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Kim SH, Jeong BY, Kim YS, Park JW. Impact of the COVID-19 pandemic on clinical and psychological aspects of temporomandibular disorders. BMC Oral Health 2024; 24:447. [PMID: 38609928 PMCID: PMC11015653 DOI: 10.1186/s12903-024-04168-y] [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: 08/22/2023] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The Coronavirus 2019 disease (COVID-19) caused drastic changes in people's lifestyle that affected TMD characteristics through its physical and psychological influences. The aim of this study was to define the clinical and psychological characteristics of a large group of well-defined TMD patients and seek their differences between before and during the COVID-19 pandemic to establish points of care to be emphasized in the post-pandemic era. METHODS TMD patients diagnosed by the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) aged ≥ 18 were analyzed. Samples between September, 2017 to July, 2019 (n = 455) and March, 2021 to June, 2022 (n = 338) were collected to represent before and during COVID-19, respectively. The Graded Chronic Pain Scale (GCPS) and Symptom Checklist-90-Revision (SCL-90-R) were used to evaluate disability levels and psychological status. Clinical indices were compared between COVID periods and factors related to higher pain levels were investigated according to pandemic period. RESULTS More patients reported pain on palpation of the masticatory muscles during the pandemic (p = 0.021) while the number decreased for neck muscles (p = 0.001) and TMJ (p < 0.001) areas. Patients reporting nocturnal bruxism (23.3-29.6%) and clenching (45.1-54.7%) significantly increased during the pandemic. TMD patients with pain without disability were more common during the pandemic regardless of pain intensity (p < 0.001). The number of patients expressing interference in daily activities decreased drastically during COVID-19 regardless of disability level (p < 0.001). Factors associated with higher than moderate pain intensity (CPI ≥ 50) were insomnia (odds ratio [OR] = 1.603, p = 0.047) and somatization (OR = 1.082, p < 0.001) before the pandemic. During the pandemic, age (OR = 1.024, p = 0.007), somatization (OR = 1.070, p = 0.006), and paranoid ideation (OR = 1.117, p = 0.003) were significantly associated with higher pain intensity. CONCLUSIONS The results of our study underline the importance of evaluating psychological profiles of TMD patients, especially somatization, paranoid ideation and psychoticism, in exceptional situations that may cause a change in individual mental status. This will lead to a better understanding of the individual TMD patient and help in planning personalized treatment strategies that will assist the patient in adjusting to changes occurring in special environments such as the COVID-19 pandemic.
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Affiliation(s)
- Seong Hae Kim
- Center for Future Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Bo Young Jeong
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Young Sun Kim
- Transdisciplinary Major in Learning Health Systems, Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Korea.
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea.
- Department of Oral Medicine and Oral Diagnosis, Seoul National University School of Dentistry, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
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Saracutu OI, Pollis M, Cagidiaco EF, Ferrari M, Manfredini D. Repeatability of Teethan® indexes analysis of the masseter and anterior temporalis muscles during maximum clenching: a pilot study. Clin Oral Investig 2023; 27:5309-5316. [PMID: 37507600 PMCID: PMC10492765 DOI: 10.1007/s00784-023-05150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES The aim of this study is to assess the repeatability of a surface electromyographic (EMG) device (Teethan®, Teethan S.p.A., Milan, Italy), designed for the analysis of the masseter and anterior temporalis muscles. MATERIALS AND METHODS Tests were performed on a sample of 30 healthy fully dentate TMD-free individuals randomly selected. Each test consisted of two distinct recordings performed at 5-min intervals: (i) the patient is asked to clench with maximum voluntary contraction (MVC), with two cotton rolls interposed between the dental arches; (ii) the patient is asked to repeat the same clenching activity without the cotton rolls. The outcomes of the study were the EMG indices conceptualized by the manufacturing company, based on the differences between the two test conditions (i.e., clenching on cotton rolls and on dentition). Pairwise correlation analysis and ANOVA test were performed to assess the strength of correlation and the significance of differences between the results of the three trials. RESULTS Thirty TMD-free healthy individuals (20 females and 10 males; mean age 44 years, range 16-60 years) took part in the study. ANOVA test did not show any statistically significant difference between the three trials. The Global Index, which is the mean of the other EMG indices, showed the highest correlation values between the three trials, while some other indices showed a weak-to-medium correlation level. One out of five participants showed a coefficient of variation higher than 10%. CONCLUSIONS The statistical analysis showed that the indices provided by the device are quite repeatable. However, this does not necessarily imply a specific clinical application of the device, which was here used in fully controlled experimental conditions. CLINICAL RELEVANCE The clinical usefulness of the applied protocol remains questionable. Further studies should test the repeatability of EMG findings gathered with this device under various circumstances, in a more heterogeneous population.
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Affiliation(s)
- Ovidiu Ionut Saracutu
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy.
| | - Matteo Pollis
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Edoardo Ferrari Cagidiaco
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
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Ferrillo M, Migliario M, Marotta N, Fortunato F, Bindi M, Pezzotti F, Ammendolia A, Giudice A, Foglio Bonda PL, de Sire A. Temporomandibular disorders and neck pain in primary headache patients: a retrospective machine learning study. Acta Odontol Scand 2023; 81:151-157. [PMID: 35906722 DOI: 10.1080/00016357.2022.2105945] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the linkage underpinning different clinical conditions as painful TMD and neck pain in patients affected by primary headaches. MATERIALS AND METHODS In this machine learning study, data from medical records of patients with headaches as migraine, tension-type headache (TTH) and other primary ones, referring to a University Hospital over a 10-year period were analysed. VAS was used to evaluate the intensity of the TMD and neck pain. Moreover, the magnetic resonance imaging was used to supplement the clinical data. RESULTS A total of 300 patients (72 male, 228 female), mean aged 37.78 ± 5.11 years, were included. Higher TMD and neck pain VAS in migraine patients were reported. The machine learning analysis focussed on type of primary headache demonstrated that a higher TMD VAS was correlated to migraine, whereas a higher neck pain VAS was correlated to TTH or migraine. Concerning the TMD type, arthrogenous and mixed TMD were correlated to mild-moderate TMD pain (depending on neck pain intensity), whereas myogenic TMD was correlated to moderate-severe TMD pain. CONCLUSIONS Machine-learning approach highlighted the complexity of diagnosis process and demonstrated that neck pain might be an influential variable on the belonging to different group of headaches in TMD patients.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Mario Migliario
- Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Dentistry Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Francesco Fortunato
- Institute of Neurology, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Marino Bindi
- Dentistry Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Federica Pezzotti
- Dentistry Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Pier Luigi Foglio Bonda
- Dentistry Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,Dentistry Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Potewiratnanond P, Limpuangthip N, Karunanon V, Buritep A, Thawai A. Factors associated with the oral health-related quality of life of patients with temporomandibular disorder at the final follow-up visit: a cross-sectional study. BDJ Open 2022; 8:30. [PMID: 36184656 PMCID: PMC9527234 DOI: 10.1038/s41405-022-00122-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To determine the oral health-related quality of life (OHRQoL) of temporomandibular disorder (TMD) patients at the final follow-up visit, and to investigate the associated factors. MATERIALS AND METHODS This cross-sectional study comprised 227 TMD patients. Dependent variable was OHRQoL determined by telephone interview using the 14-item Oral Health Impact Profile (OHIP-14) questionnaire after the final follow-up visit. Independent variables were collected from dental records, comprising age, sex, treatment duration, diagnosis, clinical parameters (mouth-opening distances), and pain perception. TMD patients were diagnosed as having masticatory muscle disorders (TMDM), temporomandibular joint (TMJ) disorders (TMDJ), or combined muscle and TMJ disorders (TMDC). Bivariate analyses and multivariable linear regression were used to analyze the factors associated with OHIP-14 scores. RESULTS Bivariate analyses demonstrated higher OHIP-14 scores in younger patients, females, having TMDC, and lower mouth-opening distance. Multivariable analysis demonstrated the association of higher OHIP-14 scores with being younger and having TMDC. Participants with TMDC demonstrated greater improvement in unassisted mouth-opening distance, compared with the other clinical diagnosis groups. CONCLUSIONS At the final follow-up visit, oral health impact problems were reported mainly in physical pain and psychological discomfort domains. Better OHRQoL was found in older, and TMDM or TMDJ patients.
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Affiliation(s)
- Prangtip Potewiratnanond
- grid.7922.e0000 0001 0244 7875Department of Occlusion, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nareudee Limpuangthip
- grid.7922.e0000 0001 0244 7875Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Varangkana Karunanon
- grid.7922.e0000 0001 0244 7875Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Ansaya Buritep
- grid.7922.e0000 0001 0244 7875Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Athitaya Thawai
- grid.7922.e0000 0001 0244 7875Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Dalewski B, Kamińska A, Szydłowski M, Kozak M, Sobolewska E. Comparison of Early Effectiveness of Three Different Intervention Methods in Patients with Chronic Orofacial Pain: A Randomized, Controlled Clinical Trial. Pain Res Manag 2019; 2019:7954291. [PMID: 30984320 PMCID: PMC6432695 DOI: 10.1155/2019/7954291] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/23/2018] [Accepted: 02/05/2019] [Indexed: 01/25/2023]
Abstract
Background Occlusal appliances are still widely used instruments in the management of orofacial pain in dentistry, yet alone or as a part of multimodal therapy. However, some of those modalities have been lacking thorough randomized assessment, and there is a conflicting evidence available. It is hypothesized that pain symptoms might improve faster and in more tangible way due to combined therapy. Also, to our best knowledge, nimesulide was never examined in this aspect, too. Objective The aim of this study was to compare early effectiveness of routine intervention methods in patients with myofascial pain (MP) after 3 weeks' notice. Three modalities were evaluated: occlusal appliance (OA) with nonsteroidal anti-inflammatory drug (NSAID) therapy (nimesulide), occlusal appliance with dry needling (DN), and occlusal appliance (OA-control group) therapy. Design Randomized controlled clinical trial (RCT) in which ninety patients with MP, who met the inclusion criteria, were randomly assigned to one of the three treatment groups. Sealed, opaque envelopes were used. Methods For evaluation, each patient completed a Visual Analogue Scale (VAS) and Sleep and Pain Activity Questionnaire (SPAQ) twice, first at the beginning of the study and again after 3 weeks (0-3). Results Posttreatment test comparison between the control group and both treated groups reveal significant differences between the control and the NSAID + occlusal appliance groups. There were also differences reported between the control and the DN + occlusal appliance groups, but these differences were, however, not statistically significant. Conclusions Occlusal appliances in conjunction with NSAID showed better orofacial pain relief after 3 weeks of therapy, compared to the use of occlusal appliances alone or in conjunction with dry needling. Additionally, differences between pain perception and quality of life between OA and DN + OA groups were not found to be statistically significant.
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Affiliation(s)
- Bartosz Dalewski
- Chair and Department of Dental Prosthetics, Pomeranian Medical University, Szczecin, Poland
| | - Agata Kamińska
- Chair and Department of Dental Prosthetics, Specialists' Dental Clinic, Pomeranian Medical University, Szczecin, Poland
| | - Michał Szydłowski
- Faculty of Mechanical Engineering and Mechatronics, West Pomeranian University of Technology, Szczecin, Poland
| | - Małgorzata Kozak
- Chair and Department of Dental Prosthetics, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Sobolewska
- Chair and Department of Dental Prosthetics, Pomeranian Medical University, Szczecin, Poland
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Canales GDLT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR, Manfredini D. Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sci 2019; 27:e20180210. [PMID: 30624469 PMCID: PMC6322638 DOI: 10.1590/1678-7757-2018-0210] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/10/2018] [Indexed: 11/21/2022] Open
Abstract
Objective the aim of this study was to describe the frequency of psychosocial diagnoses in a large sample of patients attending a tertiary clinic for treatment of temporomandibular disorders (TMD). Material and Methods six hundred and ninety-one patients who sought treatment for pain-related TMD were selected. Chronic pain-related disability (Graded Chronic Pain Scale, GCPS), depression [Symptoms Checklist-90 (SCL-90) scale for depression, DEP] and somatization levels (SCL-90 scale for non-specific physical symptoms, SOM) were evaluated through the Research Diagnostic Criteria for TMD (RDC/TMD) Axis II psychosocial assessment; TMD diagnoses were based on the Axis I criteria. Results the majority of patients presented a low disability or no disability at all, with only a small portion of individuals showing a severely limiting, high disability pain-related impairment (4.3%). On the other hand, abnormal scores of depression and somatization were high, with almost half of the individuals having moderate-to-severe levels of depression and three-fourths presenting moderate-to-severe levels of somatization. The prevalence of high pain-related disability (GCPS grades III or IV), severe/moderate depression and somatization was 14.3%, 44% and 74.1% respectively. Gender differences in scores of SCL-DEP (p=0.031) and SCL-SOM (p=0.001) scales were signficant, with females presenting the highest percentage of abnormal values. Conclusion patients with TMD frequently present an emotional profile with low disability, high intensity pain-related impairment, and high to moderate levels of somatization and depression. Therefore, given the importance of psychosocial issues at the prognostic level, it is recommended that clinical trials on TMD treatment include an evaluation of patients’ psychosocial profiles.
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Affiliation(s)
| | - Luca Guarda-Nardini
- Università di Padova, Dipartimento di Chirurgia Maxillo-Facciale, Padova, Italia
| | - Célia Marisa Rizzatti-Barbosa
- Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Prótese e Periodontia, Piracicaba, São Paulo, Brasil
| | - Paulo César Rodrigues Conti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese, Bauru, São Paulo, Brasil
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