Prevalence of awake Bruxism: A systematic review.

OBJECTIVES: To identify the prevalence of Awake Bruxism (AB). SOURCES: The electronic search was done in Embase, PubMed/MEDLINE, LILACS, Livivo, Scopus, and Web of Science databases up to January 2nd, 2023. The search strategies combined terms such as "bruxism," "awake," and related terms when conducting searches in databases. Grey literature was consulted through Google Scholar, ProQuest, and OpenGrey. STUDY SELECTION: Two independent reviewers participated in the study selection stages and included observational studies assessing the prevalence of AB, detected using reporting feedback (self or family report), clinical examination, and/or instrumental methods, regardless of the sex and age of the population. DATA: Methodological quality was assessed using the Joanna Briggs Institute's checklist for prevalence studies. Ratio meta-analyses were performed using R Statistics software. RESULTS: From a total of 3,083 studies identified by the searches on databases, 322 articles were reviewed the full-text and a total of 81 (quantitative synthesis) and 83 (narrative synthesis) studies were included. Only fifteen studies reached complete methodological quality. Two overall meta-analyses were performed, grouped based on convenience and population-based samples. The overall prevalence for possible AB was 32.08 % and 16.16 %, respectively. For the subgroup analyses, the prevalence rate showed a wide variation in different studied populations, approximately 14 %-32 % for women and 19 %-30 % for men, for population-based and convenience studies, respectively. CONCLUSION: Possible AB prevalence was set from 16 % to 32 %. Studies with probable AB and definitive AB are still necessary. CLINICAL SIGNIFICANCE: Studying the prevalence of waking bruxism is of interest to both dentists and patients. Knowing the probability of patients having awake bruxism allows the dentist to offer comprehensive preventive approaches to patients, avoiding deleterious consequences resulting from this condition. The present study reveals that the condition of bruxism during wakefulness is present in one out of every six adult patients studied. In pediatric patients, although this condition seems to be equally present, not enough studies were found to support this information for probable and definitive bruxism.

Insomnia is associated with symptoms of central sensitization in patients with painful temporomandibular disorders.

BACKGROUND: Central sensitization (CS) and temporomandibular disorder (TMD) are both associated with insomnia. Therefore, the authors aimed to investigate whether insomnia was associated with more symptoms of CS in patients with TMD. METHODS: In 82 volunteers with TMD, insomnia was clinically assessed, allowing sample stratification according to its presence. The Central Sensitization Inventory questionnaire was self-applied to assess the clinical symptoms of CS. RESULTS: Participants with insomnia had significantly higher mean (SD) scores of CS according to the Central Sensitization Inventory than participants without insomnia (43.10 [12.57] vs 26.59 [13.66]; P = < .001). CONCLUSIONS: Insomnia was associated with higher scores of CS symptoms in patients with TMD. PRACTICAL IMPLICATIONS: Insomnia influences TMD as well as its relationship with CS, and, therefore, it is critical to the clinical management of TMD.

Lack of correlation between central sensitization inventory and psychophysical measures of central sensitization in individuals with painful temporomandibular disorder.

OBJECTIVE: To assess the correlation between the Central Sensitization Inventory (CSI) scores and the results of psychophysical tests and psychosocial questionnaires according to the presence of painful temporomandibular disorder (TMD). DESIGN: It was a cross-sectional study involving 146 participants, aged 20-65 years. Painful TMD was classified using the Research Diagnostic Criteria for Temporomandibular Disorders. CSI was applied to assess "central sensitization-related symptoms", as has been suggested. Wind-up ratio, pressure pain threshold and conditioned pain modulation were used as psychophysical tests to evaluate signs and symptoms of central sensitization. Psychosocial factors were assessed by the presence of non-specific physical symptoms, depressive and anxiety symptoms. The sample was divided into two groups: Control (n = 31); Painful TMD (n = 115). Descriptive statistics characterized the sample. Correlation analysis were performed using Pearson's and Spearman's correlation coefficients (α = 5%). RESULTS: Of the total sample, 78.8 % presented painful TMD, and the mean (standard deviation) age was 37.4 (±11.5) years. Anxiety symptoms (p = 0.028) and non-specific physical symptoms (p < 0.001) were more frequent in the painful TMD group than in controls. Painful TMD patients presented higher scores of the CSI (p < 0.001) and lower pressure pain thresholds (p ≤ 0.020) compared to controls. CSI scores were significantly correlated with psychosocial measures (p < 0.001) but not with psychophysical tests (p ≥ 0.089). CONCLUSION: The CSI scores did not correlate with psychophysical measures of central sensitization but were positively correlated with the results of psychosocial questionnaires.

Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents.

Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification. OBJECTIVE: To investigate the presence of other painful conditions and systemic diseases and their association with painful TMD. METHODOLOGY: In this cross-sectional study, 690 adolescents aged between 12-14 years old were evaluated through questionnaires and clinical examinations. RESULTS: Painful TMD was found in 16.2% of the sample, with a significant association with bronchitis (OR= 2.5; p=0.003) and asthma (OR=3.1; p=0.013), reported by the parents/legal guardians of the participants. Adolescents with regional and widespread pain were 2.7 (95% CI: 1.65-4.55) and 3.6 (95% CI: 1.29-10.14) more likely to also present painful TMD. Painful TMD was associated with a higher number of body pain sites in the last 12 months (4.26 vs. 2.90; p<0.001), as well as a higher number of systemic diseases (1.48 vs. 1.18; p=0.048), when compared to adolescents without painful TMD. CONCLUSION: The findings of this study point out the importance of considering the presence of comorbid conditions in the diagnosis and management of painful TMD in adolescents. A multidisciplinary approach would contribute to better control of painful TMD and decrease its chronification risk.

Temporomandibular disorder, body pain and systemic diseases: assessing their associations in adolescents

Abstract Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification. Objective To investigate the presence of other painful conditions and systemic diseases and their association with painful TMD. Methodology In this cross-sectional study, 690 adolescents aged between 12-14 years old were evaluated through questionnaires and clinical examinations. Results Painful TMD was found in 16.2% of the sample, with a significant association with bronchitis (OR= 2.5; p=0.003) and asthma (OR=3.1; p=0.013), reported by the parents/legal guardians of the participants. Adolescents with regional and widespread pain were 2.7 (95% CI: 1.65-4.55) and 3.6 (95% CI: 1.29-10.14) more likely to also present painful TMD. Painful TMD was associated with a higher number of body pain sites in the last 12 months (4.26 vs. 2.90; p<0.001), as well as a higher number of systemic diseases (1.48 vs. 1.18; p=0.048), when compared to adolescents without painful TMD. Conclusion The findings of this study point out the importance of considering the presence of comorbid conditions in the diagnosis and management of painful TMD in adolescents. A multidisciplinary approach would contribute to better control of painful TMD and decrease its chronification risk.

Effect of educational and self-care therapies on masticatory performance of women with painful temporomandibular disorder / Efeito das terapias educacionais e do autocuidado sobre o desempenho mastigatório de mulheres com disfunção temporomandibular dolorosa

Introduction: Temporomandibular disorders (TMD) can compromise masticatory performance due to the presence of pain, muscular dysfunction and limitation of mandibular movements. Substantial improvements in TMD pain can be achieved through therapeutic approaches including education and self-care. Objective: The aim of the present study was to investigate the impact of these treatment modalities in the masticatory performance of women with painful TMD. Material and method: Fifty-two women were randomly divided into three groups: Control Group (CG); Education Group (received education about TMD) (EG); Self-Care and Education Group (received education about TMD and instructions self-care therapies) (SEG). The education instructions about TMD and self-care therapies were transmitted through a video and printed illustrative material. The masticatory performance was evaluated through the sieves method ​​with natural tested foods in the evaluation periods: baseline evaluation, 30 days after and 60 days of follow-up. Data were analyzed and used with a one-way ANOVA parametric test for mean comparison of CG, EG and SEG groups (α = 0.05). Result: The masticatory performance of the participants was similar, irrespective of the proposed treatments, at baseline (p=.604), 30 days (p=.450) and 60 days (p=.669). Conclusions: The results indicated that treatment with educational and self-care therapies over a period of 60 days had no impact on the masticatory performance of women with painful TMD.

Introdução: As disfunções temporomandibulares (DTM) podem comprometer a capacidade mastigatória devido à presença de dor, disfunção muscular e limitação dos movimentos mandibulares. Melhorias substanciais da dor relacionada à DTM podem ser alcançadas através de abordagens terapêuticas incluindo a educação e os autocuidados. Objetivo: O objetivo do presente estudo foi investigar o impacto dessas modalidades de tratamento no desempenho mastigatório de mulheres com DTM dolorosa. Material e método: Cinquenta e duas mulheres foram divididas aleatoriamente em três grupos: Grupo Controle (CG); Grupo Educação (receberam instruções sobre DTM) (EG); Grupo de Autocuidado e Educação (receberam instruções sobre DTM e instruções sobre terapias de autocuidado) (SEG). As instruções de educação sobre DTM e terapias de autocuidado foram transmitidas através de vídeo e material ilustrativo impresso. O desempenho mastigatório foi avaliado através do método dos tamises com alimentos testes naturais nos períodos de avaliação: atendimento inicial, 30 dias após e ao fim de 60 dias de acompanhamento. Os dados obtidos, em porcentagem, foram analisados e foi utilizado o teste paramétrico ANOVA one-way para comparação das médias dos grupos CG, EG e SEG (α= 0,05). Resultado: O desempenho mastigatório dos participantes foi semelhante, independentemente dos tratamentos, no atendimento inicial (p=0,604), após 30 dias (p=0,450) e após 60 dias (p=0,669). Conclusão: Os resultados indicam que o tratamento com terapias educativas e de autocuidado durante um período de 60 dias não teve impacto no desempenho mastigatório das mulheres com DTM dolorosa.

Mandibular kinesiographic pattern of women with chronic TMD after management with educational and self-care therapies: A double-blind, randomized clinical trial.

STATEMENT OF PROBLEM: Limited mandibular movements are one of the most important signs of temporomandibular disorders (TMDs) and may cause functional difficulties. PURPOSE: The purpose of this double-blind, randomized clinical trial was to evaluate the effect of treatment with only educational or education associated with self-care therapies on the pattern of mandibular movements of women with chronic painful TMDs. MATERIAL AND METHODS: Forty-two women were selected and randomly divided into 3 groups, control group (CG, n=13), education group (EG, n=16), and education and self-care group (ESG, n=13), according to the sequence of treatment they received. A kinesiograph device recorded mandibular movements during maximum mouth opening and mastication at baseline (T0) and at 30-day (T1) and 60-day (T2) follow-up. Kinesiographic data were statistically analyzed using 1-way ANOVA, followed by the Bonferroni test for multiple comparisons of means (α=.05). RESULTS: The ESG group demonstrated an improvement in the maximum vertical opening (MVO= 5.1 ±3.4 mm; P=.012) and anteroposterior mandibular movement (MAM) during maximum opening (7.4 ±9.5; P=.019), significantly higher than that of the EG (MVO=1.8 ±3.5 mm; MAM=0.8 ±5.0 mm) and the CG (MVO=0.9 ±3.8 mm; MAM=0.8 ±4.4 mm) after 30 days of follow-up. Moreover, at T1, vertical mandibular movement during mastication was significantly higher in the ESG group (17.4 ±1.7 mm) than in the EG group (15.0 ±2.8, P=.027). No significant differences were found between the women who received treatment with educational and self-care therapies for 60 days and the women who received this treatment for 30 days. CONCLUSIONS: In the short-term, education and self-care treatment positively influenced the mandibular movement pattern of women with chronic painful TMDs.

Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire.

UNLABELLED: Temporomandibular disorders (TMD) screeners assume significant item overlap with the screening questionnaire proposed by the American Academy of Orofacial Pain (AAOP). OBJECTIVE: To test the reliability and validity of the Portuguese version of AAOP questions for TMD screening among adolescents. MATERIAL AND METHODS: Diagnoses from Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were used as reference standard. Reliability was evaluated by internal consistency (KR-20) and inter-item correlation. Validity was tested by sensitivity, specificity, predictive values, accuracy and receiver operating characteristic (ROC) curves, the relationship between the true-positive rate (sensitivity) and the false-positive rate (specificity). Test-retest reliability of AAOP questions and intra-examiner reproducibility of RDC/TMD Axis I were tested with kappa statistics. RESULTS: The sample consisted of 1307 Brazilian adolescents (56.8% girls; n=742), with mean age of 12.72 years (12.69 F/12.75 M). According to RDC/TMD, 397 [30.4% (32.7% F/27.3% M)] of adolescents presented TMD, of which 330 [25.2% (27.6% F/22.2% M)] were painful TMD. Because of low consistency, items #8 and #10 of the AAOP questionnaire were excluded. Remaining items (of the long questionnaire version) showed good consistency and validity for three positive responses or more. After logistic regression, items #4, #6, #7 and #9 also showed satisfactory consistency and validity for two or more positive responses (short questionnaire version). Both versions demonstrated excellent specificity (about 90%), but higher sensitivity for detecting painful TMD (78.2%). Better reproducibility was obtained for the short version (k=0.840). CONCLUSIONS: The Portuguese version of AAOP questions showed both good reliability and validity for the screening of TMD among adolescents, especially painful TMD, according to RDC/TMD.

Temporomandibular disorders among Brazilian adolescents: reliability and validity of a screening questionnaire

Temporomandibular disorders (TMD) screeners assume significant item overlap with the screening questionnaire proposed by the American Academy of Orofacial Pain (AAOP). Objective: To test the reliability and validity of the Portuguese version of AAOP questions for TMD screening among adolescents. Material and Methods: Diagnoses from Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I were used as reference standard. Reliability was evaluated by internal consistency (KR-20) and inter-item correlation. Validity was tested by sensitivity, specificity, predictive values, accuracy and receiver operating characteristic (ROC) curves, the relationship between the true-positive rate (sensitivity) and the false-positive rate (specificity). Test-retest reliability of AAOP questions and intra-examiner reproducibility of RDC/TMD Axis I were tested with kappa statistics. Results: The sample consisted of 1307 Brazilian adolescents (56.8% girls; n=742), with mean age of 12.72 years (12.69 F/12.75 M). According to RDC/TMD, 397 [30.4% (32.7% F/27.3% M)] of adolescents presented TMD, of which 330 [25.2% (27.6% F/22.2% M)] were painful TMD. Because of low consistency, items #8 and #10 of the AAOP questionnaire were excluded. Remaining items (of the long questionnaire version) showed good consistency and validity for three positive responses or more. After logistic regression, items #4, #6, #7 and #9 also showed satisfactory consistency and validity for two or more positive responses (short questionnaire version). Both versions demonstrated excellent specificity (about 90%), but higher sensitivity for detecting painful TMD (78.2%). Better reproducibility was obtained for the short version (k=0.840). Conclusions: The Portuguese version of AAOP questions showed both good reliability and validity for the screening of TMD among adolescents, especially painful TMD, according to RDC/TMD. .

Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated.

OBJECTIVE: The aim of this study was to investigate the association among painful temporomandibular disorders (TMD), self reported tinnitus, and levels of depression. METHOD: The sample consisted of 224 individuals with ages ranges from 18 to 76 years. The Research Diagnostic Criteria for Temporomandibular Disorders Axis I were used to classify TMD and Axis II were used for self reported tinnitus, and to score the levels of depression. The odds ratio (OR) with 95% confidence interval (CI) was applied. RESULTS: The presence of painful TMD without tinnitus was significantly associated with moderate/severe levels of depression (OR=9.3, 95%; CI: 3.44-25.11). The concomitant presence of painful TMD and tinnitus self-report increased the magnitude of the association with moderate/severe levels of depression (OR=16.3, 95%; CI, 6.58-40.51). CONCLUSION: Painful temporomandibular disorders, high levels of depression, and self reported tinnitus are deeply associated. However, this association does not imply a causal relationship.

Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated / Disfuncao temporomandibular dolorosa, auto-relato de zumbido e depressao estao fortemente associados

Objective The aim of this study was to investigate the association among painful temporomandibular disorders (TMD), self reported tinnitus, and levels of depression. Method The sample consisted of 224 individuals with ages ranges from 18 to 76 years. The Research Diagnostic Criteria for Temporomandibular Disorders Axis I were used to classify TMD and Axis II were used for self reported tinnitus, and to score the levels of depression. The odds ratio (OR) with 95% confidence interval (CI) was applied. Results The presence of painful TMD without tinnitus was significantly associated with moderate/severe levels of depression (OR=9.3, 95%; CI: 3.44-25.11). The concomitant presence of painful TMD and tinnitus self-report increased the magnitude of the association with moderate/severe levels of depression (OR=16.3, 95%; CI, 6.58-40.51). Conclusion Painful temporomandibular disorders, high levels of depression, and self reported tinnitus are deeply associated. However, this association does not imply a causal relationship. .

Objetivo Investigar a associação entre disfunção temporomandibular (DTM) dolorosa, auto-relato de zumbido e níveis de depressão. Método A amostra foi composta por 224 indivíduos com idades de 18 a 76 anos. O Research Diagnostic Criteria for Temporomandibular Disorders , eixo I, foi usado para classificar a DTM e o eixo II para obtenção do auto-relato de zumbido e dos níveis de depressão. Para a análise dos dados, foi aplicado o teste odds ratio (OR) com intervalo de confiança (IC) de 95%. Resultado Somente a presença de DTM dolorosa estava significativamente associada aos níveis de depressão moderado/severo (OR=9,3, 95%; IC: 3,44-25,11). A presença concomitante de DTM dolorosa e auto-relato de zumbido aumentaram a magnitude da associação com os níveis de depressão moderado/severo (OR=16,3; 95% IC: 6,58-40,51). Conclusão Disfunção temporomandibular dolorosa, altos níveis de depressão e auto-relato de zumbido estão fortemente associados. Entretanto, o desenho do estudo não permite estabelecer uma relação causal entre essas três entidades. .

Influência de abordagens biopsicossociais e autocuidados no controle das disfunções temporomandibulares crônicas / Influence of biopsychosocial approaches and self-care to control chronic pain and temporomandibular disorders

BACKGROUND AND OBJECTIVES: Temporomandibular joint disorder (TMD), which is a musculoskeletal condition of the masticatory system, may become chronic and further worsen quality of life (QL) of patients. Due to the interrelation between physical and emotional symptoms, there is increasing search for the integrative model, which includes psychosocial approaches for the treatment of painful conditions. This study aimed at reviewing in the literature the impact of education and simple self-care modalities on pain and disorders related to chronic painful TMD. CONTENTS: Psychosocial factors are often involved with pain chronicity, making bio-behavioral approaches increasingly more indicated to change pain perception and to decrease distress and psychosocial changes which go along with persistent pain. CONCLUSION: Current literature, although not extensive, indicates positive results of education and self-care methods for chronic painful TMD. Further studies are needed to reinforce such findings and spread the application of such approaches to control chronic and TMD pain.

JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM), condição musculoesquelética do sistema mastigatório, pode se tornar crônica, causando maior comprometimento na qualidade de vida (QV) dos pacientes. Devido à inter-relação entre sintomas físicos e emocionais, há uma crescente busca pelo modelo integrativo, o qual inclui abordagens psicossociais para o tratamento de condições dolorosas. O objetivo deste estudo foi realizar uma revisão de literatura sobre o impacto da educação e modalidades simples de autocuidados podem ter na dor e na disfunção relacionadas à DTM dolorosa crônica. CONTEÚDO: Os fatores psicossociais estão frequentemente envolvidos na cronificação da dor, tornando as abordagens biocomportamentais cada vez mais indicadas para mudar a percepção da dor, reduzir o sofrimento e as alterações psicossociais que acompanham as dores persistentes. CONCLUSÃO: A literatura existente, apesar de não ser vasta, indica resultados positivos da aplicação de métodos de educação e autocuidados em DTM dolorosa crônica. Mais estudos são necessários para reforçar tais achados e disseminar a aplicação de tais abordagens no controle da dor crônica e da DTM.

New approaches to dental occlusion: a literature update.

Because the study of occlusion is a basic area in dentistry, its components, physiology and integration with the stomatognathic system (SS) have been the subject of interest in the scientific literature. However, the focus given to this issue has changed substantially. Currently, new approaches have been proposed in order to update concepts and to demonstrate the full integration and functionality of this system within the human body. With this approach, the authors proposed the following literature review aimed at gathering recent papers (published from 2000 to 2010) with innovative study design, methodology and/or results. The authors' intention is to show the main trends in the study of occlusion and the SS. The literature review was conducted in the PubMed database, using initially the term "dental occlusion" as a key-word. As items of interest were found, papers were grouped by categories according to their main subject matter. Forty-seven articles were selected and the main categories obtained were: 1. functional magnetic resonance imaging (fMRI); 2. brain activation; 3. masticatory/occlusal function; 4. body function and physical performance; 5. osseoperception; 6. finite element models; and 7. occlusion and pain. Observing the current literature, the authors found that recent studies present different methodologies for the study of occlusion. These studies have allowed scientists to obtain detailed information about the physiology of occlusion and the SS, as well as about its integration in the body. Research in this area should be continued in order to clarify, in detail, the role of each component of the SS and its interaction with human physiology.

Clinical features of the sleep bruxism and gastroesophageal reflux association deserve professional attention / Características clínicas da associação entre o bruxismo do sono e o refluxo gastroesofágico merecem atenção profissional

Introdução: Bruxismo tem sido definido como uma atividade parafuncional oral que consiste em apertar e/ou ranger os dentes durante o sono ou na vigília. Além do bruxismo do sono (BS), outros movimentos orofaciais também podem, esporadicamente, ocorrer durante o sono. A regurgitação ocasional e a queimação no peito devido ao refluxo gastroesofágico (RGE) são freqüentes sintomas relatados pela população em geral. A RGE refere-se à presença de sinais e sintomas secundários, com ou sem sinais de lesões na mucosa do esôfago. Os dentistas são, muitas vezes, os profissionais da saúde que primeiro diagnosticam o RGE por meio da observação de suas manifestações orais. Objetivo: Assim, o objetivo do presente artigo foi discutir os procedimentos clínicos e diagnósticos em dois pacientes com BS e RGE, contribuindo assim para a difusão do conhecimento sobre a interação dessas duas entidades. Recomenda-se aos dentistas estarem atentos para identificar os primeiros sinais de RGE que se manifestam na cavidade oral. Conclusão: Neste ponto, destaca-se a importância de tratar o paciente como um todo, esforçando-se para identificar outras fontes de problema que poderiam atuar como fatores agravantes destas condições.

Introduction: Bruxism has been defined as an oral parafunctional activity that includes clenching and/or grinding the teeth while asleep or awake. In addition to sleep bruxism (SB), various other orofacial movements sporadically occur during sleep. Occasional regurgitation and heartburn due to gastroesophageal reflux (GER) are frequent in the general population. GER refers to the presence of symptoms that are secondary to the reflux of gastric content through the esophagus with or without signs of esophageal mucosal lesions. Dentists are often the first health care professionals to diagnose GER through observation of its oral manifestation. Objective: The aim of the present case reports was to discuss the diagnosis and clinical procedures followed in two patients with SB and GER, thereby contributing to the dissemination of knowledge about these two entities. We therefore recommend dentists to be alert to identifying the first signs of GER that appear in the oral cavity. Conclusion: At this point, we highlight the importance of treating the patient as a whole, in an endeavor to identify other sources of the problems that could contribute as factors aggravating these conditions.

Symptoms of temporomandibular disorders in the population: an epidemiological study.

AIMS: To estimate the prevalence of symptoms of temporomandibular disorders (TMD) as a function of age and gender, in a representative urban sample from the Brazilian population. METHODS: A total of 1,230 inhabitants (51.5% women) aged 15 to 65 years were interviewed by a validated phone survey. Sample size had been previously calculated. TMD symptoms were assessed through five questions, as recommended by the American Academy of Orofacial Pain, in an attempt to identify possible TMD. Data were derived by age and gender. Prevalence of each TMD symptom, and of combination of symptoms, was calculated. RESULTS: At least one TMD symptom was reported by 39.2% of the individuals. Pain related to TMD was noted by 25.6% of the population. Temporomandibular joint (TMJ) sound was the most common symptom of TMD, followed by TMJ pain and masticatory muscle pain. All symptoms were more prevalent in women than in men. With men used as the reference, a relative risk (RR) of at least one TMD symptom in women was 1.31 (95% confidence interval [CI] = 1.14 to 1.52). When at least two symptoms were present, the RR was 1.93 (95% CI = 1.49 to 2.51). For three or more TMD symptoms, the RR was 2.49 (95% CI = 1.67 to 3.71). Women were also more likely than men to have TMD pain (RR = 1.78; 9% CI = 1.45 to 2.18). CONCLUSION: Individual symptoms, as well as a combination of TMD symptoms, are prevalent in the Brazilian urban population and are more frequent in women than in men. Additional studies should focus on risk factors for and relevance of TMD for the sufferers.

Estudos sobre a relação entre disfunção temporomandibular e cefaléia primária: avaliações populacional e clínica / Relationship between primary headache and temporomandibular disordes: populational and clinical assessments

Cefaléia é uma experiência humana universal e pode representar a expressão final de uma ampla variedade de agressões ao sistema nervoso humano. Disfunção temporomandibular (DTM) refere-se a um conjunto de condições caracterizadas por dor na articulação temporomandibular (ATM), na área periauricular ou nos músculos da mastigação, sons articulares e desvios ou restrições dos movimentos mandibulares. Sindromicamente representa a consequência de várias disfunções no sistema mastigatório. Cefaleias são sintomas comuns entre indivíduos com DTM. Além de serem prevalentes e potencialmente incapacitantes, evidências limitadas também sugerem que tipos específicos de cefaleias e DTM são condições comórbidas. Os objetivos globais dos estudos aqui apresentados foram testar se há associação entre DTM e cefaléias primárias, se existe especificidade nessa associação e finalmente se há diferença na magnitude da associação de acordo com subtipos de DTM e classificação das cefaléias primárias. Os estudos foram conduzidos em duas amostras distintas, sendo uma populacional e a outra clínica. Os dados do estudo populacional foram coletados por meio de dois questionários aplicados durante ligações telefônicas. Um deles abordava as características das cefaleias e baseava-se nos critérios da Sociedade Internacional de Cefaleias. O outro questionava a existência de sintomas relacionados às DTMs. No estudo clínico, o mesmo questionário foi usado para coletar informações sobre as cefaleias, e as DTMs foram classificadas por meio da aplicação do Critérios Diagnósticos de Pesquisa em Disfunção Temporomandibular (RDC/TMD). Concluiu-se que, em ambas as amostras, as DTMs são mais comuns entre indivíduos...

Headache is a nearly universal human experience, and may represent the final common expression of a wide variety of assaults upon the human nervous system. TMD refers to a group of conditions characterized by pain in the temporomandibular joint (TMJ), in the preauricular area or muscles of mastication, TMJ sounds, and by deviations or restriction in mandibular range of motion. Syndromically represents the consequences of several disorders into the masticatory system. Headaches have been seen as a common symptom among individuals with TMD. Beyond being prevalent and disabling disorders, limited evidence also suggest that specific headache disorders and TMD are comorbid. Controversies regarding this relation include the specificity of the association and the influence of severity of one on the other. The aims of the studies here presented were explore the relation between primary headaches and TMD focusing on prevalence of both in a populational sample, as well as to clarify the relation between TMD sub-types and TMD chronic pain severity on diagnostic and frequency of primary headaches. Sudies were conducted on two different samples, one of them a populational sample and the other a clinical sample. Data from the populational study was collected using two different questionnaires about TMD symptoms and headache features, based on International Headache Society criterias, applied by means a telephone call. On clinical study data related to headache was collected using the sample questionnaire, and TMD was classified using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). It was found that TMD symptoms are more common in migraine, episodic tension-type headache (ETTH) and chronic daily headache (CDH) relative to individuals without headache in both samples. Magnitude of association is higher...