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Zieliński G, Pająk A, Wójcicki M. Global Prevalence of Sleep Bruxism and Awake Bruxism in Pediatric and Adult Populations: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:4259. [PMID: 39064299 PMCID: PMC11278015 DOI: 10.3390/jcm13144259] [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: 07/03/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: The purpose of this systematic review was to assess the global prevalence of sleep bruxism and awake bruxism in pediatric and adult populations. Methods: This systematic review was conducted by analyzing studies published from 2003 to 2023. The following keyword combination was utilized: prevalence, epidemiology, population, and bruxism. The PubMed database was analyzed, supplemented by manual searches using the Google search. Additionally, the snowballing procedure method was applied. A double assessment of the quality of publications was carried out to preserve the highest possible quality of evidence (e.g., Joanna Briggs Institute critical appraisal checklist). Analyses were conducted using the R statistical language. Results: The global bruxism (sleep and awake) prevalence is 22.22%. The global sleep bruxism prevalence is 21% and awake prevalence is 23%. The occurrence of sleep bruxism, based on polysomnography, was estimated at 43%. The highest prevalence of sleep bruxism was observed in North America at 31%, followed by South America at 23%, Europe at 21%, and Asia at 19%. The prevalence of awake bruxism was highest in South America at 30%, followed by Asia at 25% and Europe at 18%. Conclusions: One in four individuals may experience awake bruxism. Bruxism is a significant factor among women. It was observed that age is a significant factor for the occurrence of sleep bruxism in women. Among the limitations of the study is the lack of analysis of the prevalence of bruxism in Africa and Australia due to not collecting an adequate sample for analysis. The study was registered in the Open Science Framework (10.17605/OSF.IO/ZE786).
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | - Agnieszka Pająk
- Clinic of Anaesthesiology and Paediatric Intensive Care, Medical University of Lublin, Gebali Str. 6, 20-093 Lublin, Poland
| | - Marcin Wójcicki
- Independent Unit of Functional Masticatory Disorder, Medical University of Lublin, 20-093 Lublin, Poland
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2
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Pacheco-Barrios K, Velasquez-Rimachi V, Navarro-Flores A, Huerta-Rosario A, Morán-Mariños C, Molina RA, Farroñay-García C, Metcalf T, Fregni F, Alva-Díaz C. Primary headache disorders in Latin America and the Caribbean: A meta-analysis of population-based studies. Cephalalgia 2023; 43:3331024221128265. [PMID: 36606574 DOI: 10.1177/03331024221128265] [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: 01/07/2023]
Abstract
BACKGROUND In this manuscript, we aim to systematically estimate the pooled prevalence and incidence of primary headaches and its subtypes (migraine, tension-type headache, and chronic headaches) in Latin America and the Caribbean, describing its epidemiological profile and associated factors. METHODS We systematically searched PubMed/MEDLINE, Scopus, and LILACS (From conception to March 2021), for populational studies reporting the epidemiology of primary headaches and their associated factors in Latin America and the Caribbean. The data extraction was conducted independently. We performed random-effect model meta-analysis of prevalence (overall primary headaches and by subtypes) and associated factors, assessed potential sources of heterogeneity, the risk of bias, publication bias, and the evidence certainty (GRADE methodology). RESULTS We included 32 populational studies (38 subpopulations, n = 63,813). The prevalence of primary headaches was 41.4% (95% CI 31.1-52.2%; n = 54,357), 15% for migraine (95% CI 12.0-18.3; n = 53,658 individuals), 20.6% for tension-type headache (95% CI 12.4-30.2; n = 25,840), and 6% for chronic headaches (95% CI 3.3-9.6; n = 21,720), with high between-study heterogeneity. No incidence data was found. Female sex, white ethnicity, high BMI, comorbid mental health disorders, and low-back pain were associated with higher prevalence of primary headaches. The prevalence was less in rural areas. CONCLUSION In Latin America and the Caribbean, primary headaches are highly prevalent affecting young females disproportionally. The prevalence of chronic headaches is higher than in other systematic global and regional estimations. The presence of comorbidities as modifiable risk factors should encourage their integration as targets for community-based preventive and therapeutic interventions. PROTOCOL REGISTRATION NUMBER CRD42018105116.
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Affiliation(s)
- Kevin Pacheco-Barrios
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru.,SYNAPSIS Mental Health and Neurology, Lima, Peru.,Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Victor Velasquez-Rimachi
- Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru.,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Alba Navarro-Flores
- Georg-August-University Göttingen, International Max Planck Research School for Neurosciences, Göttingen, Germany
| | | | - Cristian Morán-Mariños
- Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru.,Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Chandel Farroñay-García
- Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru.,Instituto Nacional de Salud, INS, Lima, Peru
| | - Tatiana Metcalf
- Red de Eficacia Clínica y Sanitaria, REDECS, Lima, Peru.,Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación, Hospital Daniel Alcides Carrión, Callao, Peru
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Carlos Alva-Díaz
- Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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Tao T, Liu Y, Zhang J, Lai W, Long H. NGF-Induced Upregulation of CGRP in Orofacial Pain Induced by Tooth Movement Is Dependent on Atp6v0a1 and Vesicle Release. Int J Mol Sci 2022; 23:ijms231911440. [PMID: 36232740 PMCID: PMC9569904 DOI: 10.3390/ijms231911440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
The nerve growth factor (NGF) and calcitonin gene-related peptide (CGRP) play a crucial role in the regulation of orofacial pain. It has been demonstrated that CGRP increases orofacial pain induced by NGF. V-type proton ATPase subunit an isoform 1 (Atp6v0a1) is involved in the exocytosis pathway, especially in vesicular transport in neurons. The objective was to examine the role of Atp6v0a1 in NGF-induced upregulation of CGRP in orofacial pain induced by experimental tooth movement. Orofacial pain was elicited by ligating closed-coil springs between incisors and molars in Sprague–Dawley rats. Gene and protein expression levels were determined through real-time polymerase chain reaction, immunostaining, and fluorescence in situ hybridization. Lentivirus vectors carrying Atp6v0a1 shRNA were used to knockdown the expression of Atp6v0a1 in TG and SH-SY5Y neurons. The release of vesicles in SH-SY5Y neurons was observed by using fluorescence dye FM1-43, and the release of CGRP was detected by Enzyme-Linked Immunosorbent Assy. Orofacial pain was evaluated through the rat grimace scale. Our results revealed that intraganglionic administration of NGF and Atp6v0a1 shRNA upregulated and downregulated CGRP in trigeminal ganglia (TG) and trigeminal subnucleus caudalis (Vc), respectively, and the orofacial pain was also exacerbated and alleviated, respectively, following administration of NGF and Atp6v0a1 shRNA. Besides, intraganglionic administration of NGF simultaneously caused the downregulation of Atp6v0a1 in TG. Moreover, the release of vesicles and CGRP in SH-SY5Y neurons was interfered by NGF and Atp6v0a1 shRNA. In conclusion, in the orofacial pain induced by experimental tooth movement, NGF induced the upregulation of CGRP in TG and Vc, and this process is dependent on Atp6v0a1 and vesicle release, suggesting that they are involved in the transmission of nociceptive information in orofacial pain.
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Affiliation(s)
| | | | | | | | - Hu Long
- Correspondence: (W.L.); (H.L.)
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Effectiveness of and Patient’s Satisfaction with Dental Emergency Unit in Pitié Salpêtrière Hospital (Paris), Focusing on Pain and Anxiety. Int J Dent 2022; 2022:8457608. [PMID: 35637654 PMCID: PMC9148244 DOI: 10.1155/2022/8457608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background The Dental Emergency Unit (DEU) of the Pitié Salpêtrière Hospital receives mainly painful emergencies. This study aimed at evaluating the suppression of pain and anxiety as well as the patient's satisfaction after a visit to the DEU. Patients and Methods. A prospective study was carried out in 2019 (NCT03819036) in adult patients. Data was collected on D0 on site and then on D1, D3, and D7 by phone, during daytime. The main objective and secondary objectives were, respectively, to assess the intensity of pain on D1; the intensity of pain on D3 and D7; the evolution of anxiety on D1, D3, and D7; and the patients' satisfaction. They were evaluated with a 0–10 numeric scale (NS) on D1, D3 and D7; mean scores were compared with nonparametric statistics (ANOVA, Dunn's test). Results 814 patients were contacted and 581 patients included; 87 were lost to follow-up. 376 patients completed all the questionnaires. In the final sample (59% men, 40 ± 16 y.o.), 86% had health insurance. The mean pain scores were as follows: D0: 6.36 ± 0.12; D1: 3.49 ± 0.13; D3: 2.23 ± 0.13; D7: 1.07 ± 0.11—indicating a significant decrease of 45%, 65%, and 93% on D1, D3, and D7, respectively, compared to D0 (p < 0.0001) between D0 and D1, D3, D7. The mean NS anxiety scores were as follows: D0: 3.32 ± 0.15; D1: 3.69 ± 0.16; D3: 2.75 ± 0.16; D7: 1.98 ± 0.15. The decrease was significant between D0 and D7 (p < 0.0001). The perception of general heath improved between D1 and D7. The overall score of satisfaction was 8.64 ± 0.06. Conclusion DEU enabled a significant reduction in pain and anxiety with high overall satisfaction.
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5
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Hussain A, Rizvi M, Vohra U, Kohli K, Asim S, Fikree M, Ovais Z, Ahmed SA. Prevalence of Bruxism among the Students of Gulf Medical University: A Cross-Sectional Questionnaire Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S501-S505. [PMID: 34447142 PMCID: PMC8375866 DOI: 10.4103/jpbs.jpbs_644_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/12/2020] [Accepted: 11/30/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: Bruxism is a multifactorial phenomenon that involves grinding or clenching of teeth. The parafunctional habit includes abnormal tooth wear, tooth fracture, pain, and tooth mobility, along with headaches and facial muscle hypertrophy. It is imperative for students to be conscious of teeth grinding along with its possible causes. The student will be alert to visit the dentist if required and contribute to the recognition of etiological factors, to eliminate them. Objective: This study aims to find the prevalence and understanding of bruxism among Gulf Medical University (GMU) students. Materials and Methods: A cross-sectional, questionnaire-based study was conducted among 451 GMU students. The parameters for data collection were age, gender, prevalence, associated signs and symptoms, causes, genetic predisposition, time of day, and effect on the appearance of teeth. Results: While 35.9% were unaware, 41.7% of our samples reported bruxism. The majority recognized temporomandibular joint and facial pain as causative, and 24.8% reported symptoms. Headache (26.4%) was prime and 7.5% were associated with fracture and abnormal tooth wear to bruxism (38.1%) experienced night bruxism. A significant number of students (32.4%) identified abnormal anterior teeth relationship as the cause and (64.3%) associated bruxism and esthetics. Conclusion: Nearly 41.7% of the students reported bruxism. Around 35.9% of the samples were uninformed. Nearly 20.8% believed that bruxism had genetic relevance. Nearly 51.9% of the participants were asymptomatic. Around 38.1% had night bruxism and 32.4% identified abnormal anterior teeth relationship as the cause. The majority of the sample (64.3%) connected bruxism to negative effects on teeth and esthetics.
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Affiliation(s)
| | | | - Umika Vohra
- Interns, Gulf Medical University, Ajman, UAE
| | | | - Sundus Asim
- Interns, Gulf Medical University, Ajman, UAE
| | | | | | - Sura Ali Ahmed
- Diagnostic and Surgical Dental Sciences Department, Gulf Medical University, UAE
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Fehlberg BK, Barros MBDA, Lima MG. Health behaviors and multimorbidity associated with bruxism: Population-based study. Oral Dis 2021; 29:245-253. [PMID: 34056810 DOI: 10.1111/odi.13928] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/26/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Determine the prevalence of possible bruxism in the adult population of Campinas, Brazil, and investigate its association with health behaviors, health status, and multimorbidity. METHODS A population-based cross-sectional study was conducted with data from the 2014/2015 Campinas Health Survey. The sample was composed of 1986 adults (≥20 years of age). The data were collected with the aid of a pre-coded questionnaire, and the dependent variable was self-reported bruxism (possible bruxism). The prevalence of possible bruxism was estimated according to the independent variables (health-related behaviors, morbidities, demographic and socioeconomic characteristics). A hierarchical model was employed using stepwise backward regression in two stages. Principal component analysis was also performed to identify multimorbidity patterns. RESULTS The prevalence of possible bruxism was 13.6%. Associations were found with the consumption of alcoholic beverages, sleep quality, and the number of chronic diseases/health problems. Bruxism was more associated with multimorbidity pattern 2, which was composed of asthma, rhinitis, sinusitis, dizziness/vertigo, migraine/headache, emotional/mental problem, back pain, and allergy. CONCLUSION The present findings justify the planning of actions directed at reducing the consumption of alcoholic beverages and can help guide the health actions of the multidisciplinary team, prioritizing a reduction in the harm caused by the simultaneous presence of health problems associated with possible bruxism.
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Affiliation(s)
- Bruna Kelly Fehlberg
- Department of Public Health, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
| | | | - Margareth Guimarães Lima
- Department of Public Health, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, Brazil
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7
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Jin Y, Yang H, Zhang F, Wang J, Liu H, Yang X, Long H, Li F, Gong Q, Lai W. The Medial Thalamus Plays an Important Role in the Cognitive and Emotional Modulation of Orofacial Pain: A Functional Magnetic Resonance Imaging-Based Study. Front Neurol 2021; 11:589125. [PMID: 33551953 PMCID: PMC7859266 DOI: 10.3389/fneur.2020.589125] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/23/2020] [Indexed: 02/05/2023] Open
Abstract
The thalamus plays a critical role in the perception of orofacial pain. We investigated the neural mechanisms of orofacial pain by exploring the intrinsic functional alterations of the thalamus and assessing the changes in functional connectivity (FC) between the thalamic subregions with significant functional alterations and other brain regions in orofacial pain using the seed-based FC approach. There were 49 participants in the orofacial pain group and 49 controls. Orofacial pain was caused by orthodontic separators. The resting-state functional magnetic resonance imaging data of the two groups were analyzed to obtain the fractional amplitude of low-frequency fluctuations (fALFF) of the thalamus; the thalamic subregions with significant fALFF abnormalities were used as seeds for FC analysis. Student's t-tests were used for comparisons. Pearson's correlation analysis was performed using SPM software. Forty-four participants with orofacial pain (mean age, 21.0 ± 0.9 years; 24 women) and 49 age- and sex-matched controls (mean age, 21.0 ± 2.6 years; 27 women) were finally included. Compared with the control group, the orofacial pain group demonstrated the following: (1) increased function in the dorsal area of the thalamus and decreased function in the medial thalamus; (2) decreased FC between the medial thalamus and 12 brain regions (p < 0.05, family-wise error corrected, voxel > 100); and (3) potential positive and negative correlations between the medial thalamus-seeded FC and visual analog scale score changes (p < 0.05, AlphaSim corrected). The findings show that the medial and dorsal thalami play important roles in orofacial pain perception, and that the medial thalamus likely plays an important role in the cognitive and emotional modulation of orofacial pain.
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Affiliation(s)
- Yu Jin
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hong Yang
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Feifei Zhang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Jue Wang
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - He Liu
- Department of Orthodontics, China-Japan Friendship Hospital, Beijing, China
| | - Xin Yang
- Department of Stomatology, Shanghai Jiao Tong University School of Medicine Xinhua Hospital, Shanghai, China
| | - Hu Long
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Fei Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
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8
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Varotto BLR, Martinez RCR, Gouveia FV, Antunes GF, Fabri GMDC, Ballester G, Antequera R, de Siqueira SRDT, Fonoff ET, Teixeira MJ, de Siqueira JTT. Increased Anxiety-Like Behavior in the Acute Phase of a Preclinical Model of Periodontal Disease. Front Neurol 2021; 11:598851. [PMID: 33414759 PMCID: PMC7782965 DOI: 10.3389/fneur.2020.598851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease (PD) is an infectious-inflammatory oral disease that is highly prevalent among adolescence and adulthood and can lead to chronic orofacial pain and be associated with anxiety, stress and depression. This study aimed to identify anxiety-like behaviors in the ligature-induced murine preclinical model of PD in different phases of the disease (i.e., acute vs. chronic). Also, we investigated orofacial mechanical allodynia thresholds and superficial cortical plasticity along the orofacial motor cortex in both disease phases. To this aim, 25 male Wistar rats were randomly allocated in acute (14 days) or chronic (28 days) ligature-induced-PD groups and further divided into active-PD or sham-PD. Anxiety-like behavior was evaluated using the elevated plus maze, mechanical allodynia assessed using the von Frey filaments test and superficial motor cortex mapping was performed with electrical transdural stimulation. We observed increased anxiety-like behavior in active-PD animals in the acute phase, characterized by decreased number of entries into the open arm extremities [t(1,7) = 2.42, p = 0.04], and reduced time spent in the open arms [t(1,7) = 3.56, p = 0.01] and in the open arm extremities [t(1,7) = 2.75, p = 0.03]. There was also a reduction in the mechanical allodynia threshold in all active-PD animals [Acute: t(1,7) = 8.81, p < 0.001; Chronic: t(1,6) = 60.0, p < 0.001], that was positively correlated with anxiety-like behaviors in the acute group. No differences were observed in motor cortex mapping. Thus, our findings show the presence of anxiety-like behaviors in the acute phase of PD making this a suitable model to study the impact of anxiety in treatment response and treatment efficacy.
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Affiliation(s)
- Bruna Luiza Roim Varotto
- Dental Team, and Dental Research Group on Pain and Mental Health of Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Raquel Chacon Ruiz Martinez
- Division of Neuroscience, Hospital Sirio Libanês, São Paulo, Brazil.,School of Medicine, LIM/23 - Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Flavia Venetucci Gouveia
- Division of Neuroscience, Hospital Sirio Libanês, São Paulo, Brazil.,Biological Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Geiza Fernanda Antunes
- Division of Neuroscience, Hospital Sirio Libanês, São Paulo, Brazil.,School of Medicine, LIM/23 - Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | | | - Gerson Ballester
- School of Medicine, City of São Paulo University, São Paulo, Brazil
| | - Reynaldo Antequera
- Dental Team, and Dental Research Group on Pain and Mental Health of Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Erich Talamoni Fonoff
- Pain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Pain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - José Tadeu Tesseroli de Siqueira
- Dental Team, and Dental Research Group on Pain and Mental Health of Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil.,Pain Center and Division of Functional Neurosurgery, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.,Orofacial Pain Team, Dentistry Division, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil
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9
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Costa YM, De Koninck BP, Elsaraj SM, Exposto FG, Herrero Babiloni A, Kapos FP, Sharma S, Shimada A. Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain. J Dent Educ 2020; 85:349-358. [PMID: 33098113 DOI: 10.1002/jdd.12461] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 08/31/2020] [Accepted: 10/02/2020] [Indexed: 12/30/2022]
Abstract
Dentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients. Education in OFP is necessary to improve the quality of general dental care and reduce individual and societal burden of chronic pain through prevention and improved quality of life for OFP patients. Our aims are to emphasize the goals of OFP education, to identify barriers for its implementation, and to suggest possible avenues to improve OFP education in general, postgraduate, and continuing dental education levels, including proposed minimum OFP competencies for all dentists. Moreover, patient perspectives are also incorporated, including a testimony from a person with OFP. General dentists, OFP experts, educators, researchers, patients, and policy makers need to combine efforts in order to successfully address the urgent need for quality OFP education.
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Affiliation(s)
- Yuri M Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Beatrice P De Koninck
- Research Center, Sacré-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada
| | - Sherif M Elsaraj
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.,Department of Dentistry, Jewish General Hospital, Montreal, Quebec, Canada
| | - Fernando G Exposto
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Alberto Herrero Babiloni
- Research Center, Sacré-Coeur Hospital, University of Montreal, Montreal, Quebec, Canada.,Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sonia Sharma
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | - Akiko Shimada
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
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Liang H, Hu H, Shan D, Lyu J, Yan X, Wang Y, Jian F, Li X, Lai W, Long H. CGRP Modulates Orofacial Pain through Mediating Neuron-Glia Crosstalk. J Dent Res 2020; 100:98-105. [PMID: 32853530 DOI: 10.1177/0022034520950296] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Calcitonin gene-related peptide (CGRP) plays a crucial role in the modulation of orofacial pain, and we hypothesized that CGRP mediated a neuron-glia crosstalk in orofacial pain. The objective of this study was to elucidate the mechanisms whereby CGRP mediated trigeminal neuron-glia crosstalk in modulating orofacial pain. Orofacial pain was elicited by ligating closed-coil springs between incisors and molars. Trigeminal neurons and satellite glial cells (SGCs) were cultured for mechanistic exploration. Gene and protein expression were determined through immunostaining, polymerase chain reaction, and Western blot. Orofacial pain was evaluated through the rat grimace scale. Our results revealed that the expressions of CGRP were elevated in both trigeminal neurons and SGCs following the induction of orofacial pain. Intraganglionic administration of CGRP and olcegepant exacerbated and alleviated orofacial pain, respectively. The knockdown of CGRP through viral vector-mediated RNA interference was able to downregulate CGRP expressions in both neurons and SGCs and to alleviate orofacial pain. CGRP upregulated the expression of inducible nitric oxide synthase through the p38 signaling pathway in cultured SGCs. In turn, L-arginine (nitric oxide donor) was able to enhance orofacial pain by upregulating CGRP expressions in vivo. In cultured trigeminal neurons, L-arginine upregulated the expression of CGRP, and this effect was diminished by cilnidipine (N-type calcium channel blocker) while not by mibefradil (L-type calcium channel blocker). In conclusion, CGRP modulated orofacial pain through upregulating the expression of nitric oxide through the p38 signaling pathway in SGCs, and the resulting nitric oxide in turn stimulated CGRP expression through N-type calcium channel in neurons, building a CGRP-mediated positive-feedback neuron-glia crosstalk.
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Affiliation(s)
- H Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Key Laboratory of Oral Diseases of Gansu Province, Northwest Minzu University; Key Laboratory of Stomatology of State Ethnic Affairs Commission, Northwest Minzu University, Lanzhou, Gansu, China
| | - H Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - D Shan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - J Lyu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Yan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Y Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - F Jian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - W Lai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - H Long
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Mksoud M, Ittermann T, Daboul A, Schneider P, Bernhardt O, Koppe T, Bülow R, Metelmann HR, Völzke H, Kindler S. Are third molars associated with orofacial pain? Findings from the SHIP study. Community Dent Oral Epidemiol 2020; 48:364-370. [PMID: 32420644 DOI: 10.1111/cdoe.12540] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the association between third molars and orofacial pain. We hypothesized that impacted third molars are a cause of orofacial pain. METHODS Magnetic resonance images of 1808 participants from two population-based cohorts from Northeastern Germany were analysed to define the status of third molars according to the Pell and Gregory classification. A self-reported questionnaire and a clinical dental examination were used to detect chronic and acute complaints of orofacial pain, masticatory muscle pain, migraine and other types of headache. Logistic regression models were used to analyse the associations between third molar status and orofacial pain. RESULTS Individuals with impacted third molars in the maxilla had a higher chance of chronic orofacial pain than those with erupted third molars (odds ratio 2.19; 95% CI 1.19-4.02). No such association was detected for third molars in the lower jaw. Third molars were not associated with masticatory muscle pain, migraine or other types of headache. CONCLUSIONS Impacted maxillary third molars might be a cause of chronic orofacial pain. Thus, physicians should consider the eruption/impaction status of third molars in their decision-making process when treating patients who complain of orofacial pain.
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Affiliation(s)
- Maria Mksoud
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Amro Daboul
- Department of Prosthodontics, Gerodontology and Biomaterials, University Medicine Greifswald, Greifswald, Germany
| | - Philipp Schneider
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Olaf Bernhardt
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Koppe
- Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Hans-Robert Metelmann
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Kindler
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Greifswald, Germany
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ECHEVERRIA MS, DUMITH SC, SILVA AER. Prevalência e fatores associados a dor dentária - estudo de base populacional com adultos e idosos do sul do Brasil. REVISTA DE ODONTOLOGIA DA UNESP 2020. [DOI: 10.1590/1807-2577.03920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução A dor dentária, ou odontalgia, é definida como uma dor de origem orofacial, que ocorre como consequência dos problemas que afetam os dentes e as estruturas de suporte. Objetivo O objetivo do presente estudo foi analisar os fatores associados à dor dentária em indivíduos com 18 anos ou mais de idade, no município de Rio Grande-RS, ao sul do Brasil. Material e método Estudo transversal de base populacional. Foram entrevistados, no domicílio, 1.099 indivíduos, por meio de um questionário com questões fechadas. Foram obtidas informações demográficas, socioeconômicas e relativas a hábitos e comportamentos de saúde geral e bucal. O relato de dor dentária nos seis meses anteriores ao inquérito foi o desfecho do estudo. As análises foram baseadas em regressão de Poisson. Resultado A prevalência de dor dentária foi de 18,0% (IC95% 15,6; 20,4). Ao se analisar por faixa etária, a prevalência de dor dentária foi de 23,9% (IC95% 20,3; 27,4), 14,0% (IC95% 10,6; 17,5) e 10,4% (IC95% 5,8; 15,0), considerando a população adulta de 20 a 39 anos e de 40 a 59 anos, e a população idosa, acima de 60 anos, respectivamente. Maiores prevalências de dor origem dentária foram em indivíduos solteiros (RP=1,50; IC95% 1,11; 2,03), com menor escolaridade (menos de oito anos de estudo) (RP=1,62; IC95% 1,16; 2,27) e com o hábito de ranger os dentes (RP=1,67; IC95% 1,18; 2,38). Já os idosos apresentaram menores prevalências de dor origem dentária, quando comparados aos indivíduos adultos (RP=0,50; IC95% 0,32; 0,80). Conclusão Maior atenção deve ser dada aos solteiros, menos escolarizados, que rangem os dentes, e aos adultos jovens.
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Modulation of COX-2, INF-ɣ, glutamatergic and opioid systems contributes to antinociceptive, anti-inflammatory and anti-hyperalgesic effects of bis(3-amino-2-pyridine) diselenide. Chem Biol Interact 2019; 311:108790. [DOI: 10.1016/j.cbi.2019.108790] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/23/2019] [Accepted: 08/07/2019] [Indexed: 02/07/2023]
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14
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Photobiomodulation-induced analgesia in experimental temporomandibular disorder involves central inhibition of fractalkine. Lasers Med Sci 2019; 34:1841-1847. [DOI: 10.1007/s10103-019-02785-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 04/03/2019] [Indexed: 12/19/2022]
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15
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Synthesis and Pharmacological Evaluation of Novel Selenoethers Glycerol Derivatives for the Treatment of Pain and Inflammation: Involvement of Nitrergic and Glutamatergic Systems. Appl Biochem Biotechnol 2018; 187:1398-1423. [DOI: 10.1007/s12010-018-2887-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/10/2018] [Indexed: 12/12/2022]
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16
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SOUZA SP, ANTEQUERDDS R, ARATANGY EW, SIQUEIRA SRDT, CORDÁS TA, SIQUEIRA JTT. Pain and temporomandibular disorders in patients with eating disorders. Braz Oral Res 2018; 32:e51. [DOI: 10.1590/1807-3107bor-2018.vol32.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/03/2018] [Indexed: 11/21/2022] Open
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Long H, Liao L, Zhou Y, Shan D, Gao M, Huang R, Yang X, Lai W. A novel technique of delivering viral vectors to trigeminal ganglia in rats. Eur J Oral Sci 2017; 125:1-7. [PMID: 28067416 DOI: 10.1111/eos.12326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Hu Long
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Lina Liao
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Yang Zhou
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Di Shan
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Meiya Gao
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Renhuan Huang
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Xin Yang
- Department of Stomatology; Shanghai Tenth People's Hospital; Tongji University School of Medicine; Shanghai China
| | - Wenli Lai
- Department of Orthodontics; State Key Laboratory of Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
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The impact of chronic orofacial pain on daily life: the vulnerable patient and disruptive pain. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 123:58-66. [PMID: 27727115 DOI: 10.1016/j.oooo.2016.08.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 08/10/2016] [Accepted: 08/15/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To identify patient and pain characteristics associated with negative impacts on daily life among patients with chronic orofacial pain (COFP). STUDY DESIGN Medical records of 200 COFP patients were analyzed. RESULTS Diagnostic categories included temporomandibular disorders (85; 42.7%), headaches (47; 23.6%), neuropathic pain (37; 18.5%), trigeminal neuralgia (16; 8.0%), and painful posttraumatic trigeminal neuropathy (PTTN) (14; 7.0%). Of these, 47 (23.7%) had medical and 13 (6.5%) had psychiatric comorbidities and 71 (35.7%) experienced physical trauma. Seven (5%) had stopped working, and mean days absent from work was 3.3 ± 19.3. Patients were previously treated by 2.7 ± 1.4 caregivers. Mean scores on a 0-10 scale were as follows: pain (7.13 ± 2.3), sleep quality (6.6 ± 2.4), and quality of life (5.58 ± 3.1). PTTN patients were more likely to quit work (P = .009) and had more days absent from work (mean 24.3; P = .009). We identified patient and pain profiles that predict these poor outcomes. The "vulnerable patient" profile includes health and psychiatric comorbidities and trauma history, particularly PTTN. The "disruptive pain" profile includes severe, continuous, burning, electrical pain accompanied by systemic signs. These profiles intersect in a complex manner, creating a complex feedback loop. CONCLUSIONS A multidisciplinary team approach is recommended to manage COFP patients, in order to improve treatment outcomes and avert more serious consequences.
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Smiljic S, Savic S, Stevanovic J, Kostic M. Prevalence and characteristics of orofacial pain in university students. J Oral Sci 2016; 58:7-13. [PMID: 27021534 DOI: 10.2334/josnusd.58.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Sonja Smiljic
- Department of Physiology, Medical Faculty, University of Pristina
| | - Sladjana Savic
- Department of Histology, Medical Faculty, University of Pristina
| | | | - Mirjana Kostic
- Department of Public Health, Medical Faculty, University of Pristina
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Sipilä K, Tolvanen M, Mitrirattanakul S, Sitthisomwong P, Järvelin MR, Taanila A, Anttonen V, Lahti S. Orofacial pain and symptoms of temporomandibular disorders in Finnish and Thai populations. Acta Odontol Scand 2015; 73:330-5. [PMID: 25613141 DOI: 10.3109/00016357.2014.949842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Cultural or ethnic factors may play an important role in subjects' pain reports. The aim of the study was to compare the prevalence of orofacial pain symptoms between Finnish and Thai populations. MATERIALS AND METHODS The Finnish study population comprised the Northern Finland Birth Cohort 1966, of which 5696 subjects participated in the present study. The Thai sample consisted of 1501 randomly selected people living in 10 different districts in Bangkok. Data on orofacial pain was collected based on questionnaires. RESULTS After adjusting for age, gender and education, the logistic regression analysis showed that Thai subjects had an increased risk for reporting oral pain (OR = 4.5, 95% CI = 3.7-5.4), tooth pain (OR = 2.0, 95% CI = 1.8-2.4) and pain in the face (OR = 1.5, 95% CI = 1.2-1.7). CONCLUSIONS It can be concluded that Thai people report more orofacial pain symptoms than Finnish subjects. Cross-cultural factors exist in the background of reporting pain symptoms in the oral and facial area.
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Affiliation(s)
- Kirsi Sipilä
- Institute of Dentistry, University of Eastern Finland , Finland
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Das S, Gupta R, Dhyani M, Goel D. Headache secondary to sleep-related bruxism: A case with polysomnographic findings. J Neurosci Rural Pract 2015; 6:248-51. [PMID: 25883492 PMCID: PMC4387823 DOI: 10.4103/0976-3147.150293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep.
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Affiliation(s)
- Sourav Das
- Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Ravi Gupta
- Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Mohan Dhyani
- Department of Psychiatry and Sleep Clinic, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Deepak Goel
- Department of Neurology and Sleep Clinic, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Karibe H, Goddard G, Shimazu K, Kato Y, Warita-Naoi S, Kawakami T. Comparison of self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial temporomandibular disorders by age group: a prospective outcome study. BMC Musculoskelet Disord 2014; 15:423. [PMID: 25496226 PMCID: PMC4295233 DOI: 10.1186/1471-2474-15-423] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Subjective symptoms of temporomandibular disorders (TMDs) have rarely been studied by age group. We aimed to compare self-reported pain intensity, sleeping difficulty, and treatment outcomes of patients with myofascial TMDs among three age groups. METHODS The study population included 179 consecutive patients (151 women and 28 men) who underwent comprehensive clinical examinations at a university-based orofacial pain center. They were classified into myofascial pain subgroups based on the Research Diagnostic Criteria for Temporomandibular Disorders. They were stratified by age group: M1, under 20 years; M2, 20-39 years; and M3, 40 years and older. The patients scored their pretreatment symptoms (first visit) and post-treatment symptoms (last visit) on a form composed of three items that assessed pain intensity and one item that assessed sleeping difficulty. Their treatment options (i.e., pharmacotherapy, physical therapy, and orthopedic appliances) and duration were recorded. All variables were compared between sexes in each group and between the age groups by using the Kruskal-Wallis test, the Mann-Whitney U test, the chi-square test, and analysis of variance (p < 0.05). RESULTS No significant sex differences were found in any age group. Only sleeping difficulty was significantly different before treatment (p = 0.009). No significant differences were observed in the treatment options or treatment duration. After treatment, the intensity of jaw/face pain and headache and sleeping difficulty was significantly reduced in groups M2 and M3, but only the intensity of jaw/face pain was significantly decreased in group M1. The changes in the scores of pain intensity and sleeping difficulty were not different between the groups. CONCLUSIONS Pain intensity does not differ by age group, but older patients with myofascial TMDs had greater sleeping difficulties. However, there were no differences between the age groups in the treatment outcomes. Clinicians should carefully consider the age-related characteristics of patients with myofascial TMDs when developing appropriate management strategies.
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Affiliation(s)
- Hiroyuki Karibe
- Department of Pediatric Dentistry, School of Life Dentistry, Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan.
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