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Dai B, Han S, Shen Y, Li Z, Chen S, Wang Z, Yuan Y, Zhang R, Wang C, Zheng J, Liang Q, Wang Q, Zhang Y, Zhang X, Wang F, Jin Y. Mycoplasma pneumonia in a patient with X-linked agammaglobulinemia. BMC Infect Dis 2024; 24:972. [PMID: 39271984 PMCID: PMC11395589 DOI: 10.1186/s12879-024-09743-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/09/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND X-linked agammaglobulinemia (XLA), also referred to as Bruton's tyrosine kinase deficiency, is a rare genetic disorder that affects the immune system. We conducted genetic analysis on patients suffering from immunodeficiency by utilizing Next-Generation Sequencing techniques, as well as their closest relatives, to facilitate accurate diagnosis, offer genetic counseling services, and enhance our comprehension of XLA.
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Affiliation(s)
- Bowen Dai
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Shujuan Han
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Yuanfang Shen
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Zhi Li
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Shouhang Chen
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Zhuangzhuang Wang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Yan Yuan
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Ruyu Zhang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Chenyu Wang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Jiaying Zheng
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Qiujing Liang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Qingmei Wang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Yaodong Zhang
- Henan International Joint Laboratory of Children's Infectious Diseases, Henan Children's Hospital, Children's Hospital, Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China
| | - Xiaolong Zhang
- NHC Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, 450018, China
| | - Fang Wang
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China.
| | - Yuefei Jin
- Department of Infectious Diseases, Henan Children's Hospital, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Zhengzhou, 450018, China.
- College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
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Felin GC, Tagliari CVDC, Agostini BA, Collares K. Prevalence of psychological disorders in patients with temporomandibular disorders: A systematic review and meta-analysis. J Prosthet Dent 2024; 132:392-401. [PMID: 36114016 DOI: 10.1016/j.prosdent.2022.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Temporomandibular disorders (TMDs) affect the muscles of mastication, the temporomandibular joint, and associated structures. They are generally classified as muscular or articular and are the main cause of pain in the orofacial region, eventually causing psychological problems. However, the real burden of psychological disorders is unknown. PURPOSE The purpose of this systematic review and meta-analysis was to assess the prevalence of psychological disorders in patients with TMDs. MATERIAL AND METHODS The study was conducted through a bibliographic search carried out without initial limit until July 2021 in the following electronic databases: MEDLINE/PubMed, Scopus, and PsycINFO. Clinical observational studies investigating depression and somatization in patients with TMD diagnosed by the Diagnostic Research for Temporomandibular Disorders (RDC/TMD) criteria in muscular, articular, and disc disorders were included. A descriptive analysis of the included studies and a meta-analysis for the prevalence data were performed for the synthesis of evidence. RESULTS A total of 2320 studies were found, of which 48 complete articles were assessed for eligibility and 22 were included in the analysis. The general prevalence of depression and moderate and severe somatization in patients diagnosed with TMD was estimated at 43.0% (95% confidence interval (CI), 36.0% to 50.0%) and 60.0% (95% CI 52.0 - 67, 0%). The average overall score for depression was estimated at 0.92 (95% CI, 0.69-1.15), being classified as moderate depression. The average overall score for somatization was estimated at 1.09 (95% CI, 0.81-1.36), being classified as severe somatization. All analyses showed high heterogeneity (I2>90%). Based on the quality assessment, 80.9% of studies included in the review had low to moderate risk of bias. CONCLUSIONS Patients with TMDs who seek clinical care show a high prevalence of depression and somatization.
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Affiliation(s)
- Gabriela Caovilla Felin
- Master's student, Post-Graduation Program in Dentistry, Dental School, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | - Camila Vieira da Cunha Tagliari
- PhD student, Post-Graduation Program in Dentistry, Dental School, University of Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil
| | | | - Kaue Collares
- Professor, Post-Graduation Program in Dentistry, University of Passo Fundo, Passo Fundo, Rio Grande do Sul, Brazil.
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3
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Wu S, Chen Z, Zhao Y, He Q, Yin Z, Yao H, Liu H, Yan L. Genetically predicted major depression causally increases the risk of temporomandibular joint disorders. Front Genet 2024; 15:1395219. [PMID: 38836036 PMCID: PMC11148344 DOI: 10.3389/fgene.2024.1395219] [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: 03/03/2024] [Accepted: 04/23/2024] [Indexed: 06/06/2024] Open
Abstract
Objective Observational studies have reported that mental disorders are comorbid with temporomandibular joint disorder (TMD). However, the causal relationship remains uncertain. To clarify the causal relationship between three common mental illnesses and TMD, we conduct this Mendelian Randomization (MR) study. Methods The large-scale genome-wide association studies data of major depression, bipolar disorder and schizophrenia were retrieved from the Psychiatric Genomics Consortium. The summary data of TMD was obtained from the Finn-Gen consortium, including 211,023 subjects of European descent (5,668 cases and 205,355 controls). The main approach utilized was inverse variance weighting (IVW) to evaluate the causal association between the three mental disorders and TMD. Five sensitivity analyses including MR-Egger, Maximum Likelihood, Weighted median, MR. RAPS and MR-PRESSO were used as supplements. We conducted heterogeneity tests and pleiotropic tests to ensure the robustness. Results As shown by the IVW method, genetically determined major depression was associated with a 1.65-fold risk of TMD (95% CI = 1.10-2.47, p < 0.05). The direction and effect size remained consistent with sensitivity analyses. The odds ratios (ORs) were 1.51 (95% CI = 0.24-9.41, p > 0.05) for MR-Egger, 1.60 (95% CI = 0.98-2.61, p > 0.05) for Weighted median, 1.68 (95% CI = 1.19-2.38, p < 0.05) for Maximum likelihood, 1.56 (95% CI = 1.05-2.33, p < 0.05) for MR. RAPS, and 1.65 (95% CI = 1.10-2.47, p < 0.05) for MR-PRESSO, respectively. No pleiotropy was observed (both P for MR-Egger intercept and Global test >0.05). In addition, the IVW method identified no significant correlation between bipolar disorder, schizophrenia and TMD. Conclusion Genetic evidence supports a causal relationship between major depression and TMD, instead of bipolar disorder and schizophrenia. These findings emphasize the importance of assessing a patient's depressive status in clinical settings.
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Affiliation(s)
- Shiqian Wu
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zhuo Chen
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yawen Zhao
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Qiang He
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhongxiu Yin
- Queen Mary School, Nanchang University, Nanchang, China
| | - Hailiang Yao
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Huili Liu
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Lihui Yan
- Department of Stomatology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, China
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de Almeida Hoff E, Grossi RK, Bozzetti Pigozzi L, Bueno CH, Pattussi MP, Rossi T, Quarti Irigaray T, Weber JBB, Grossi ML. Depression and the risk of developing temporomandibular disorders in different diagnostic groups: A systematic review with meta-analysis. Cranio 2024:1-13. [PMID: 38461514 DOI: 10.1080/08869634.2024.2323424] [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: 03/12/2024]
Abstract
OBJECTIVE To evaluate the role of depression in the development of TMD groups. METHODS This systematic review with meta-analysis compared the prevalence and scores of depression between TMD groups and controls. RESULTS The results showed that depression was a significant risk factor in the development of RDC/TMD axis I muscle disorders (group I) and arthralgia/osteoarthritis/osteoarthrosis (group III), and non-significant for disc displacements (group II). Severe depression had almost four times the risk of developing TMD as compared to moderate depression. CONCLUSION These findings suggest that addressing psychological factors in general, and depression in particular, in the managemenof TMD is crucial, especially in those TMD groups with higher pain levels (I and III), and the TMD pain reduction is crucial in reducing depression levels.
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Affiliation(s)
- Elisa de Almeida Hoff
- Undergraduate Student, School of Health and Life Sciences, Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Rafaela Krieger Grossi
- Undergraduate Student, Psychology Program (Specialist), University of Toronto, Mississauga, Canada
| | - Lucas Bozzetti Pigozzi
- Faculty of Serra Gaúcha, Program in Dentistry, Department of Prosthodontics, City of Caxias do Sul, Brazil
| | - Caroline Hoffmann Bueno
- Post-Graduate Program in Dentistry (Oral and Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Marcos Pascoal Pattussi
- Post-Graduate Program in Public Health, Vale do Rio dos Sinos University (UNISINOS), City of São Leopoldo, Brazil
| | - Tainá Rossi
- (Clinical Psychology), Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Tatiana Quarti Irigaray
- Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - João Batista Blessmann Weber
- Post-Graduate Program in Dentistry (Oral and Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
| | - Márcio Lima Grossi
- Post-Graduate Program in Psychology, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), City of Porto Alegre, Brazil
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Seyhan M, Atalay ES. Is core stability training effective in temporomandibular disorder? A randomized controlled trial. Clin Oral Investig 2023; 27:7237-7246. [PMID: 37924356 DOI: 10.1007/s00784-023-05274-x] [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: 08/20/2022] [Accepted: 09/23/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES This study investigated the effect of core stability training on pain, function, quality of life, and posture in individuals with temporomandibular disorder. MATERIALS AND METHODS Participants were divided into the following: the core stability group and the control group. For pain assessment, the Graded Chronic Pain Scale 2.0; for function, the 20-item Jaw Functional Limitation Scale (JFLS-20); for oral health-related quality of life, Oral Health Impact Profile-14 (OHIP-14); and for posture assessment, the New York Scale were used. Rocabado exercises were applied to the control group. Additionally, spinal stabilization exercises were applied for the core stability group for 6 weeks. RESULTS Both types of exercise contribute positively to the quality of life associated with oral health. Rocabado exercise provided a significant change in Chronic Pain Intensity and Disability Score. CONCLUSION Rocabado exercise and core stability training, implemented with Rocabado, provide significant changes in pain values. When evaluated in terms of function, no significant difference was found in both exercise programs. CLINICAL RELEVANCE Core stability training with Rocabado provides significant changes. CLINICAL TRIAL REGISTRATION NUMBER NCT04755621.
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Affiliation(s)
- Merve Seyhan
- Department of Physical Therapy and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Emre Serdar Atalay
- Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Emrah Mah, Ankara, Turkey.
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El-Shaheed NH, Mostafa AZH, Aboelez MA. Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial. J Oral Rehabil 2023; 50:177-193. [PMID: 36564950 DOI: 10.1111/joor.13405] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Stabilisation splint therapy (SST) and low-level laser therapy (LLLT) are effective-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown. OBJECTIVES The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR. METHODS This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software. RESULTS Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II. CONCLUSION All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement. CLINICAL TRIAL REGISTRATION NUMBER NCT05548894.
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Banafa A, Suominen AL, Sipilä K. Association between cynical hostility and temporomandibular pain mediated through somatization and depression: an 11-year follow-up study on Finnish adults. Acta Odontol Scand 2023; 81:79-85. [PMID: 35731236 DOI: 10.1080/00016357.2022.2085323] [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: 02/08/2023]
Abstract
BACKGROUND Hostility is believed to have an adverse effect on physical health through mediating psychosocial factors. OBJECTIVES This study aimed to investigate the association of hostility with temporomandibular (TMD) pain. Another aim was to investigate if the association is mediated through increases in depressiveness and somatization in an 11-year follow-up on Finnish adults, based on the Health 2000 and 2011 Surveys (BRIF8901). MATERIAL AND METHODS The sample comprised subjects who underwent clinical TMD pain examination (pain on palpation of the masticatory muscles and temporomandibular joints) in 2000 and 2011 and responded to questions on TMD pain symptoms in 2011. Hostility was measured using the Cynical Distrust Scale, somatization was measured using the Symptom Checklist-90, and depressiveness using Beck's Depression Inventory-21. Four subgroups were formed based on the presence of TMD pain: no pain, pain in 2000 only, pain in 2011 only, and pain in 2000 and 2011. Analyses included chi-square test cross-sectionally, and multinomial logistic regression longitudinally with the level of hostility in 2000 as the predictor. Mediation analysis was performed using Hayes' Process v3.5. RESULTS Those with higher hostility showed a higher prevalence of TMD pain. Longitudinally, the association of hostility with TMD pain in 2000 only, and with TMD pain in both years, was mediated either by somatization only or by depressiveness that was mediated by somatization. In those with TMD pain in 2011 only, the association was mediated by depressiveness that was mediated by somatization. CONCLUSION Hostility increased the risk of TMD pain through increases in depressiveness and somatization.
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Affiliation(s)
- Aisha Banafa
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Kirsi Sipilä
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Oral and Maxillofacial Department, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
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Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update. Diagnostics (Basel) 2022; 12:diagnostics12122914. [PMID: 36552921 PMCID: PMC9776546 DOI: 10.3390/diagnostics12122914] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022] Open
Abstract
Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders affecting the temporomandibular joint (TMJ) could easily confuse physicians. In addition to the basics, such as thorough history taking and meticulous clinical examinations, different imaging techniques are useful adjuncts to facilitate the diagnostic process. This review presents an overview of the current understanding on a variety of diagnostic and treatment modalities for M-TMD patients. It is essential to highlight that there is not a single treatment for all, and the benefits of multidisciplinary strategies have been noted for the effective management of myogenous TMD pain. Treatment modalities ranging from conservative to minimally invasive options are discussed in this review.
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Reis PHF, Laxe LAC, Lacerda‐Santos R, Münchow EA. Distribution of anxiety and depression among different subtypes of temporomandibular disorder: A systematic review and meta‐analysis. J Oral Rehabil 2022; 49:754-767. [DOI: 10.1111/joor.13331] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/22/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Laisa Araújo Cortines Laxe
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Restorative Dentistry School of Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
| | - Rogério Lacerda‐Santos
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Dentistry Health Science Institute Federal University of Juiz de Fora Governador Valadares Brazil
| | - Eliseu Aldrighi Münchow
- Postgraduate Program in Dentistry Federal University of Juiz de Fora Juiz de Fora Brazil
- Department of Conservative Dentistry School of Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
- Postgraduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
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10
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Kleykamp BA, Ferguson MC, McNicol E, Bixho I, Arnold LM, Edwards RR, Fillingim R, Grol-Prokopczyk H, Ohrbach R, Turk DC, Dworkin RH. The prevalence of comorbid chronic pain conditions among patients with temporomandibular disorders: A systematic review. J Am Dent Assoc 2022; 153:241-250.e10. [PMID: 34952681 DOI: 10.1016/j.adaj.2021.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/23/2021] [Accepted: 08/19/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND This systematic review was designed to evaluate the presence of comorbid conditions among patients with temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED The authors reviewed studies that reported the prevalence or incidence of chronic pain conditions or psychiatric disorders (anxiety, mood, personality disorders) among patients with any type of TMD. The authors calculated sample size-weighted prevalence estimates when data were reported in 2 or more studies for the same comorbid condition. RESULTS A total of 9 prevalence studies and no incidence studies were eligible for review; 8 of the studies examined chronic pain comorbidities. Weighted estimates showed high prevalence of pain comorbidities across studies, including current chronic back pain (66%), myofascial syndrome (50%), chronic stomach pain (50%), chronic migraine headache (40%), irritable bowel syndrome (19%), and fibromyalgia (14%). A single study examined psychiatric disorders and found that current depression was the most prevalent disorder identified (17.5%). CONCLUSIONS AND PRACTICAL IMPLICATIONS There is a high prevalence of comorbid chronic pain conditions among patients with TMDs, with more than 50% of patients reporting chronic back pain, myofascial syndrome, and chronic stomach pain. Psychiatric disorders among patients with different types of TMDs were studied less commonly in this pain population. Knowledge of the distribution of these and other comorbid disease conditions among patients with different types of TMDs can help dentists and other health care providers to identify personalized treatment strategies, including the coordination of care across medical specialties.
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Chung J, Lobbezoo F, van Selms MKA, Chattrattrai T, Aarab G, Mitrirattanakul S. Physical, psychological and socio-demographic predictors related to patients' self-belief of their temporomandibular disorders' aetiology. J Oral Rehabil 2020; 48:109-123. [PMID: 33051894 DOI: 10.1111/joor.13113] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/20/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aetiology of temporomandibular disorders (TMDs) has been widely discussed in literature, but little is known about patients' self-belief of their TMD aetiology. OBJECTIVE For six categories of self-believed aetiology of the TMD complaint (viz., occlusal factors, physical trauma, emotional stress, deep pain input, parafunctions and unknown), associations with physical, psychological and socio-demographic predictors were assessed. METHODS In this retrospective study, medical records of 328 TMD patients who had visited a clinic for Orofacial Pain and Dental Sleep Medicine were analysed. RESULTS The most frequently reported self-believed TMD aetiology was 'unknown' (42.3%). The category 'occlusal factors' was associated with pain worsening with emotion. 'Physical trauma' as self-believed aetiology was associated with TMD dysfunction score. 'Emotional stress' was associated with awake bruxism and age 18-49 years. 'Deep pain input' was associated with TMD dysfunction score, sleep bruxism, and arthritis or joint pain. 'Parafunctions' were associated with sleep bruxism. 'Unknown' was associated with TMD symptoms severity and work disability. CONCLUSION For each category of self-believed aetiology of the TMD complaint, different associations with physical, psychological and socio-demographic predictors were identified. This may suggest that individual phenotypes play a role in the patient's belief in the cause of the TMD complaint. Determination of phenotypic risk factors associated with aetiological self-belief might help clinicians to provide better treatment, including counselling, to their patients.
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Affiliation(s)
- Joey Chung
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thiprawee Chattrattrai
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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12
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Jung W, Lee KE, Suh BJ. Influence of psychological factors on the prognosis of temporomandibular disorders pain. J Dent Sci 2020; 16:349-355. [PMID: 33384819 PMCID: PMC7770244 DOI: 10.1016/j.jds.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/03/2020] [Indexed: 10/26/2022] Open
Abstract
Background/purpose The leading symptom of temporomandibular disorders (TMD) is pain, and psychological factors are involved in the persistence of TMD-related pain. Therefore, this study was aimed to analyze the influence of psychological factors on the prognosis of TMD-related pain. Materials and methods The medical records of 486 patients with TMD-related pain were analyzed. Each patient's psychological profile was assessed using the Symptom Checklist-90-Revised (SCL-90-R). Patients were classified into two groups according to a post-treatment numeric rating scale (NRS). Patients with an NRS score of 0 or 1 at the last visit were classified into group G, and those with an NRS score of 2 or greater were classified into group P. Following this, all patients were re-classified into groups N and R according to pain recurrence. Statistical analysis was performed to evaluate differences in the SCL-90-R T scores between the groups. In addition, multiple logistic regression analysis was used to identify psychological factors that affected treatment outcome. Results The patients in groups P and R had higher scores in all subscales of the SCL-90-R than groups G and N, respectively. In particular, somatization (SOM) and psychoticism (PSY) scores showed significant differences between the groups in the treatment outcome. Conclusion A correlation is identified between psychological factors and treatment outcome in patients with TMD-related pain. In particular, patients with elevated SOM and PSY scores are more likely to develop refractory pain, and thus require additional interventions to control this risk.
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Affiliation(s)
- Won Jung
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
| | - Kyung-Eun Lee
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
| | - Bong-Jik Suh
- Department of Oral Medicine, School of Dentistry, Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
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Kotsiubinskaya JV, Mikhailov VA, Mazo GE, Ashnokova IA. [Myofascial pain syndrome in the dysfunction of the temporomandibular joint]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:21-26. [PMID: 31851167 DOI: 10.17116/jnevro201911911121] [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] [Indexed: 11/18/2022]
Abstract
AIM Selection of the clinical characteristics of pain syndrome in the orofacial region in temporomandibular joint pain dysfunction syndrome (TMJ PDS). MATERIAL AND METHODS One hundred and two patients with TMJ PDS were examined using the Verbal Descriptive Pain Rating Scale of the orofacial area. The Clinical Index of TMJ dysfunction (CID) by Helkimo M. was used for objectification of the level of musculo-tonic disorders in the area of the chewing muscles. The psychopathological status of patients with TMJ PDS was assessed with HRDS and SCL-90-R. RESULTS A significant proportion of patients with TMJ PDS, in addition to algic symptoms, have hypertonus of the facial muscles, the nature and severity of which require not only a special diagnostic assessment, but also follow-up treatment. The analysis of data allowed us to identify three clinical groups of patients: with isolated (muscular-tonic), neurological symptoms; with mixed (combination of muscular-tonic and somatoform manifestations) neurological and psychopathological symptoms and with somatoform symptoms. CONCLUSION Patients with TMJ PDS are clinically heterogeneous and require clinical differentiation, distinguishing the common group of patients with muscular dysfunction accompanied by pain and emotional response to it (anxiety and minor depressive symptoms) and the group of patients with a somatoform disorder (and manifestations as general anxiety).
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Affiliation(s)
- J V Kotsiubinskaya
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - V A Mikhailov
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - G E Mazo
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
| | - I A Ashnokova
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia
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Wieckiewicz M, Zietek M, Smardz J, Zenczak-Wieckiewicz D, Grychowska N. Mental Status as a Common Factor for Masticatory Muscle Pain: A Systematic Review. Front Psychol 2017; 8:646. [PMID: 28536539 PMCID: PMC5422479 DOI: 10.3389/fpsyg.2017.00646] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/11/2017] [Indexed: 02/02/2023] Open
Abstract
Masticatory muscle pain (MMP) is the primary reason for chronic non-odontogenic orofacial pain in the human population. MMP has become a considerable social problem, which affects about 12-14% of the adult population and is 1.5-2 times more frequent in women than in men. This term defines a pain which has its origins in the masticatory muscles. Although MMP is typically felt in the face, jaws, and preauricular area, MMP can radiate to the ear, teeth, head, and neck. This systematic review explains the relationship between MMP and common mental states, such as anxiety, depression, mood and stress-related disorders, and is reported in accordance with PRISMA guidelines. We performed a search in the PubMed database for peer-reviewed articles published after November 1st 2006 in the context of MMP and mental states. According to the defined criteria, 38 studies were finally included into the systematic review, of which prospective cohort studies were found to be the most common. We investigated four primary outcomes (anxiety, depression, mood disorders, and stress-related disorders) and several secondary outcomes of search. Seventy-nine percent of studies concerned depression, 42% anxiety, 29% mood disorders, and 21% stress-related disorders. Most of the studies showed a relationship between MMP and alterations in mental status. Nonetheless, the researchers usually evidenced only the co-occurrence of psychiatric disorders and dysfunctions of the masticatory muscles among the group of patients, in large part in women. Moreover, some studies were marked with limited generalizability of the reported results, quality flaws and heterogeneity. In the light of the analyzed literature, the causal relationship between mental states and MMP is still not clearly established.
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Affiliation(s)
- Mieszko Wieckiewicz
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
| | - Marek Zietek
- Department of Periodontology, Wroclaw Medical UniversityWroclaw, Poland
| | - Joanna Smardz
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
| | | | - Natalia Grychowska
- Department of Prosthetic Dentistry, Wroclaw Medical UniversityWroclaw, Poland
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Manfredini D, Cerea S, Pavan C, Guarda-Nardini L. Personality traits are potentially associated with the presence of chronic temporomandibular joint pain in patients without effusion as determined by T-2 weighted magnetic resonance. Cranio 2017; 36:91-97. [PMID: 28317450 DOI: 10.1080/08869634.2017.1303879] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The study aimed at investigating personality traits in chronic temporomandibular joints (TMJ) pain patients with and without joint effusion. METHODS Two groups of chronic TMJ pain patients were recruited. The TMJ pain control group was composed of patients showing magnetic resonance imaging (MRI) signs of TMJ effusion, while the TMJ pain test group included patients with chronic TMJ pain seemingly not justified, due to the absence of MRI-detected disorders. A third set of pain free individuals was selected as a comparison group. All patients completed a personality assessment with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) instrument, and the between-group differences were assessed for significance by performing an analysis of variance test. RESULTS Patients of the TMJ pain test group had higher scores than subjects belonging to the TMJ pain and pain-free control groups in almost all of the MMPI-2 clinical scales. A significant difference was shown for the scales related to concerns about physical health (Scale 1-Hs; F = 7.74; p = .001) and physical symptoms (Scale 3-Hy; F = 8.43; p = .001). CONCLUSIONS Chronic TMJ pain patients without MRI-detected TMJ effusion have a different personality profile than patients with TMJ effusion and pain-free individuals, regarding high levels of concerns about physical health and physical symptoms. CLINICAL IMPLICATIONS This study has important clinical implications for temporomandibular disorders practitioners, providing suggestions that symptoms in the TMJ area are not only related to a physical disorder. The possible existence of a psychologically modulated condition in patients who refer pain in the TMJ area without signs of effusion should be carefully taken into consideration.
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Affiliation(s)
- Daniele Manfredini
- a Department of Neurosciences, School of Dentistry and Temporomandibular Disorders Clinic , University of Padova , Padova , Italy
| | - Silvia Cerea
- b Department of General Psychology , University of Padova , Padova , Italy
| | - Chiara Pavan
- c Department of Neurosciences, Psychiatry Clinic , University of Padova , Padova , Italy
| | - Luca Guarda-Nardini
- d Section of Dentistry and Maxillofacial Surgery , Hospital of Treviso , Treviso , Italy
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Gupta P, Singh V, Sethi S, Kumar A. A Comparative Study of Trigger Point Therapy with Local Anaesthetic (0.5 % Bupivacaine) Versus Combined Trigger Point Injection Therapy and Levosulpiride in the Management of Myofascial Pain Syndrome in the Orofacial Region. J Maxillofac Oral Surg 2015; 15:376-383. [PMID: 27752210 DOI: 10.1007/s12663-015-0858-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 10/05/2015] [Indexed: 11/28/2022] Open
Abstract
AIM To compare the efficacy of combined local anesthetic injection with 0.5 % bupivacaine and levosulpiride versus local anesthetic injection alone on outcome measures including levels of pain intensity and depression in the management of myofascial pain syndrome in orofacial region. PATIENTS AND METHODS This was a prospective, randomized, controlled and open-label comparative clinical study. Seventy-four patients diagnosed to have myofascial pain syndrome and fulfilling the inclusion criteria were enrolled for the study. Patients were randomly assigned into 2 groups. Group A received local anesthetic injection (0.5 % bupivacaine) on trigger points and Group B received combined trigger point injection therapy and 50 mg of tablet Levosulpiride orally B.I.D. They were assessed for pain intensity and depression at baseline and at follow-up of 1, 4, 6 and 12 week intervals. RESULTS The mean age of patients was 44.54 + 15.977 years in group A and 39.97 + 14.107 years in group B (P value = 0.2). Group A comprised of 25 females (67.567 %) and 12 males (32.432 %) while group B had 27 females (75 %) and 9 males (25 %). 70.27 % were diagnosed with moderate depression in group A and 75 % in group B. 18.91 % in group A and 19.44 % in group B were diagnosed with severe depression. When the VAS score and BDI score was compared at the follow-up intervals with the baseline scores in both treatment groups, the mean difference was highly significant at all the follow-up intervals. However when the relative efficacies of two interventions were compared between the two groups, improvement in pain was significant at all the follow-up intervals except the 1st week follow-up whereas the improvement in depression was non-significant at 1st and 4th week interval while it was highly significant at 6th and 12th week intervals. CONCLUSION The combined therapy with trigger point injection and levosulpiride as antidepressant significantly reduces pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region.
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Affiliation(s)
- Pranav Gupta
- Department of Dentistry, SHKM Govt. Medical College, Mewat, Haryana India
| | - Virendra Singh
- Department of Oral and Maxillofacial Surgery, PGIDS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Sujata Sethi
- Department of Psychiatry, PGIMS, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana 124001 India
| | - Arun Kumar
- Department of Community Medicine, SHKM Govt. Medical College, Mewat, Haryana 122107 India
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Tinastepe N, Oral K. Investigation of the Relationship between Increased Vertical Overlap with Minimum Horizontal Overlap and the Signs of Temporomandibular Disorders. J Prosthodont 2015; 24:463-8. [PMID: 25556905 DOI: 10.1111/jopr.12249] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to test the null hypothesis that there was no relationship between increased vertical overlap (vertical overlap ≥4 mm) with minimal horizontal overlap (horizontal overlap ≤2 mm) and the signs of temporomandibular disorders. MATERIALS AND METHODS Thirty participants (20 women, aged 20 to 45 years) with increased vertical overlap and minimal horizontal overlap, and 30 participants (20 women, aged 20 to 45 years) with no contact between the anterior teeth (control group) were examined. Diagnoses, psychological status (depression and nonspesific physical symptoms), and chronic pain severity were judged according to the Research Diagnostic Criteria for Temporomandibular Disorders and then compared. For statistical analysis of quantitative data, along with the descriptive statistical methods (mean, standard deviation, frequency), Student's t-test was used to compare parameters that reflected a normal distribution. Comparison of qualitative data between groups was performed using Chi-square and Fisher's exact tests. The level of significance was set at p < 0.05. RESULTS In this study, deviation upon maximum opening was found significantly more frequently in the increased vertical overlap group than in the control group (p < 0.05). Tenderness upon palpation of lateral pterygoid muscles was observed more often in the increased vertical overlap group compared with the control group (p < 0.05). Opening-closing joint sounds occurred significantly more often in the increased vertical overlap group than in the control group (p = 0.050). CONCLUSION Within the limitations of this study, deviation upon maximum opening, tenderness of lateral pterygoid muscles (upon palpation), and opening-closing joint sounds occurred more often in the increased vertical overlap occlusions with minimum horizontal overlap compared to the control groups. These results indicated that clinicians should pay special attention to the tempormandibuar joint status of patients with significant vertical overlap anteriorly and position of the incisors when performing dental treatments that require reestablishment of incisor relationships.
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Affiliation(s)
- Neslihan Tinastepe
- Department of Prosthodontics, Yeditepe University School of Dentistry, Istanbul, Turkey
| | - Koray Oral
- Department of Prosthodontics, Yeditepe University School of Dentistry, Istanbul, Turkey
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Cooper BC, Adib F. An assessment of the usefulness of Kinesiograph as an aid in the diagnosis of TMD: a review of Manfredini et al.'s studies. Cranio 2014; 33:46-66. [PMID: 25115950 DOI: 10.1179/2151090314y.0000000010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
AIM Performing a literature review of publications by Dr. Manfredini et al. related to their temporomandibular joint (TMJ) injection therapy outcome with conclusions on the clinical utility of computerized measurement devices used in the management of temporomandibular disorders (TMDs). In addition, reviewing their published opinion on an occlusion: TMD versus a biopsychosocial paradigm for TMD. Manfredini et al. authored an article published in the Journal of the American Dental Association (JADA) 2013, "An Assessment of the usefulness of jaw kinesiography in monitoring temporomandibular disorders," the most recent of 12 articles. In all studies, subjects received TMJ injections with an objective measurement outcome criterion; increased maximum mouth opening (MMO) and subjective symptom improvement of pain and chewing function. In the 2013 JADA article, the Mandibular Kinesiograph, referred to as KG, measured MMO before and after therapy. In 11 prior articles, all subject groups with limited mouth opening exhibited very significant increased MMO post-treatment, documenting treatment success using the same 2013 protocol. The 2013 study showed a 1·1 mm improved MMO, described as insignificant. The authors did not critique or explain the aberrant, skewed 2013 outcome data contrasted with their prior studies, which showed overwhelmingly significant increased MMO. Instead, they concluded that the MMO recording device was clinically useless. This motivated a literature review of the authors' TMD publications. CONCLUSION The publications by Manfredini et al. recognized proponents of the psychosocial model of TMD, including the 2013 article, appear to be part of a campaign denying an occlusion: TMD relationship and disparaging the specific computerized measurement devices and the dentists using them in the management of their TMD patients using neuromuscular occlusion dental treatment.
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Parental Loss During Childhood and Outcomes on Adolescents’ Psychological Profiles: A Longitudinal Study. CURRENT PSYCHOLOGY 2014. [DOI: 10.1007/s12144-014-9228-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nadendla LK, Meduri V, Paramkusam G, Pachava KR. Evaluation of salivary cortisol and anxiety levels in myofascial pain dysfunction syndrome. Korean J Pain 2013; 27:30-4. [PMID: 24478898 PMCID: PMC3903798 DOI: 10.3344/kjp.2014.27.1.30] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 12/07/2013] [Accepted: 12/10/2013] [Indexed: 11/10/2022] Open
Abstract
Background Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. Methods Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. Results The mean serum cortisol level of the MPDS group showed a highly significant difference (p < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (p < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. Conclusions These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.
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Affiliation(s)
- Lakshmi Kavitha Nadendla
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, India
| | - Venkateswarlu Meduri
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, India
| | - Geetha Paramkusam
- Department of Oral Medicine and Radiology, Kamineni Institute of Dental Sciences, Narketpally, India
| | - Koteswara Rao Pachava
- Department of Prosthodontics, Kamineni Institute of Dental Sciences, Narketpally, India
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Alburquerque-Sendín F, Camargo PR, Vieira A, Salvini TF. Bilateral myofascial trigger points and pressure pain thresholds in the shoulder muscles in patients with unilateral shoulder impingement syndrome: a blinded, controlled study. Clin J Pain 2013; 29:478-86. [PMID: 23328323 DOI: 10.1097/ajp.0b013e3182652d65] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To identify the presence of myofascial trigger points (TrPs) and pressure pain threshold (PPT) levels in the shoulder muscles of both involved and uninvolved sides in patients with unilateral shoulder impingement syndrome (SIS). METHODS Twenty-seven patients with SIS and 20 matched control patients participated in this study. TrPs of 10 shoulder muscles and 8 PPTs, including tibialis anterior PPT, were assessed. RESULTS SIS group showed a greater number of TrPs (t=-2.697; P=0.010) than the control group. The muscles of the uninvolved side of the SIS group also presented some active TrPs. PPTs showed small differences between involved and uninvolved sides of patients with SIS and higher differences between both sides of the SIS group and dominant side of controls although with significant difference only in the supraspinatus PPT (F=3.239; P=0.045). The muscle PPTs of the patients presenting TrPs in each muscle of the involved side were lower than the PPTs of the patients without TrPs in the same muscle for both involved and uninvolved sides with few significant differences. DISCUSSION The high number of TrPs in the involved side of patients with SIS suggests the presence of peripheral sensitization. The results reject the presence of central alterations. Finally, the patients with unilateral SIS may present bilateral deficits related to myofascial pain.
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Tecco S, Marzo G, Crincoli V, Di Bisceglie B, Tetè S, Festa F. The prognosis of myofascial pain syndrome (MPS) during a fixed orthodontic treatment. Cranio 2012; 30:52-71. [PMID: 22435177 DOI: 10.1179/crn.2012.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Among treatments in the literature for myofascial pain syndrome (MPS), the most reliable therapies in dentistry are spray and stretch, and, although less frequently used, anesthetic injection. Adult MPS subjects are often treated using fixed orthodontic therapy for resolution of malocclusion. There is no clarity in the literature on the prognosis of MPS during orthodontic therapy. The purpose of this study was to analyze the prognosis of MPS during orthodontic treatment of subjects with malocclusion, initially diagnosed as having MPS. The analysis covered the medical records of 91 young adult Caucasians scheduled for orthodontic treatment for various malocclusions. Thirty-seven of the patients were initially diagnosed as also having MPS (T0). Thirty patients began the orthodontic treatment and were recalled for a re-evaluation of MPS after dental alignment and dental class correction was achieved (T1). A wait-and-see strategy was applied in seven subjects who were included as the control subjects. They received no treatment for MPS. At T1, a statistically significant decrease was observed in the study group in the presence of any clicking or creaking noises from the jaw joint, a significant jaw joint and jaw muscle pain reduction, and a quality of life improvement. Among patients who were depressed at the beginning of treatment, the majority felt better at the follow-up evaluation. On muscular palpation, a statistically significant decrease was found on the visual analogic scale value of the middle fibers of the temporalis muscle, temporalis tendon, clavicular and sternal division of the sternocleidomastoid muscle, masseter muscles, and posterior cervical muscles. The temporalis and the masseter muscles showed a significant decrease in the number of subjects with trigger points (TrPs) in all areas in the study group, after treatment. The digastric and sternocleidomastoid muscles also showed a significant reduction in the number of subjects with TrPs. Subjects with MPS and malocclusion were treated using a fixed orthodontic treatment. They showed improvement, although no resolution, in the signs and symptoms of MPS, compared with the untreated control group.
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Affiliation(s)
- Simona Tecco
- Unit of Orthodontics, Dept. of Oral Science, University G. D'Annunzio Chieti/Pescara, Via dei Vestini 31, Chieti 66013, Italy.
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Galli U, Ettlin DA, Palla S, Ehlert U, Gaab J. Do illness perceptions predict pain-related disability and mood in chronic orofacial pain patients? A 6-month follow-up study. Eur J Pain 2012; 14:550-8. [DOI: 10.1016/j.ejpain.2009.08.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Revised: 07/23/2009] [Accepted: 08/26/2009] [Indexed: 10/20/2022]
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Yoon HJ, Lee SH, Hur JY, Kim HS, Seok JH, Kim HG, Huh JK. Relationship between stress levels and treatment in patients with temporomandibular disorders. J Korean Assoc Oral Maxillofac Surg 2012. [DOI: 10.5125/jkaoms.2012.38.6.326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Hyung-Jun Yoon
- Department of Psychiatry, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Sung-Hee Lee
- Department of Dentistry, Yongin Severance Hospital, Yonsei University, Yongin, Korea
| | - Jun-Young Hur
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hye-Sun Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea
| | - Hyung-Gon Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, College of Dentistry, Yonsei University, Seoul, Korea
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Kim MJ, Lim MJ, Park WK, Kho HS. Comparison between the SCL-90-R and MMPI in TMD patients with psychological problems. Oral Dis 2011; 18:140-6. [PMID: 21973102 DOI: 10.1111/j.1601-0825.2011.01854.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the relationships between the Symptom Checklist-90-Revision (SCL-90-R) and the Minnesota Multiphasic Personality Inventory (MMPI) in temporomandibular disorders (TMD) patients with psychological problems. MATERIALS AND METHODS Subjective symptoms, objective signs, and psychological characteristics of 36 TMD patients with psychological problems were analyzed. The symptom severity index (SSI) and craniomandibular index (CMI) were used to assess subjective symptoms and objective signs of patients with TMD, respectively. The SCL-90-R and MMPI were used for psychological evaluation. RESULTS The SSI was not significantly correlated with the CMI in TMD patients with psychological problems, and these indices displayed significant correlations with the SCL-90-R and MMPI in several selected subscales. The results of SCL-90-R had a limited relationship with those of MMPI in these patients. Based on the MMPI diagnosis, the SCL-90-R somatization subscale showed moderate to high sensitivity and specificity, but the SCL-90-R depression subscale showed moderate to low sensitivity and specificity. CONCLUSIONS Considering the limited relationship between the SCL-90-R and MMPI in TMD patients with psychological problems, more comprehensive psychological tests are recommended when clinicians suspect patients with TMD of having accompanying psychological problems.
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Affiliation(s)
- M-J Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
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Bossola M, Ciciarelli C, Di Stasio E, Panocchia N, Conte GL, Rosa F, Tortorelli A, Luciani G, Tazza L. Relationship between appetite and symptoms of depression and anxiety in patients on chronic hemodialysis. J Ren Nutr 2011; 22:27-33. [PMID: 21684178 DOI: 10.1053/j.jrn.2011.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 01/22/2011] [Accepted: 02/23/2011] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE We aimed at evaluating the association between appetite and symptoms of depression and anxiety, cognitive dysfunction, fatigue, and comorbidities in patients on hemodialysis (HD). DESIGN A cross-sectional study was conducted. SETTING The study was conducted in an outpatient HD service of a tertiary level academic hospital. PATIENTS A total of 90 patients on HD were evaluated for appetite (during the past week, how would you rate your appetite?), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (Hamilton Anxiety Rating Scale [HARS]), cognitive dysfunction (Mini Mental State Examination [MMSE]), and comorbidities (Charlson Comorbidity Index). MAIN OUTCOME MEASURE Relationship between appetite and symptoms of depression and/or anxiety, cognitive dysfunction, and comorbidities was assessed. RESULTS In 43 patients, the appetite was very good/good (group 1), in 22, it was fair (group 2), and in 25, it was poor/very poor (group 3). Mean and median BDI were significantly higher in group 3 as well as the percentage of patients with BDI ≥16. Mean and median HARS and the percentage of patients with HARS >13 were significantly higher in group 3. MMSE was significantly lower in group 3 as well as the percentage of patients with MMSE ≤23. Multiple linear regression analysis showed a dependence of appetite by age and BDI (P = .007 and P = .002, respectively). CONCLUSIONS Anorexia is associated with older age and symptoms of depression in patients on HD.
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi, Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, Roma, Italia.
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Bossola M, Ciciarelli C, Di Stasio E, Conte GL, Vulpio C, Luciani G, Tazza L. Correlates of symptoms of depression and anxiety in chronic hemodialysis patients. Gen Hosp Psychiatry 2010; 32:125-31. [PMID: 20302985 DOI: 10.1016/j.genhosppsych.2009.10.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 10/29/2009] [Accepted: 10/30/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about the demographic, clinical and laboratory variables which may be correlated with symptoms of depression and anxiety in hemodialysis (HD) patients. The present study aimed at evaluating such correlation in HD patients treated at a single HD center in a Mediterranean country. METHODS Eighty HD patients were assessed for depression and anxiety with the Beck Depression Inventory (BDI) and the Hamilton Anxiety Rating Scale (HARS). The scores of BDI and HARS were correlated with demographic, clinical and laboratory variables. RESULTS Based on the Beck Depression Inventory, 38 patients had no symptoms of depression and 42 had symptoms of depression. Based on the HARS, three patients had no symptoms of anxiety and 38 had mild symptoms of anxiety, whereas moderate or severe symptoms of anxiety were present in 39 patients. In univariate analysis, BDI score correlated significantly with age, the Charlson Comorbidity Index, SF-36 Vitality Subscale, Mini-Mental Status Examination, creatinine, albumin, plasma 25-hydroxy vitamin D and interleukin-6 (IL-6) levels. HARS score correlated significantly with age, Charlson Comorbidity Index, SF-36 Vitality Subscale and parathyroid hormone (PTH) levels. In the multivariate analysis, a direct and an inverse correlation between BDI and IL-6 [P=.042, OR=1.31 (95% CI=1.01-1.71)] and creatinine [P=.050, OR=0.73 (95% CI=0.54-1.00)] was observed. With regard to HARS, only a direct correlation with Charlson Comorbidity Index [P<.001, OR=1.55 (95% CI=1.22-1.96)] was found. CONCLUSION Although numerous demographic, clinical and laboratory variables correlated with BDI and HARS in univariate analysis, the multivariate regression analysis showed only a direct correlation between BDI and IL-6 [P=.042, OR=1.31 (95% CI=1.01-1.71)] and an inverse correlation between BDI and creatinine [P=.050, OR=0.73 (95% CI=0.54-1.00)] and a direct correlation between HARS and the Charlson Comorbidity Index [P<.001, OR=1.55 (95% CI=1.22-1.96)].
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi, Istituto di Clinica Chirurgica, Università Cattolica del Sacro Cuore, 8-00168 Rome, Italy.
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Psychological correlates of medical comorbidities in patients with temporomandibular disorders. J Am Dent Assoc 2010; 141:22-31. [DOI: 10.14219/jada.archive.2010.0017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Penna PP, Recupero M, Gil C. Influence of psychopathologies on craniomandibular disorders. Braz Dent J 2009; 20:226-30. [PMID: 19784469 DOI: 10.1590/s0103-64402009000300010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Psychopathologies play a role in the etiology and maintenance of craniomandibular disorders (CMD). In this study, the craniomandibular index was applied to valuate signs and symptoms of CMD in 60 dentate patients, who were assigned to 2 groups: symptomatic (n=35) and asymptomatic (n=25). An interview on psychopathologies was carried out with the aim to detect the presence of some mood disorders, such as depression, dysthymic and bipolar I disorders. Among these disturbances, depression was the most significant aspect to be reported (p<0.05) since it was present in most symptomatic patients. This important interaction was also significantly correlated (p<0.05) with the Palpation Index. These results suggest that psychopathological aspects could increase muscle tenderness and pain in addition to sleep dysfuntions and other physical complaints. Therefore, psychopathologies should be regarded as an important aspect in patients with orofacial pains.
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Pain catastrophizing and salivary cortisol responses to laboratory pain testing in temporomandibular disorder and healthy participants. THE JOURNAL OF PAIN 2009; 11:186-94. [PMID: 19853521 DOI: 10.1016/j.jpain.2009.07.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 07/06/2009] [Accepted: 07/11/2009] [Indexed: 12/31/2022]
Abstract
UNLABELLED Pain catastrophizing is an important variable in the context of acute and chronic pain. The neurophysiological correlates of pain catastrophizing, however, have not been rigorously evaluated. We examined the relationship between trait-pain catastrophizing and morning salivary cortisol levels before and following a 45-minute laboratory pain-testing session in healthy, pain-free (n = 22), and temporomandibular disorder (TMD) participants (n = 39). We also examined whether TMD patients evidenced generalized hyperalgesia and hypercortisolism. Pain catastrophizing was associated with a flattened morning salivary cortisol profile in the context of pain testing, irrespective of pain status. Cortisol profiles did not differ between healthy and TMD participants. TMD was associated with mechanical hyperalgesia only at the masseter. These data are the first to show an association between pain catastrophizing and elevated salivary cortisol profiles in the context of standardized experimental pain testing. These findings in both healthy individuals and those with chronic orofacial pain suggest that aberrant adrenocortical responses to pain may serve as a neurophysiologic pathway by which pain catastrophizing enhances vulnerability for development of chronic pain and maintains and/or exaggerates existing pain and associated morbidity. PERSPECTIVE Neurophysiological mechanisms by which pain catastrophizing is related to acute and chronic pain recently have come under empirical study. Understanding of these mechanisms has the unique potential to shed light on key central-nervous-system factors that mediate catastrophizing-pain relations and therapeutic benefits associated with changes in catastrophizing and related cognitive processes.
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Current World Literature. Curr Opin Support Palliat Care 2009; 3:144-51. [DOI: 10.1097/spc.0b013e32832c6adb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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MANFREDINI D, MARINI M, PAVAN C, PAVAN L, GUARDA-NARDINI L. Psychosocial profiles of painful TMD patients. J Oral Rehabil 2009; 36:193-8. [DOI: 10.1111/j.1365-2842.2008.01926.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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