast of Brazil. RESULTS The sample consisted in 42 patients with primary headache, 59.5% male. The prevalence of > 6 TMD signs and symptoms was 54.8%. In those patients with migraine TMD was present in 71.4% and in tension-type headache in 38.1% (p = 0.030; OR = 4.1). TMD was related to the clinical status of headache associated or attributed to medication overuse (p = 0.001). CONCLUSION TMD has a high prevalence in patients with primary headaches (54.8%). Special attention must be given to patients with migraine and headache associated or attributed to medication overuse.
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Affiliation(s)
- James Felipe Tomaz-Morais
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | | | - Isabella Araújo Mota
- Ambulatório de Neurologia, Hospital Universitário Lauro Wanderley, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
| | | | - Brunna Thaís Luckwu de Lucena
- Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba, João Pessoa, PB, Brazil
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Abstract
AIMS The purpose of this case report is to share an incidence where a bite force imbalance and occlusal interferences contributed to chronic daily headaches. METHODS A TekScan digital occlusal analyzer was used to evaluate the bite and systematically guide alterations to the patient's occlusion. RESULTS After the bite was adjusted and optimized, the patient reported a decrease in her headaches.Shortly afterward, she sustained trauma to her face that altered the way her bite came together. Via physical therapy modalities to heal the muscle, occlusion was restored to the pre-trauma relationship. CONCLUSIONS Once the patient's bite was balanced and the interferences removed, the headaches were greatly improved.
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Affiliation(s)
- Ben A Sutter
- a Private Practice, TMD Headache Oregon , 1045 Willagillespie Rd., Ste. 150, Eugene , OR, 97401 USA
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Takeuchi T, Arima T, Ernberg M, Yamaguchi T, Ohata N, Svensson P. Symptoms and physiological responses to prolonged, repeated, low-level tooth clenching in humans. Headache 2015; 55:381-94. [PMID: 25754714 DOI: 10.1111/head.12528] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND The traditional view contends bruxism, such as tooth grinding/clenching, is part of the etiology of temporomandibular disorders (TMD) including some subtypes of headaches. The purpose of this study is to investigate if a low-level but long-lasting tooth-clenching task initiates TMD symptoms/signs. METHODS Eighteen healthy participants (mean age ± SD, 24.0 ± 4.3 years) performed and repeated an experimental 2-hour tooth-clenching task at 10% maximal voluntary occlusal bite force at incisors (11.1 ± 4.6 N) for three consecutive days (Days 1-3). Pain and cardiovascular parameters were estimated during the experiment. RESULTS The task evoked pain in the masseter/temporalis muscles and temporomandibular joint after 40.0 ± 18.0 minutes with a peak intensity of 1.6 ± 0.4 on 0-10 numerical rating scale (NRS) after 105.0 ± 5.0 minutes (Day 1). On Day 2 and Day 3, pain had disappeared but the tasks, again, evoked pain with similar intensities. The onset and peak levels of pain were not different between the experimental days (P = .977). However, the area under the curve of pain NRS in the masseter on Day 2 and Day 3 were smaller than that on Day 1 (P = .006). Cardiovascular parameters changed during the task but not during the days. CONCLUSIONS Prolonged, low-level tooth clenching evoked short-lived pain like TMD. This intervention study proposes that tooth clenching alone is insufficient to initiate longer lasting and self-perpetuating symptoms of TMD, which may require other risk factors.
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Affiliation(s)
- Tamiyo Takeuchi
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Speciali JG, Dach F. Temporomandibular Dysfunction and Headache Disorder. Headache 2015; 55 Suppl 1:72-83. [DOI: 10.1111/head.12515] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 01/03/2023]
Affiliation(s)
- José G. Speciali
- Headache Clinic; University Hospital; School of Medicine of Ribeirao Preto; University of São Paulo; Ribeirão Preto SP Brazil
| | - Fabíola Dach
- Headache Clinic; University Hospital; School of Medicine of Ribeirao Preto; University of São Paulo; Ribeirão Preto SP Brazil
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Abstract
Migraine and tension-type headache, the two dominant primary headache disorders, are among the most common causes of lost work time. The population impact of both disorders is similar, but the demographics and individual impact differ. Approximately 18% of females and 6% of males have migraine in the general population. Prevalence is highest around age 40, when individuals are at the peak of their work abilities. Headaches cause substantial individual impact on work productivity and employer and societal burden from direct medical costs, lost work time, and underemployment, and, in more severe persistent headache, unemployment. The lost work time costs greatly exceed medical care costs. Chronic daily headache (15 or more headache days per month) represents a widely accepted stage of pain progression that occurs in 2-4% of the population. Treatment of headaches can be acute or preventive. The goals of acute treatment are timely alleviation of pain and associated symptoms without recurrence, the restoring of ability to function, minimizing the use of back-up and rescue medications with minimal adverse events, and providing the best cost-effective management. Migraine-preventive medications are used to decrease future attack frequency, severity, and duration, improving responsiveness to acute treatments, and improving overall function and decreasing disability. Preventing analgesic overuse that leads to chronic daily headache is another goal of using preventive treatment. Preventive medications should be considered in migraine patients reporting either 3-6 or more headache days per month, depending on how headaches impair function.
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Abstract
Headache and facial pain - in particular, temporomandibular disorders (TMDs) - are very prevalent conditions in the general population. TMDs are defined as a collection of symptoms and signs involving masticatory muscles, the temporomandibular joints (TMJs), or both. The pain reported by TMD patients is typically located in the muscles of mastication, in the preauricular area, or in the TMJs. In many cases, headaches and facial pain will occur in the same patient. Much of the research relative to the relationship of these disorders focuses on statistics of association and prevalence data. This review will provide a brief description of the types and classifications of orofacial pains (OFPs), as well as point to relevant research describing the commonalities and potential comorbid nature of these maladies. Finally, several recent papers describing morphologic changes to the brain in headache and TMD individuals will be discussed in an effort to stimulate further research into the potential common pathophysiologic mechanism that may explain the comorbid nature of these disorders.
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Abstract
OBJECTIVE To verify whether headaches (HAs) are associated with temporomandibular disorders (TMD) in young Brazilian adolescents. METHODS From a population sample, 3117 public school children (12 to 14 y) were randomly invited to participate in this study. TMD was assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, in addition to questions #3, #4, and #14 of Axis II history questionnaire. HAs were investigated with question #18 of RDC/TMD Axis II. Chronic TMD pain was considered as pain that has persisted for 6 months or more, as proposed by the International Association for the Study of Pain. The statistical analysis consisted of χ tests, odds ratio (OR), and logistic regression models, adopting a significance level of 5%. RESULTS The sample included 1307 individuals (a response rate of 41.93%), and 56.8% (n=742) were girls. Overall, 330 adolescents (25.2%) were diagnosed with painful TMD and 595 (45.5%) presented with HAs. Individuals presenting with HAs were more likely to present painful TMD (OR=4.94; 95% confidence interval [CI], 3.73-6.54, P<0.001), especially combined muscle and joint painful TMD (OR=7.58; 95% CI, 4.77-12.05, P<0.001). HAs also increased the risk to a higher magnitude for chronic TMD pain (OR=6.12; 95% CI, 4.27-8.78, P<0.0001). All estimated ORs remained essentially unchanged after adjusting for sex. DISCUSSION HAs were a potential risk factor for TMD in adolescents, and the risk was particularly higher for painful and chronic TMD. When HAs are present in young adolescents, a complete examination is strongly recommended with regard to the presence of painful TMD, and vice versa.
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Sanders AE, Slade GD, Bair E, Fillingim RB, Knott C, Dubner R, Greenspan JD, Maixner W, Ohrbach R. General health status and incidence of first-onset temporomandibular disorder: the OPPERA prospective cohort study. THE JOURNAL OF PAIN 2014; 14:T51-62. [PMID: 24275223 DOI: 10.1016/j.jpain.2013.06.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 05/20/2013] [Accepted: 06/15/2013] [Indexed: 12/19/2022]
Abstract
UNLABELLED Temporomandibular disorder (TMD) overlaps with other health conditions, but no study has examined which of these conditions increase the risk of developing first-onset TMD. The authors prospectively evaluated the relationship between health status at enrollment and subsequent incidence of TMD in 2,722 men and women. Participants aged 18 to 44 years had no history of TMD and were clinically free of TMD when enrolled in 2006 to 2008 at 4 U.S. study sites in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) prospective cohort study. First-onset examiner-classified TMD developed in 260 people over a median 2.8 years of follow-up. Cox regression estimated the association between health conditions and TMD incidence while accounting for potential confounders. Incidence of first-onset TMD was 50% higher for people with low back pain (adjusted hazard ratio [AHR] = 1.50, 95% confidence limits [CLs]: 1.08, 2.10) and 75% higher for people with genital pain symptoms (AHR = 1.75, 95% CLs = 1.04, 2.93) than people without a history of these pain disorders. Digit ratio, a marker of intrauterine exposure to sex hormones, was significantly associated with TMD incidence. Other independent predictors of first-onset TMD were sleep disturbance and cigarette smoking. These findings reveal multiple influences of health status on incidence of first-onset TMD. PERSPECTIVE This article examines health conditions that commonly overlap with TMD to determine which ones predict first-onset TMD. A history of low back pain and genital pain conditions at baseline were important predictors. Novel findings were that disrupted sleep and conditions in utero may increase incidence of first-onset TMD.
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Affiliation(s)
- Anne E Sanders
- Regional Center for Neurosensory Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Porporatti AL, Costa YM, Conti PCR, Bonjardim LR, Calderon PDS. Primary headaches interfere with the efficacy of temporomandibular disorders management. J Appl Oral Sci 2014; 23:129-34. [PMID: 25004051 PMCID: PMC4428456 DOI: 10.1590/1678-775720130557] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 03/31/2014] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache
(PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and
its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I) Muscular
TMD (n=64); II) Muscular TMD+PH (n=48); III) Muscular TMD+Articular TMD (n=173);
IV) Muscular TMD+Articular TMD+PH (n=115). All groups had undergone a TMD therapy
for three months with a stabilization appliance and counseling for habits and
behavioral changes, with no specific headache management. Current pain intensity
and existence or not of self-reported bruxism were assessed. Repeated measures
ANOVA and Chi-Square test followed by Odds were used for statistical analysis,
with a significance level of 5%. RESULTS: results of this study showed that: (1) A conservative therapy with stabilization
appliance and counseling for habits and behavioral changes was effective in the
TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the
pain improvement significantly; and (3) no association between the presence of
self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD
management.
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Affiliation(s)
- André Luís Porporatti
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Yuri Martins Costa
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Leonardo Rigoldi Bonjardim
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. J Oral Facial Pain Headache 2014; 28:6-27. [PMID: 24482784 DOI: 10.11607/jop.1151] [Citation(s) in RCA: 2144] [Impact Index Per Article: 214.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. METHODS Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. RESULTS The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra-articular disorder (sensitivity of 0.80 and specificity of 0.97). Diagnostic criteria for other common intra-articular disorders lack adequate validity for clinical diagnoses but can be used for screening purposes. Inter-examiner reliability for the clinical assessment associated with the validated DC/TMD criteria for pain-related TMD is excellent (kappa ≥ 0.85). Finally, a comprehensive classification system that includes both the common and less common TMD is also presented. The Axis II protocol retains selected original RDC/TMD screening instruments augmented with new instruments to assess jaw function as well as behavioral and additional psychosocial factors. The Axis II protocol is divided into screening and comprehensive self report instrument sets. The screening instruments' 41 questions assess pain intensity, pain-related disability, psychological distress, jaw functional limitations, and parafunctional behaviors, and a pain drawing is used to assess locations of pain. The comprehensive instruments, composed of 81 questions, assess in further detail jaw functional limitations and psychological distress as well as additional constructs of anxiety and presence of comorbid pain conditions. CONCLUSION The recommended evidence-based new DC/TMD protocol is appropriate for use in both clinical and research settings. More comprehensive instruments augment short and simple screening instruments for Axis I and Axis II. These validated instruments allow for identification of patients with a range of simple to complex TMD presentations.
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Cooper BC, Kleinberg I. Relationship of Temporomandibular Disorders to Muscle Tension-Type Headaches and a Neuromuscular Orthosis Approach to Treatment. Cranio 2014; 27:101-8. [DOI: 10.1179/crn.2009.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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