Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking.

OBJECTIVE: To study and estimate the impact of clinical, somatosensory, and psychosocial variables associated with the concomitant presence of temporomandibular joint (TMJ) pain in patients with TMJ clicking. MATERIALS AND METHODS: Ninety-three individuals composed the sample: patients with painful TMJ clicking (n = 47) and patients with painless TMJ clicking (n = 46). Four categories of data were evaluated: clinical features (gender, maximal interincisal distance (MID), side of complaint, age); bruxism (sleep bruxism (SB), awake bruxism (AB)); somatosensory (mechanical pain threshold (MPT), wind-up ratio (WUR), pressure pain threshold (PPT), conditioned pain modulation (CPM)); and psychosocial (Pittsburgh Sleep Quality Index (PSQI), pain vigilance and awareness questionnaire (PVAQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD), Oral Behaviors (OBs)). RESULTS: Female gender, AB, WUR, CPM, PSQI, PCS, and OBs significantly (p < 0.05) increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. On the other hand, MID, MPT, and PPT significantly (p < 0.05) decreased this chance. The other variables had no association. CONCLUSION: It can be concluded that being a woman, having AB, hyperalgesia in WUR, less efficient CPM, poor sleep quality, pain catastrophizing, and harmful OBs significantly increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. In the opposite, high figures of MID, MPT, and PPT decreased the chance. CLINICAL RELEVANCE: Most patients with TMJ clicking usually postpone seeking treatment until the clicking truly disturbs or there is a concomitant presence of TMJ pain. Understanding the variables associated with this concomitance can be important in clinical practice.

Prevalencia de Bruxismo y Trastornos Temporomandibulares Asociados en una Población de Escolares de San Luis Potosí, México / Prevalence of Bruxism and Associated Temporomandibular Disorders in a Population of School Children of San Luis Potosí, México

RESUMEN: El término "Transtornos Temporomandibulares" (TTM) incluye numerosos problemas clínicos asociados con las articulaciones temporomandibulares, músculos de la masticación y otras estructuras asociadas. El bruxismo, un hábito oral parafuncional, consiste en rechinar o apretar de manera rítmica e involuntaria los dientes, lo que puede conducir a trauma oclusal y problemas articulares. El objetivo del estudio fue determinar la frecuencia y prevalencia de signos y síntomas de TTM y bruxismo en niños escolares de 6 a 12 años, en una población de San Luis Potosí, México. Se empleó un diseño transversal descriptivo en una muestra de 314 participantes, estudiantes de una escuela primaria de la ciudad de San Luis Potosí, México. Los participantes fueron seleccionados aleatoriamente en forma estratificada y polietápica. La muestra total consistió en 153 femeninos y 161 masculinos. Los signos y síntomas de TTM más frecuentes fueron la alteración de la función de la ATM (35 %), seguido por los ruidos y chasquido articulares (29,2 %). En los sujetos con diagnóstico de bruxismo, la alteración más frecuente fueron molestias asociadas en la ATM (19,4 %), dolor de cabeza (17,8 %) y atrición dental (16,5 %).

ABSTRACT: The term "Temporomandibular disorders" (TTM) includes numerous clinical problems associated with joint temporomandibular, muscles of mastication and other associated structures. Bruxism, oral parafunctional habit, consists of grinding or clenching of involuntary, rhythmic manner, which can lead to trauma, occlusal and problems joint. The objective of the study was to determine the frequency and prevalence of signs and symptoms of DTM and bruxism in school children aged 6 to 12, in a population of San Luis Potosí, México. A crosssectional descriptive design was used in a sample of 314 participants, students of a primary school in the city of San Luis Potosi, Mexico. The participants were randomly selected in tiered form and conglomerated. The total sample consisted of 153 female and male 161. The signs and symptoms of TMD frequent were alteration of the function of the ATM (35 %), followed by noise and snap joint (29.2 %). In subjects with a diagnosis of bruxism, the most frequent alteration was associated with TMJ discomfort (19.4 %), headache (17.8 %) and dental attrition (16.5 %).

Valoración de ruidos articulares en la ATM: punto de vista odontológico / Assessment of TMJ joint sounds: dental point of view

El objetivo este estudio, fue identificar la importancia que le da a diferentes aspectos relacionados con la aparición de ruidos articulares (RA) la articulación en temporomandibular (ATM), un grupo de 290 odontólogos. A los odontólogos se les aplicó una encuesta, en donde se les preguntó acerca de la importancia que les merecía la aparición de RA (clicking y crepitación) y su tratamiento, en ausencia o presencia de otros signos o síntomas; como también, acerca de la relación causal entre maloclusión y RA y sobre la posibilidad de considerarlos normales. Los resultados mostraron que para estos odontólogos, la aparición de RA y su tratamiento, son importantes; ya sea que se presenten, o no, asociados con otros signos o síntomas; y además, consideran que la relación causal entre maloclusión y aparición de RA, es alta.

The purpose of this study was to identify the value of different aspects related with the apperance of TMJ sounds by the dentists. A survey was conducted to the dentists and they were enquired about the importance attached to joint sounds (clicking and crepitus) and their treatment when other signs or symptoms are present or absent. Also, they were asked about the causal relation between malocclusion and joint sounds and the possibility of being considered normal. The results showed that the presence of TMJ sounds and their treatment are important for the dentist, whether the sounds are associated or not with other signs or symptoms. Morover, they considered the causal relation between malocclusion and presence of joint sounds high.