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.

Quality of life in young and middle age adult temporomandibular disorders patients and asymptomatic subjects: a systematic review and meta-analysis.

AIMS: To compare the difference in the quality of life between temporomandibular disorders (TMD) patients and non-TMD subjects diagnosed with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). METHODS: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched in studies published in English and Portuguese. The search was performed by two independent reviewers in duplicate. A manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the RDC/TMD axis I and quality of life with standard questionnaires in young and middle-aged adult population (18-55 years). The data were analyzed quantitatively by combining the results in a meta-analysis using forest plots. The measure of effect used was the standardized mean difference (SMD) in depression levels. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. The publication bias was assessed by funnel plots. The initial search included 806 articles without duplications. RESULTS: Twenty-four articles were included in the final systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in all axis I groups: (a) global TMD-groups I, II and III combined, N = 3829, SMD (95% CI) = 1.06 (0.65-1.51), p = 0.000; (b) group I-muscle disorders, N = 3,056, SMD (95% CI) = 0.82 (0.45-1.18), p = 0.000; (c) group II-disc displacements, N = 3,184, SMD (95% CI) = 0.59 (0.26-0.91), p = 0.000; and (d) group III-arthralgia/arthritis/arthrosis, N = 2781, SMD (95% CI) = 0.98 (0.59-1.36), p = 0.000. When compared to controls. CONCLUSIONS: Quality of life is affected in all axis I TMD patients, especially in groups I and III with higher pain intensity and disability as compared to group II.

Study on the association between sleep disorders versus oral health related variables / Estudio sobre la asociación entre los trastornos del sueño versus variables relacionadas con la salud bucal

Background: To study the association between sleep quality and oral health related variables, which still haveconflicts in the literature.Material and Methods: This was a population-based case-control study between subjects with versus withoutsleep disorders from the Brazilian Public Health System (SUS), city of Maringá (N=1,643). Subjects answeredself-reported questionnaires: a) Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), b)Sleep Assessment Questionnaire (SAQ) and c) North York Dental Health Survey (NYDHS).Results: No significant difference was found for gender, marital status, or income; however, non-Caucasians, peo-ple with lower levels of education, and those between 20 to 50 years old had worse scores of sleep disorders in theSAQ. Self-perceived oral health, masticatory capacity to eat foods, and gingival bleeding was significantly worseamong subjects with self-reported sleep disorders. Self-reported tooth loss, edentulism and use of removable par-tial dentures (with clasps) or complete dentures showed no significant difference between groups. Self-reportedsleep disorder subjects presented significantly higher prevalence of both self-reported tooth and TMJ pain.Conclusions: It can be concluded that individuals with self-reported sleep disorders presented worse self-perceivedoral health for most studied variables.(AU)

Analysis of Marginal Adaptation of Porcelain Laminate Veneers Produced by Computer-Aided Design/Computer-Assisted Manufacturing Technology: A Preliminary In Vitro Study.

PURPOSE: To analyze the marginal adaptation of computer-aided design/computer-assisted manufactured (CAD/CAM) porcelain laminate veneers. MATERIALS AND METHODS: A total of 25 three-dimensional (3D) machine-milled laminate veneers were divided into five groups of five each according to fabrication material (E-max; Empress; Lava Ultimate; Suprinity; and Vita Mark II) and cemented in 25 prepared acrylic central incisors. Digital microscopy images (×7.5 magnification) were analyzed for gaps in the mesial/distal surfaces of the prepared tooth and in the cervical, medial, and incisal thirds. RESULTS AND CONCLUSION: All CAD/CAM laminate veneers except for Empress and Suprinity in the middle and incisal thirds showed good results (ie, gaps < 120 µm in the cervical, middle, and incisal thirds).