Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 53
Filtrar
1.
Head Face Med ; 18(1): 2, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996509

RESUMO

BACKGROUND: Arthroscopy is a minimally invasive diagnostic tool and treatment strategy in patients suffering from temporomandibular disorders (TMD) when conservative treatment fails. This study aimed to find specific variables on pre-operative MRI or during arthroscopy that could predict success of arthroscopic lysis and lavage. METHODS: This retrospective analysis compared pre-operative maximum interincisal opening (MIO), pain and main complaint (pain, limited MIO or joint sounds) with results at short-term and medium-term follow-up (ST and MT respectively). Different variables scored on MRI or arthroscopy were used to make a stepwise regression model, subsequently a combined analysis was conducted using variables from both MRI and arthroscopy. RESULTS: A total of 47 patients (50 joints) met the inclusion criteria. The main complaint improved by 62 and 53% at ST and MT respectively. The absolute or probable absence of a crumpled disc scored on MRI predicted success at ST and MT (p = 0.0112 and p = 0.0054), and remained significant at MT in the combined analysis (p = 0.0078). Arthroscopic findings of degenerative joint disease predicted success at ST (p = 0.0178), absolute or probable absence of discal reduction scored during arthroscopy significantly predicted success in the combined analysis at ST (p = 0.0474). CONCLUSION: To improve selection criteria for patients undergoing an arthroscopic lysis and lavage of the TMJ, future research might focus on variables visualized on MRI. Although more research is needed, disc shape and in particular the absolute or probable absence of a crumpled disc might be used as predictive variable for success.


Assuntos
Luxações Articulares , Transtornos da Articulação Temporomandibular , Artroscopia , Humanos , Imageamento por Ressonância Magnética , Amplitude de Movimento Articular , Estudos Retrospectivos , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/cirurgia , Resultado do Tratamento
2.
Pain ; 163(4): e557-e571, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-34393199

RESUMO

ABSTRACT: Neurosensory disturbances (NSDs) caused by injury to the trigeminal nerve can affect many aspects of daily life. However, factors affecting the persistence of NSDs in patients with posttraumatic trigeminal neuropathies (PTTNs) remain largely unknown. The identification of such risk factors will allow for the phenotyping of patients with PTTNs, which is crucial for improving treatment strategies. We therefore aimed to identify the prognostic factors of NSD persistence, pain intensity, and quality of life (QoL) in patients with PTTNs and to use these factors to create a prognostic prediction model. We first performed a bivariate analysis using retrospective longitudinal data from 384 patients with NSDs related to posttraumatic injury of the trigeminal nerve (mean follow-up time: 322 ± 302 weeks). Bivariate and multivariate analyses were performed. The multivariable prediction model to predict persistent NSDs was able to identify 76.9% of patients with persistent NSDs, with an excellent level of discrimination (area under the receiver operating characteristic curve: 0.84; sensitivity: 81.8%; specificity: 70.0%). Furthermore, neurosensory recovery was significantly associated with sex; injury caused by local anesthesia, extraction, third molar surgery, or endodontic treatment; and the presence of thermal hyperesthesia. Pain intensity and QoL analysis revealed several factors associated with higher pain levels and poorer QoL. Together, our findings may aid in predicting patient prognosis after dental, oral, and maxillofacial surgery and might lead to personalized treatment options and improved patient outcomes.


Assuntos
Doenças do Nervo Trigêmeo , Traumatismos do Nervo Trigêmeo , Humanos , Prognóstico , Qualidade de Vida , Estudos Retrospectivos
3.
J Oral Rehabil ; 48(7): 846-871, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33772835

RESUMO

BACKGROUND: Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. OBJECTIVES: (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited-channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. METHOD: A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. RESULTS: Seventy-eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). CONCLUSION: Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.


Assuntos
Bruxismo , Bruxismo do Sono , Eletromiografia , Humanos , Músculo Masseter , Músculos da Mastigação , Polissonografia , Bruxismo do Sono/diagnóstico
4.
Odontology ; 109(1): 29-40, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32274673

RESUMO

PURPOSE: To examine the effect of preloading eccentric exercise on pain sensitivity in healthy volunteers. METHODS: In 20 healthy volunteers, pain-related sensations (6 items: pain, unpleasantness, fatigue, stiffness, tension, and soreness during maximum biting), and pain intensities induced by repeated electrical stimuli on the masseter and the hand palm were evaluated using a visual analog scale (VAS) of 0-100 mm. Eccentric exercise (6 min-test) or gum chewing (6 min-control) was used as preloading exercise to evaluate the effect on pain sensitivities before and after low-level clenching (15 min) performed 2 days after the preloading exercise. RESULTS: Eccentric exercise induced only low levels of pain-related sensations 2 days later. However, the time course of temporal summation induced by four repeated electrical stimuli on the masseter was influenced by the type of preloading exercise, i.e., temporal summation increased after the low-level clenching (P = 0.016) when preloading was done by the eccentric exercise, while no significant change was observed when preloading was done by the gum chewing. CONCLUSIONS: Eccentric exercise may facilitate pain sensitivity induced by subsequent low-level clenching via the central nervous system. In addition, it was demonstrated that pain sensitivity after the low-level clenching could be influenced by the type of preloading exercise. These experimental results may suggest that eccentric exercise could act as one of the triggering factors in the mechanism by which tooth clenching leads to a chronic pain condition in susceptible individuals.


Assuntos
Bruxismo , Limiar da Dor , Humanos , Músculo Masseter , Dor , Medição da Dor
5.
J Oral Rehabil ; 47(10): 1212-1221, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32687637

RESUMO

BACKGROUND: Post-traumatic trigeminal neuropathy (PTN) is a disturbance of function or pathological change of the trigeminal nerve branches following trauma and has an important impact on patient's quality of life (QoL). OBJECTIVES: To provide diagnostic data on PTN and illustrate differences in aetiology, injured nerve, pain distribution, sensory profile and QoL between PTN subgroups. METHODS: 1331 patients with painful or non-painful PTN were retrospectively reviewed in two centres, extracting demographic data, time and cause of trauma, clinical findings including signs and symptoms, basic neurosensory testing, imaging modalities, treatments, and QoL or psychosocial assessment. RESULTS: More females were represented (70%) than males. The inferior alveolar nerve was most frequently damaged (60%) followed by the lingual nerve (28%). Wisdom teeth removal was considered the main cause (48%). Pain was reported in 63% of patients and pain frequency increased with age without clinically significant gender differences. Numbness was reported in 50% of PTN patients. Neurosensory testing showed larger affected dermatome involvement in persistent injuries, with no differences between the non-painful and painful PTN groups. Patient clustering indicated different sensory profile distributions when stratified according to aetiology or affected nerve branch. High interference with lifestyle was reported (78%), and patients suffering from painful PTN had worse QoL and psychosocial outcomes. CONCLUSION: Patients with painful PTN had different clinical profiles and lower QoL scores than those with non-painful PTN. Sensory profiles may provide important prognostic and therapeutic information; however, more research is needed to assess the clustering procedure and link these clusters to therapeutic guidelines.


Assuntos
Qualidade de Vida , Traumatismos do Nervo Trigêmeo , Feminino , Humanos , Masculino , Estudos Retrospectivos , Centros de Atenção Terciária , Traumatismos do Nervo Trigêmeo/complicações , Traumatismos do Nervo Trigêmeo/epidemiologia
6.
Eur J Pain ; 24(8): 1425-1439, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32557971

RESUMO

BACKGROUND AND OBJECTIVE: Orofacial quantitative sensory testing (QST) is an increasingly valuable psychophysical tool for evaluating neurosensory disorders of the orofacial region. Here, we aimed to evaluate the current evidence regarding this testing method and to discuss its future clinical potential. DATA TREATMENT: We conducted a literature search in Medline, Embase and Scopus for English-language articles published between 1990 and 2019. The utilized search terms included QST, quantitative, sensory testing and neurosensory, which were combined using the AND operator with the terms facial, orofacial, trigeminal, intraoral and oral. RESULTS: Our findings highlighted many methods for conducting QST-including method of levels, method of limits and mapping. Potential stimuli also vary, and can include mechanical or thermal stimulation, vibration or pinprick stimuli. Orofacial QST may be helpful in revealing disease pathways and can be used for patient stratification to validate the use of neurosensory profile-specific treatment options. QST is reportedly reliable in longitudinal studies and is thus a candidate for measuring changes over time. One disadvantage of QST is the substantial time required; however, further methodological refinements and the combination of partial aspects of the full QST battery with other tests and imaging methods should result in improvement. CONCLUSIONS: Overall, orofacial QST is a reliable testing method for diagnosing pathological neurosensory conditions and assessing normal neurosensory function. Despite the remaining challenges that hinder the use of QST for everyday clinical decisions and clinical trials, we expect that future improvements will allow its implementation in routine practice.


Assuntos
Limiar da Dor , Vibração , Humanos , Limiar Sensorial
7.
J Oral Rehabil ; 47(6): 775-781, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32061108

RESUMO

Toothache represents the most common example of oro-facial pain. Its origin is mostly odontogenic, but several other conditions may mimic dental pain or present themselves as such. Well-known examples are myofascial pain, trigeminal neuropathies like neuralgia and painful post-traumatic trigeminal neuropathic pain, oro-facial neurovascular pains, cardiac pain and sinus disease. This review first discusses the current knowledge on the underlying pathophysiology of heterotopic tooth pain. Afterwards, several conditions potentially presenting as toothache will be illustrated regarding clinical features, diagnosis and management.


Assuntos
Neuralgia , Neuralgia do Trigêmeo , Diagnóstico Diferencial , Dor Facial , Humanos , Odontalgia
8.
Front Physiol ; 10: 1021, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31447704

RESUMO

The sagittal split ramus osteotomy is a key approach for treating dentofacial deformities. Although it delivers excellent results, the sagittal split ramus osteotomy is believed to induce stress to the temporomandibular joint. Potential stress inducers could be classified as intra- and postoperative factors resulting in an inflammatory response and molecular cascades, which initiate physiological remodeling. Occasionally, this process exceeds its capacity and causes pathological remodeling, through either degenerative joint disease or condylar resorption. Hard evidence on how orthognathic surgery causes inflammation and how this inflammation is linked to the spectrum of remodeling remains scarce. Current concepts on this matter are mainly based on clinical observations and molecular mechanisms are extrapolated from fundamental research in other body parts or joints. This perspective study provides an overview of current knowledge on molecular pathways and biomechanical effects in temporomandibular joint remodeling. It provides research directions that could lead to acquiring fundamental evidence of the relation of orthognathic surgery and inflammation and its role in remodeling. Performing osteotomies in animal models and identifying inflammatory mediators as well as their effect on the joint seem promising. Patients affected by pathological remodeling can also provide samples for histological as well as molecular analysis. Individual susceptibility analysis by linking certain suspect phenotypes to genetic variation could identify the cause and molecular pathway responsible for degenerative joint disease and condylar resorption, ultimately leading to clinically applicable treatment and prevention strategies.

9.
J Oral Facial Pain Headache ; 33(4): 389­398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31247061

RESUMO

AIMS: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises. METHODS: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from "strongly agree" to "strongly disagree." The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts' earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement. RESULTS: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality. CONCLUSION: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.


Assuntos
Transtornos da Articulação Temporomandibular , Consenso , Técnica Delfos , Terapia por Exercício , Humanos , Mialgia
10.
J Prosthodont Res ; 63(2): 193-198, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30559085

RESUMO

PURPOSE: To investigate the effect of sleep restriction on somatosensory sensitivity related to occlusion. METHODS: Twelve healthy participants participated in an experimental voluntary total sleep restriction (SR) study. In a study design, they were invited to sleep as usual, normal sleep (NS) or to restrict their sleep for four nights. Following the SR night, participants were followed for 3 consecutive days including the 2 sleep nights. In NS experiment, all participants were instructed to maintain NS both nights. During all nights, actigraphy data were collected and total sleep time was estimated. On days before and after sleep conditions, all participants underwent measurements of tactile detection threshold (TDT), interocclusal detection threshold (IDT), perception of unpleasantness (POU), and the Epworth sleepiness scale (ESS). RESULTS: As expected, total sleep time on the first night in SR experiment was significantly shorter than on the second night in SR experiment and on the first night in NS experiment (P<0.05). ESS values on Day-2 following SR experiment were significantly higher than on Day-1 and Day-3 in SR experiment and Day-2 in NS experiment (P<0.05). There were no significant differences in TDT and IDT between each day at each measurement point in both experiments. POU was significantly lower on Day-2 in SR experiment than on Day-1 and Day-3 in SR experiment and on Day-2 in NS experiment (P<0.05). CONCLUSIONS: The present results suggest that SR affects to occlusal sensation related to POU.


Assuntos
Oclusão Dentária , Face/fisiologia , Boca/fisiologia , Percepção/fisiologia , Sensação/fisiologia , Privação do Sono/fisiopatologia , Córtex Somatossensorial/fisiologia , Adulto , Limiar Diferencial , Feminino , Humanos , Masculino , Parestesia , Fatores de Tempo , Adulto Jovem
11.
J Oral Rehabil ; 46(4): 303-309, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30570153

RESUMO

BACKGROUND: No studies have addressed the effect of SR on somatosensory function in the oro-facial area. OBJECTIVES: The aim of this study was to investigate the effect of sleep restriction (SR) on the somatosensory perception of the tip of the tongue. MATERIALS AND METHODS: Using a crossover study design, 13 healthy participants took part in a random order, to a two arms experiments: the SR and control/no SR-arms. For all participants, the Epworth Sleepiness Scale (ESS) was used to assess sleepiness and mechanical sensitivity, and pain detection threshold was estimated at the tongue tip and right thumb (as a body area control site). In the SR-arm of the study, on day one, we estimated sensory baseline perception and repeated tests on day two, after a night of voluntary SR, and on day 3, after a recovery night. In the second arm, same sensory tests were done but no SR was requested. RESULTS: Significantly more sleepiness was observed after SR in comparison with baseline and recovery testing days (P < 0.05). After SR, mechanical pain threshold on the tip of the tongue was significantly lower on day after SR (day 2) and a rebound, higher values, were observed on the third day (P < 0.05); no difference on thumb site. In the control arm, no SR and no significant differences between days were observed for all the variables of interest. CONCLUSIONS: The present results suggest that SR may affect somatosensory perception in the oro-facial area.


Assuntos
Limiar da Dor/fisiologia , Limiar Sensorial/fisiologia , Privação do Sono/fisiopatologia , Polegar/inervação , Língua/inervação , Estudos Cross-Over , Feminino , Voluntários Saudáveis , Humanos , Masculino , Medição da Dor , Estimulação Física , Reprodutibilidade dos Testes , Polegar/fisiologia , Língua/fisiologia , Adulto Jovem
12.
J Oral Rehabil ; 46(1): 1-4, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30203622

RESUMO

The field of temporomandibular disorders (TMDs) and bruxism research has recently witnessed a publishing trend leaning towards an overuse of systematic reviews (SRs) that contribute little or nothing to current knowledge. The majority of these seem to be more methodological exercises than manuscripts prepared to provide clinicians and researchers with up-to-date information to advance knowledge. In addition, given the increasing number of researchers who have been reviewing the dental literature on various topics without seemingly having any specific clinical or scientific background in the topic under review, the ultimate value of some SRs is questionable. Some of them end up producing meta-analyses (MAs) to give "numbers" (eg, risk measures and strength of association) that do not have a biological basis, due to the clinical heterogeneity of the articles being reviewed. Based on the above, the present commentary discusses this ongoing publishing trend that is affecting the TMD and bruxism field, which does not align well with the core principles of evidence-based dentistry (EBD). Ideally, EBD should be derived from a combination of literary, clinical and patient-centred information, but relying only on the bibliographic aspects could potentially expose less expert clinicians and other readers who merely browse the literature to incomplete, misdirected or even incorrect conclusions.


Assuntos
Bruxismo , Odontologia Baseada em Evidências/tendências , Pesquisa sobre Serviços de Saúde/tendências , Editoração/tendências , Transtornos da Articulação Temporomandibular , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
13.
J Dent Anesth Pain Med ; 18(6): 361-365, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30637346

RESUMO

Background: Recently, we examined the effects of 2% lidocaine gel on the tactile sensory and pain thresholds of the face, tongue and hands of symptom-free individuals using quantitative sensory testing (QST); its effect was less on the skin of the face and hands than on the tongue. Consequently, instead of 2% lidocaine gel, we examined the effect of 8% lidocaine spray on the tactile sensory and pain thresholds of the skin of the face and hands of healthy volunteers. Methods: Using Semmes-Weinstein monofilaments, QST of the skin of the cheek and palm (thenar skin) was performed in 20 healthy volunteers. In each participant, two topical sprays were applied. On one side, 0.2 mL of 8% lidocaine pump spray was applied, and on the other side, 0.2 mL of saline pump spray was applied as control. In each participant, QST was performed before and 15 min after each application. Pain intensity was measured using a numeric rating scale (NRS). Results: Both the tactile detection threshold and filament-prick pain detection threshold of the cheek and thenar skin increased significantly after lidocaine application. A significant difference between the effect of lidocaine and saline applications was found on the filament-prick pain detection threshold only. NRS of the cheek skin and thenar skin decreased after application of lidocaine, and not after application of saline. Conclusion: The significant effect of applying an 8% lidocaine spray on the sensory and pain thresholds of the skin of the face and hands can be objectively scored using QST.

14.
Int J Oral Maxillofac Implants ; 32(2): 439-444, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28291863

RESUMO

PURPOSE: To report on a cohort of patients referred to a tertiary center because of neuropathic pain after dental implant placement. MATERIALS AND METHODS: This retrospective study of pain after dental implant placement involved a minimum follow-up of 12 months after the initial diagnosis of neuropathic pain or persistent, uncontrolled postoperative pain at the Department of Oral and Maxillofacial Surgery, Leuven University, Leuven, Belgium, from January 2013 to June 2014. RESULTS: Following clinical and radiologic examination, the cause of pain was established in 17 of 26 patients, while the cause was unknown in 9 of 26 patients. Regular implants were placed in the mandibles of 18 patients; in the remaining 8 patients, 6 received regular implants and 2 received a zygoma implant in the maxilla. Surgical management alone brought relief to 2 patients, surgical and pharmacologic management did so for 12 patients, and pharmacologic management alone brought relief for 10 patients. CONCLUSIONS: Early removal of an at-risk implant seems justified, preferably within 48 hours after placement. No treatment, either surgical or medical, seems to cure neuropathic pain, but amitriptyline appears to be associated with consistent improvement in symptoms.


Assuntos
Implantação Dentária Endóssea/efeitos adversos , Implantes Dentários , Neuralgia/epidemiologia , Dor Pós-Operatória/epidemiologia , Adulto , Idoso , Analgésicos/uso terapêutico , Antidepressivos/uso terapêutico , Bélgica/epidemiologia , Dor Crônica/epidemiologia , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Pessoa de Meia-Idade , Neuralgia/tratamento farmacológico , Neuralgia/etiologia , Dor Pós-Operatória/etiologia , Estudos Retrospectivos , Adulto Jovem , Zigoma/cirurgia
15.
Arch Oral Biol ; 72: 51-55, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27541635

RESUMO

OBJECTIVE: The aim of the present study was to examine the effect of lidocaine application to the face, tongue and hand on sensory and pain thresholds of symptom-free subjects. DESIGN: Eighteen females (mean age 25.7 years, range 22-38) participated. Using Semmes-Weinstein monofilaments, the tactile detection threshold (TDT) and the filament-prick pain detection threshold (FPT) were measured on the cheek skin (CS), tongue tip (TT) and palm side of the thenar skin (TS). Subjects were tested in 2 sessions at a 1week interval in randomised order. Lidocaine (session A) or placebo gel (session B) was applied for 5min. The TDT and FPT were measured before and after application. RESULTS: The TDT at all sites in session A significantly increased after 5min, but a significant session effect on the TDT was only found at the TT (P<0.01). On the other hand, there were significant session effects on the FPT at all sites (P<0.01). CONCLUSION: These results indicate that the pain threshold (FPT) is more susceptible to local anesthetics than the sensory threshold (TDT), but further study is needed to use topical lidocaine for the control of oral and facial pain in the clinic.


Assuntos
Anestésicos Locais/uso terapêutico , Dor Facial/prevenção & controle , Lidocaína/uso terapêutico , Limiar Sensorial , Administração Tópica , Adulto , Anestésicos Locais/administração & dosagem , Feminino , Mãos , Humanos , Lidocaína/administração & dosagem , Medição da Dor , Limiar da Dor , Pele , Língua
16.
J Oral Sci ; 57(4): 355-60, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26666859

RESUMO

The aim of this study was to evaluate the relationship between pain intensities and psychosocial characteristics in middle-aged and older patients with temporomandibular disorders (TMDs) and burning mouth syndrome (BMS). Subjects were selected according to the Research Diagnostic Criteria for TMD (n = 705) and International Association for the Study of Pain criteria for BMS (n = 175). Patients were then divided into two age groups: 45-64 years (middle-aged, Group A) and 65-84 years (older, Group B). Pain intensity and depression and somatization scores were evaluated in both groups. In BMS patients, present and worst pain intensities were significantly higher in Group B than in Group A {4.6 [95% confidence interval (CI) = 4.0-5.2] vs. 3.5 [95% CI = 3.1-3.9] and 5.9 [95% CI = 5.2-6.4] vs. 5.0 [95% CI = 4.5-5.6], respectively; P < 0.05}, with no difference observed in TMD patients. The depression and somatization scores were significantly higher in Group A than in Group B among BMS patients [0.57 (95% CI = 0.45-0.69) vs. 0.46 (95% CI = 0.34-0.59) and 0.537 (95% CI = 0.45-0.63) vs. 0.45 (95% CI = 0.34-0.55); P < 0.05], with no difference observed in TMD patients. The results of the present study indicate that pain intensities and psychosocial characteristics in BMS appear to differ between middle-aged and older patients.


Assuntos
Síndrome da Ardência Bucal/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Imaging Sci Dent ; 45(2): 89-94, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26125003

RESUMO

PURPOSE: This study was performed to evaluate the relationship between pterygoid plate asymmetry and temporomandibular joint disorders. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) images of 60 patients with temporomandibular disorders (TMD) involving pain were analyzed and compared with images of 60 age- and gender-matched controls. Three observers performed linear measurements of the lateral pterygoid plates. RESULTS: Statistically significant differences were found between measurements of the lateral pterygoid plates on the site that had pain and the contralateral site (p<0.05). The average length of the lateral pterygoid plates (LPPs) in patients with TMD was 17.01±3.64 mm on the right side and 16.21±3.51 mm on the left side, and in patients without TMD, it was 11.86±1.97 mm on the right side and 11.98±1.85 mm on the left side. Statistically significant differences in the LPP length, measured on CBCT, were found between patients with and without TMD (p<0.05). The inter-examiner reliability obtained in this study was very high for all the examiners (0.99, 95% confidence interval: 0.98-0.99). CONCLUSION: Within the limits of the present study, CBCT lateral pterygoid plate measurements at the side with TMD were found to be significantly different from those on the side without TMD. More research is needed to explore potential etiological correlations and implications for treatment.

18.
Arch Oral Biol ; 60(5): 681-9, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25757146

RESUMO

OBJECTIVE: To examine the effect of low-level jaw clenching on temporal summation in healthy volunteers. DESIGN: In 18 healthy volunteers, the pain intensities evoked at the masseter muscle and the hand palm by the first and last stimuli in a train of repeated electrical stimuli (0.3 or 2.0 Hz) were rated using 0-100mm visual analogue scales (VAS), in order to evaluate temporal summation before and after three types of jaw-muscle tasks: low-level jaw clenching, repetitive gum chewing and mandibular rest position. A set of concentric surface electrodes with different diameters (small and large) was used for the electrical stimulation. RESULTS: The temporal summation evoked by the large diameter electrode with 2.0 Hz stimulation decreased significantly both on the masseter and the hand after low-level clenching (P ≤ 0.03), but did not show any significant change after the other tasks (P > 0.23). The VAS score of the first stimulation did not show any significant changes after low-level clenching (P > 0.57). CONCLUSIONS: Experimental low-level jaw clenching can inhibit pain sensitivity, especially temporal summation. Low-level jaw clenching can modify pain sensitivity, most likely through the central nervous system. The findings suggest that potential harmful low-level jaw clenching or tooth contacting could continue despite painful symptoms, e.g., temporomandibular disorders.


Assuntos
Arcada Osseodentária/fisiologia , Músculo Masseter/fisiologia , Contração Muscular/fisiologia , Adulto , Estimulação Elétrica , Eletromiografia , Dor Facial/etiologia , Feminino , Voluntários Saudáveis , Humanos , Masculino , Medição da Dor , Limiar da Dor/fisiologia
19.
J Oral Sci ; 56(3): 221-5, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25231149

RESUMO

We investigated the relationship between pain intensity and psychosocial characteristics in patients with temporomandibular disorder (TMD). Participants with painful TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD), were recruited from our clinic and classified into six age groups: 15 to 24, 25 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 to 85 years (Groups A through F, respectively). Self-reported present pain intensity and worst pain intensity during the past 6 months were ascertained using a numeric rating scale (0 to 10). Depression and somatization scores were evaluated using the RDC/TMD axis II questionnaire. Among women, worst pain intensity was significantly lower in Groups E and F than in Groups B and C (P < 0.05). In Groups A, C, and D, depression scores were significantly higher in women than in men (P < 0.05). Among women, depression score was significantly lower in Group F than in Groups A through C (P < 0.05). In Groups A through D, somatization scores were significantly higher for women than for men (P < 0.05). Depression score and TMD symptom severity appear to decrease with age in women.


Assuntos
Fatores Etários , Transtornos da Articulação Temporomandibular/fisiopatologia , Transtornos da Articulação Temporomandibular/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Medição da Dor , Inquéritos e Questionários , Adulto Jovem
20.
J Clin Periodontol ; 41(7): 724-32, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24708422

RESUMO

AIM: To assess in a randomized study the patient-centred outcome of two guided surgery systems (mucosa or bone supported) compared to conventional implant placement, in fully edentulous patients. MATERIAL AND METHODS: Fifty-nine patients (72 jaws) with edentulous maxillas and/ or mandibles, were consecutively recruited and randomly assigned to one of the treatment groups. Outcome measures were the Dutch version of the McGill Pain Questionnaire (MPQ-DLV), the Health-related quality of life instrument (HRQOL), visual analogue scales (VAS), the duration of the procedure, and the analgesic doses taken each day. RESULTS: Three hundred and fourteen implants were placed successfully. No statistical differences could be shown between treatment groups on pain response (MPQ-DLV), treatment perception (VAS) or number or kind of pain killers. For the HRQOLI-instrument, a significant difference was found between the Materialise Mucosa and Materialise Bone group at day 1 (p = 0.02) and day 2 (p = 0.01). For the duration of the surgery, a statistical difference (p = 0.005) was found between the Materialise mucosa and the Mental group, in favour of the first. CONCLUSION: In this study little difference could be found in the patient outcome variables of the different treatment groups. However there was a tendency for patients treated with conventional flapped implant placement to experience the pain for a longer period of time.


Assuntos
Implantação Dentária Endóssea/métodos , Arcada Edêntula/cirurgia , Satisfação do Paciente , Cirurgia Assistida por Computador/métodos , Adulto , Idoso , Analgésicos/uso terapêutico , Atitude Frente a Saúde , Desenho Assistido por Computador , Implantação Dentária Endóssea/psicologia , Implantes Dentários , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/cirurgia , Maxila/cirurgia , Pessoa de Meia-Idade , Duração da Cirurgia , Osteotomia/métodos , Medição da Dor/métodos , Dor Pós-Operatória/psicologia , Planejamento de Assistência ao Paciente , Qualidade de Vida , Cirurgia Assistida por Computador/psicologia , Retalhos Cirúrgicos/cirurgia , Resultado do Tratamento , Escala Visual Analógica
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...