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Catunda IS, Lima Junior MOD, Costa Araujo FAD, Fontan Soares C, Ferreira JCA, Kosminsky M, Vasconcelos BCDE, Vasconcellos RJDH. Is Muscle Pain in Temporomandibular Disorder a Hyperactivity Problem? A Clinical, Thermographic, and Electromyographic Analysis. J Craniofac Surg 2024:00001665-990000000-01661. [PMID: 38829989 DOI: 10.1097/scs.0000000000010209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/09/2024] [Indexed: 06/05/2024] Open
Abstract
ABSTRACT This study aimed to report clinical data on muscle pain in temporomandibular disorders using thermography, algometry, and surface electromyography (EMG). This was done to support or rule out the hypothesis that painful muscles are always related to muscular hyperactivity. This cross-sectional, analytical study included 50 participants who underwent clinical examination and evaluation of anterior temporal muscles and bilateral masseters using thermography, algometry, and EMG. The muscles with greater pain symptoms had hyporadiation and a lower temperature compared with both contralateral muscles and muscles in the asymptomatic group. There was no muscle hyperactivity at rest on EMG analysis; however, there was a greater capacity for muscle recruitment of these symptomatic muscles after a joint decompression test with cotton rolls, suggesting hypoactivity of the affected muscles in the symptomatic patient group. Muscle pain may be related to hypoactivity of the musculature when there is neurological inhibition of the recruitment of muscle fibers, and treatment must consider these neurophysiological alterations. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
| | | | | | - Cauê Fontan Soares
- Department of Prosthesis and Maxillofacial Surgery, Faculty of Dentistry, Federal University of Pernambuco (UFPE), Recife, PE, Brazil
| | | | - Maurício Kosminsky
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Pernambuco (UPE)
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Rytivaara R, Näpänkangas R, Kainulainen T, Sipola A, Kallio-Pulkkinen S, Raustia A, Thevenot J. Thermographic findings related to facial pain - a survey of 40 subjects. Cranio 2024; 42:69-76. [PMID: 33689590 DOI: 10.1080/08869634.2021.1894859] [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] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this study was to assess how thermography findings relate painful symptoms and signs of temporomandibular disorders (TMD). METHODS Thermography, combined with chewing of paraffin wax, was performed on 40 subjects. The results were analyzed according to gender and pain-related TMD symptoms and clinical signs. RESULTS The overall temperatures after chewing were higher in TMD patients than in controls. For females, the most significant findings were the thermal increase between the relaxed state and subjects' state after chewing in temporal and temporomandibular joint (TMJ) regions. For males, all calculated parameters demonstrated a poor ability to discriminate TMD from controls. CONCLUSION Thermography could be a potential tool in diagnostics of female TMD patients. The results suggest that the thermal information assessed in specific facial areas could help to discriminate TMD patients from non-TMD patients and could be used to quantify the pain associated with TMD.
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Affiliation(s)
- Riina Rytivaara
- Department of Dental Imaging, Oulu University Hospital, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ritva Näpänkangas
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tiina Kainulainen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Annina Sipola
- Department of Dental Imaging, Oulu University Hospital, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Soili Kallio-Pulkkinen
- Department of Dental Imaging, Oulu University Hospital, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aune Raustia
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jérôme Thevenot
- Medical Imaging, Physics and Technology Research Unit, University of Oulu, Oulu, Finland
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Diniz de Lima E, Souza Paulino JA, Lira de Farias Freitas AP, Viana Ferreira JE, Barbosa JDS, Bezerra Silva DF, Bento PM, Araújo Maia Amorim AM, Melo DP. Artificial intelligence and infrared thermography as auxiliary tools in the diagnosis of temporomandibular disorder. Dentomaxillofac Radiol 2022; 51:20210318. [PMID: 34613829 PMCID: PMC8802706 DOI: 10.1259/dmfr.20210318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To assess three machine learning (ML) attribute extraction methods: radiomic, semantic and radiomic-semantic association on temporomandibular disorder (TMD) detection using infrared thermography (IT); and to determine which ML classifier, KNN, SVM and MLP, is the most efficient for this purpose. METHODS AND MATERIALS 78 patients were selected by applying the Fonseca questionnaire and RDC/TMD to categorize control patients (37) and TMD patients (41). IT lateral projections of each patient were acquired. The masseter and temporal muscles were selected as regions of interest (ROI) for attribute extraction. Three methods of extracting attributes were assessed: radiomic, semantic and radiomic-semantic association. For radiomic attribute extraction, 20 texture attributes were assessed using co-occurrence matrix in a standardized angulation of 0°. The semantic features were the ROI mean temperature and pain intensity data. For radiomic-semantic association, a single dataset composed of 28 features was assessed. The classification algorithms assessed were KNN, SVM and MLP. Hopkins's statistic, Shapiro-Wilk, ANOVA and Tukey tests were used to assess data. The significance level was set at 5% (p < 0.05). RESULTS Training and testing accuracy values differed statistically for the radiomic-semantic association (p = 0.003). MLP differed from the other classifiers for the radiomic-semantic association (p = 0.004). Accuracy, precision and sensitivity values of semantic and radiomic-semantic association differed statistically from radiomic features (p = 0.008, p = 0.016 and p = 0.013). CONCLUSION Semantic and radiomic-semantic-associated ML feature extraction methods and MLP classifier should be chosen for TMD detection using IT images and pain scale data. IT associated with ML presents promising results for TMD detection.
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Affiliation(s)
- Elisa Diniz de Lima
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | | | | | | | | | - Patrícia Meira Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | - Daniela Pita Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
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Diagnosis of Temporomandibular Disorders Using Thermovision Imaging. Pain Res Manag 2020; 2020:5481365. [PMID: 33282037 PMCID: PMC7685803 DOI: 10.1155/2020/5481365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022]
Abstract
Temporomandibular joint dysfunction (TMD) is a chronic disease of various etiologies. Correct TMD diagnosis enables to apply effective treatment and significantly improves the quality of patients' lives. One of the diagnostic methods subjected to evaluation in recent years is thermography, which enables safe, noninvasive, and quick imaging of the temperature distribution of temporomandibular joint-associated tissues. This paper, based on Medline, Dentistry & Oral Sciences Source, Academic Search Ultimate, Medline Complete databases, presents basic information related to thermovision imaging and outlines the direction of research conducted in recent years which fight with difficulties in the interpretation of thermograms that require specialized, dedicated analysis and processing of the obtained images. The problem concerns also no standardized protocol for measuring masticatory muscle temperature.
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Barbosa JS, Amorim A, Arruda M, Medeiros G, Freitas A, Vieira L, Melo DP, Bento PM. Infrared thermography assessment of patients with temporomandibular disorders. Dentomaxillofac Radiol 2019; 49:20190392. [PMID: 31794257 DOI: 10.1259/dmfr.20190392] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess patients with and without temporomandibular disorders (TMD) infrared thermography according to the differences in thermal radiance using quantitative sensitivity and specificity tests; and to evaluate the thermal asymmetry and the correlation of the thermal intensity with the intensity of pain upon palpation. METHODS This cross-sectional study performed a quantitative evaluation of clinical and thermographic examinations. The volunteers were evaluated for the presence of TMD using RDC/TMD (Diagnostic Research Criteria for Temporomandibular Disorders), and were divided into two groups: TMD group (n = 45); control group (n = 41), composed of volunteers without TMD, according to the Fonseca Anamnestic Index. The images were assessed for selected regions of interest for the masseter, anterior temporal and TMJ muscles. The mean values of the areas of both groups were compared under the receiver operating characteristic curve. Spearman correlation analysis (non-parametric data) between pain level and mean temperature, by region, and the Pearson's χ2 test was used to verify the association between the presence of temperature and pain asymmetry. The level of significance was set at p < 0.05. RESULTS Both Groups, with and without TMD, presented with absolute and non-dimensional mean temperature without statistical differences (p>0.05). When correlating temperature with intensity of pain upon palpation, a negative correlation was observed for the masseter muscle. CONCLUSION Infrared Thermography resulted in low area under the curve, making it difficult to differentiate TMD via thermographic analysis. The intensity of pain upon palpation in patients with TMD may be accompanied by a decrease in local temperature.
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Affiliation(s)
- J S Barbosa
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Amam Amorim
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Mjalla Arruda
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Gbs Medeiros
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Aplf Freitas
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - Lem Vieira
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - D P Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
| | - P M Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, Brazil
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Riquet D, Houel N, Bodnar JL. Effect of osteopathic treatment on a scar assessed by thermal infrared camera, pilot study. Complement Ther Med 2019; 45:130-135. [PMID: 31331549 DOI: 10.1016/j.ctim.2019.06.005] [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: 02/20/2019] [Revised: 05/23/2019] [Accepted: 06/10/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Scar formation is influenced by mechanical forces and may generate mechanical tension. Scars induce a temperature difference in the body objectified by thermal imaging camera. The osteopath's task is to ensure the tissue good mobility in the body. The aim of this study was to measure the influence of osteopathic treatment on a scar by thermal camera. METHOD 12 subjects were analyzed: 4 scars by wounds and 8 by operations. A thermal camera was used to measure the temperature variations of the scars and peri-scar area after cooled stimulation. Measurements were made before and after osteopathic treatment. RESULTS/FINDINGS A significant difference was found between the scar and the peri-scar area before osteopathic treatment (p = 0.044) and no significant difference after osteopathic treatment (p = 0.069). Results showed that osteopathic treatment on a scar induces a more homogeneous local warming temperature. CONCLUSION The osteopathic treatment allows different warming between scar and peri-scar area; this suggests a modification of the connective tissue function after osteopathic treatment. Further studies are required to better understand the function of connective tissue and the mechanism of healing.
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Affiliation(s)
- Damien Riquet
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, Champs sur Marne, France; Institut de thermique Mécanique Matériaux, Campus du Moulin de la Housse, Reims, France.
| | - Nicolas Houel
- ESO Paris Recherche, Ecole Supérieure d'Ostéopathie, Cité Descartes, Champs sur Marne, France; Laboratoire Performance, Santé, Métrologie, Société, EA - 7507, UFR STAPS Campus du Moulin de la Housse, Reims, France.
| | - Jean-Luc Bodnar
- Institut de thermique Mécanique Matériaux, Campus du Moulin de la Housse, Reims, France.
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Altindiş T, Güngörmüş M. Thermographic evaluation of occlusal splint and low level laser therapy in myofascial pain syndrome. Complement Ther Med 2019; 44:277-281. [DOI: 10.1016/j.ctim.2019.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/30/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022] Open
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Abstract
Abstract
The aim of this study is to compare the pain intensity reduction between the mean radiation doses per session of gallium-aluminum-arsenide (GaAIAs) laser with superluminous diodes (SLD) in four of the most common pain-related chronic temporomandibular disorders (TMD) - local myalgia, myofascial pain, myofascial pain with a referral, and arthralgia. This study was implemented on 124 patients with pain-related temporomandibular disorders according to the DC/TMD criteria. We applied trigger point oriented near-infrared laser (785 nm, 100 s, 8 J/cm2) and SLD cluster sessions (the cluster is composed of 49 SLDs with a combination of visible red (633 nm) and infrared (880 nm) diodes, 200 mW, 300 s, 8 J/cm2) for the temporomandibular joints and the affected muscles. Patients were evaluated at the start of the treatment, and after the 6th session of combined phototherapy. The pain intensity scores were measured according to the Visual Analogue Scale (VAS). Our results show that the most statistically manifested pain reduction is found for the SLD dose, р = 0,000118, followed by the overall dose (laser plus SLD); р = 0,001031, and the laser dose; р = 0,030942 (ANOVA dispersion analyses). Consequently, it can be concluded that myalgia is better treated through lower doses of red light compared to infrared laser doses because SLDs combine the prooxidative effect of photons with 633 nm wavelength, a large area of exposure, sufficient tissue penetration, and some positive warming thermal impact of the SLD clusters.
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Thevenot J, Lopez MB, Hadid A. A Survey on Computer Vision for Assistive Medical Diagnosis From Faces. IEEE J Biomed Health Inform 2017; 22:1497-1511. [PMID: 28991753 DOI: 10.1109/jbhi.2017.2754861] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Automatic medical diagnosis is an emerging center of interest in computer vision as it provides unobtrusive objective information on a patient's condition. The face, as a mirror of health status, can reveal symptomatic indications of specific diseases. Thus, the detection of facial abnormalities or atypical features is at upmost importance when it comes to medical diagnostics. This survey aims to give an overview of the recent developments in medical diagnostics from facial images based on computer vision methods. Various approaches have been considered to assess facial symptoms and to eventually provide further help to the practitioners. However, the developed tools are still seldom used in clinical practice, since their reliability is still a concern due to the lack of clinical validation of the methodologies and their inadequate applicability. Nonetheless, efforts are being made to provide robust solutions suitable for healthcare environments, by dealing with practical issues such as real-time assessment or patients positioning. This survey provides an updated collection of the most relevant and innovative solutions in facial images analysis. The findings show that with the help of computer vision methods, over 30 medical conditions can be preliminarily diagnosed from the automatic detection of some of their symptoms. Furthermore, future perspectives, such as the need for interdisciplinary collaboration and collecting publicly available databases, are highlighted.
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Priego Quesada JI, Kunzler MR, Carpes FP. Methodological Aspects of Infrared Thermography in Human Assessment. BIOLOGICAL AND MEDICAL PHYSICS, BIOMEDICAL ENGINEERING 2017. [DOI: 10.1007/978-3-319-47410-6_3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Haddad DS, Brioschi ML, Baladi MG, Arita ES. A new evaluation of heat distribution on facial skin surface by infrared thermography. Dentomaxillofac Radiol 2016; 45:20150264. [PMID: 26891669 DOI: 10.1259/dmfr.20150264] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify the facial areas defined by thermal gradient, in individuals compatible with the pattern of normality, and to quantify and describe them anatomically. METHODS The sample consisted of 161 volunteers, of both genders, aged between 26 and 84 years (63 ± 15 years). RESULTS The results demonstrated that the thermal gradient areas suggested for the study were present in at least 95% of the thermograms evaluated and that there is significant difference in temperature between the genders, racial group and variables "odontalgia", "dental prothesis" and "history of migraine" (p < 0.05). Moreover, there was no statistically significant difference in the absolute temperatures between ages, and right and left sides of the face, in individuals compatible with the pattern of normality (ΔT = 0.11°C). CONCLUSIONS The authors concluded that according to the suggested areas of thermal gradients, these were present in at least 95% of all the thermograms evaluated, and the areas of high intensity found in the face were medial palpebral commissure, labial commissure, temporal, supratrochlear and external acoustic meatus, whereas the points of low intensity were inferior labial, lateral palpebral commissure and nasolabial.
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Affiliation(s)
- Denise S Haddad
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marcos L Brioschi
- 2 Clinical Hospital, School of Medicine, University of São Paulo (HCFMUSP), Pain Center, HCFMUSP, São Paulo, Brazil
| | - Marina G Baladi
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko S Arita
- 1 Oral Radiology Division, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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