TMD diagnosis: Sensitivity and specificity of the Fonseca Anamnestic Index.

OBJECTIVE: To verify whether the Fonseca Anamnestic Index (FAI) has adequate sensitivity and specificity to be used in the diagnosis of temporomandibular disorder (TMD). METHODS: Two hundred-sixty-five participants with symptoms of TMDs were assessed through the FAI and through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then classified as sick or non-sick. The sensitivity, specificity, and predictive values of the FAI in relation to the RDC/TMD were calculated using the STATA 14.0 software. RESULTS: Most of the patients were female, white, without a steady job, and the average age was 37.57 years. The FAI showed high sensitivity (97.21%) but obtained a low specificity (26.00%). The positive and negative predictive values were 84.96% and 68.42%, respectively. CONCLUSION: The FAI is very sensitive in identifying patients who actually have TMD but not very specific in identifying non-TMD patients, being indicated only for initial screening of patients.

Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: A double-blind, randomized clinical trial.

OBJECTIVE: To compare the effect of a rapid low-level laser therapy (LLLT) protocol to Michigan occlusal splint in the treatment of myofascial pain, as well as to evaluate their impact on Oral Health-Related Quality of Life (OHRQoL). METHODS: Thirty participants were randomly allocated into three groups: G1: occlusal splint (n = 11), G2: LLLT (n = 10), and G3: LLLT placebo (n = 9). LLLT and placebo were applied in the points of pain upon palpation. RESULTS: G1 presented improvement in pain (p = 0.014) and in the diagnosis of myofascial pain (p = 0.008), while G2 and G3 did not. Regarding OHRQoL, G1 and G2 presented significant improvement (p = 0.005, in both), whereas, G3 did not. CONCLUSION: Michigan occlusal splint was effective in reducing pain and improving OHRQoL. Treatment with the rapid LLLT protocol only provided an improvement in OHRQoL.

Changes in oral health-related quality of life after self-care treatment in patients with myofascial pain.

Objective:The aim of this study was to evaluate the changes in oral health-related quality of life (OHRQoL) of patients with myofascial pain treated by means of self-care measures.Methods:Fifteen patients with myofascial pain had OHRQoL evaluated by the Oral Health Impact Profile (OHIP-TMD) questionnaire and were instructed for self-care measures verbally and with a printed guide in the first consultation (T0), after 30 days (T1) and 60 days (T2). Paired t-test was performed to evaluate changes through time.Results:OHIP-TMD scores were 29.3 (SD 10.2) at T0, 18.9 (SD 11.2) at T1, and 15.9 (SD 10.7) at T2. There was a reduction of scores related to the OHIP-TMD domains of functional limitation, physical pain, psychological and social inability and incapacity (T1 and T2), and psychological discomfort (T2).Conclusion:Self-care measures had positive effects on the myofascial pain treatment, reducing physical pain generated by TMD and improving patients' OHRQoL.

Avaliação com escalas de dor antes e após três e seis meses de uso de placa oclusal / Assessment with pain scales before and after three and six months of occlusal splint use

Objetivo: Analisar o efeito do uso de placa oclusal acrílica em pacientes com disfunção temporomandibular (DTM) por meio de três escalas subjetivas de dor: escala analógica visual (VAS), escala numérica (NRS) e o questionário de dor McGill (MGPQ) antes, após três e seis meses de uso deste dispositivo. Métodos: A amostra foi composta por 24 pacientes assistidos na Clínica de Oclusão da Universidade Federal de Santa Maria (UFSM), RS, Brasil, adequados aos critérios de inclusão. As escalas subjetivas de dor foram aplicadas antes, após três e seis meses de uso da placa oclusal. Os valores de dor registrados por meio de cada uma das escalas foram analisados pela estatística descritiva no programa SPSS (Statistical Package for Social Sciences, versão 18.0). A normalidade de distribuição foi verificada com o teste de Shapiro-Wilk. Os valores de dor antes, após uso por três e seis meses de placa, foram comparados utilizando o teste não paramétrico de Wilcoxon (? = 0,05). Resultados: Os valores relevantes estatisticamente de melhora na sintomatologia dolorosa para pacientes portadores de DTM foram encontrados em todas as escalas avaliadas, com exceção da VAS (inicial x três meses) e do MGPQ, subdivisão sensorial (inicial x seis meses). Conclusão: Sugere-se que o uso de placa oclusal contribui com a melhora da sintomatologia dolorosa após três meses de tratamento, utilizando as escalas NRS e MGPQ como método de avaliação de dor, o que dá credibilidade a esta modalidade de tratamento.