Distúrbios craniomandibulares em pacientes edentados unilaterais inferiores com e sem próteses parciais removíveis (PPR): um estudo transversal utilizando o índice craniomandibular

Assessment of somatosensory changes in Chinese temporomandibular disorders arthralgia patients by quantitative sensory testing

BACKGROUND

Somatosensory changes in Chinese temporomandibular disorders (TMD) arthralgia patients have not been fully studied by the latest technologies.

OBJECTIVE

This study aims at assessing somatosensory changes in Chinese TMD arthralgia patients quantitatively.

METHODS

Standardised quantitative sensory testing (QST) was performed on the pain sites and contralateral sites of 40 patients diagnosed with TMD arthralgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) before and after medication; similar measures were taken in 40 age- and gender-matched healthy controls. Differences within and between groups were assessed through Z-scores, two-way ANOVA and loss/gain coding system.

RESULTS

The pain sites of patients presented increased sensitivity to thermal stimuli and mechanical pain stimuli together with decreased sensitivity to mechanical tactile stimuli before medication (P < .001). Before treatment, 100% of patients had somatosensory abnormalities at the pain sites; the most frequent abnormalities were somatosensory gain to cold nociceptive, pinprick and pressure stimuli, and the most frequent loss/gain score was L0G3 (no somatosensory loss with a gain of thermal and mechanical somatosensory function; 70.0%). After treatment, although the clinical symptoms and signs of 40 patients disappeared, 80.0% of the patients' pain sites still showed multiple phenotype abnormalities. The most frequent loss/gain score was L0G2 (no somatosensory loss with a gain of mechanical somatosensory function; 35.0%).

CONCLUSIONS

Multiple phenotypes of facial somatosensory abnormalities were detected in Chinese TMD arthralgia patients before and after treatment, despite the disappearance of clinical signs and symptoms. Individual variations indicate a possible need for subgroup classification, individualised management and mechanism-based treatment.

Comparison of temporomandibular disorders in Iranian dental and nondental students

AIM

The aim of this study was to define the prevalence and severity of temporomandibular disorders (TMD) among Iranian dental and nondental students who attended Shiraz University of Medical Sciences.

MATERIALS AND METHODS

The samples consisted of 200 subjects, 100 dental and 100 nondental students (equal distribution between males and females). Subjects ages ranged from 18 to 30 years (24.07 ± 2.93). A functional evaluation was performed using the Helkimo dysfunction index (Di). Data were evaluated by the Chi-square test.

RESULTS

Among the total study population, 71% showed some degree of dysfunction. Prevalence ratio in dental students was 80%, while in nondental students was 62% (p > 0.05, odds ratio = 0.679). With respect to gender, women (80%) were more affected than men (62%). A significant relationship was found between gender and the occurrence of TMD (p > 0.05).

CONCLUSION

A high prevalence of signs of TMD in Iranian university students was seen which was greater in dental students and women.

CLINICAL SIGNIFICANCE

The results of this study showed that the prevalence of TMD among dental students and women was significantly higher than nondental students and men. These findings might be due to poor postural style or emotional stress during dental practice.

Analysis of helkimo and craniomandibular indexes for temporomandibular disorder diagnosis on rheumatoid arthritis patients

Summary

Aim: The aim of this study was to evaluate the use of two indexes (Helkimo and Craniomandibular) for the diagnosis of temporomandibular disorder (TMD) in patients with Rheumatoid Arthritis (RA).

Patients and methods

The sample was composed of 80 patients divided into two groups: patients with RA and patients without RA. In both groups the two indexes were used. For TMD diagnosis, the following signs and symptoms were evaluated: TMJ pain, limited mouth opening and joint sounds.

Results

Results showed that of the RA patients, 87.1% were females and 12.9% were males. Among the patients without RA, 70% were females and 30% were males. The age of these RA patients ranged between 24 and 78 years. Among patients without RA, the age of the patients ranged between 22 and 72 years. It was observed that the prevalence of TMD was higher in the group with RA (98.6% - Helkimo and 87.1% - Craniomandibular) when compared to the group without the disorder (80% - Helkimo and 50% - Craniomandibular).

Conclusion

In summary, one could conclude that both indexes are capable to diagnose temporomandibular disorders in RA patients, although the Helkimo index is less accurate.

Análise dos índices de Helkimo e craniomandibular para diagnóstico de desordens temporomandibulares em pacientes com artrite reumatóide

OBJETIVO: O estudo teve como finalidade avaliar a utilização de dois índices (Helkimo e craniomandibular) para o diagnóstico da desordem temporomandibular (DTM) em pacientes com Artrite Reumatóide (AR). MATERIAIS E MÉTODOS: A amostra foi de 80 pacientes divididos em dois grupos: pacientes com AR e pacientes sem AR. Em ambos os grupos os dois índices foram utilizados. No diagnóstico da DTM foram avaliados os seguintes sinais e sintomas: dor na ATM; limitação de abertura de boca e ruídos articulares. RESULTADOS: Os resultados mostram que dos pacientes com AR 87,1% eram do gênero feminino e 12,9% do masculino. Entre os pacientes sem AR, 70% eram do gênero feminino e 30% do masculino. A idade dos pacientes com AR variou de 24 a 78 anos. Entre os pacientes sem AR, a idade variou de 22 a 72 anos. Foi verificado que a prevalência de DTM foi mais elevada no grupo de pacientes com AR (98,6% - Helkimo e 87,1% - craniomandibular) do que no grupo sem a doença (80% - Helkimo e 50% - craniomandibular). CONCLUSÃO: Em resumo, temos que ambos os índices são capazes de diagnosticar a desordem temporomandibular em pacientes com AR, entretanto o Índice de Helkimo é menos preciso.