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1.
Front Pain Res (Lausanne) ; 3: 956117, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36093390

RESUMO

Although most cases of pain-related temporomandibular disorders (TMD) are mild and self-limiting, about 10% of TMD patients develop severe disorders associated with chronic pain and disability. It has been suggested that pain intensity contributes to the transition from acute to chronic pain-related TMD. Therefore, the aims of this current prospective cohort study were to assess if pain intensity, pain always being present, pain or stiffness on awakening, jaw activities, and interference, were associated with the transition from acute to chronic pain-related TMD at 3 months of follow-up. One hundred and nine participants, recruited from four clinics in Montreal and Ottawa, received examinations and completed the required instruments at baseline and at the 3rd month of follow-up. In a multivariable analysis including sex, age, characteristic pain index (CPI) (OR = 1.03, 95%CI = 1.01-1.06, P = 0.005), moderate to severe average pain intensity (OR = 3.51, 95%CI = 1.24-9.93, P = 0.02), disability points score (OR = 1.29, 95%CI = 1.06-1.57, P = 0.01), interferences (ORs = 1.30-1.32, P = 0.003-0.005), screening score (OR = 1.37, 95%CI = 1.08-1.76, P = 0.01), and pain always present (OR = 2.55, 95%CI = 1.08-6.00, P = 0.03) assessed at first-visit were related to the transition outcome at the 3rd month of follow-up. Further, we found that if 4 patients with acute pain-related TMD on average were exposed to these risk factors at baseline, 1 would have the transition from acute to chronic pain at 3 months of follow-up. Results indicate that these factors are associated with the transition from acute to chronic pain-related TMD, and therefore should be considered as important factors when evaluating and developing treatment plans for patients with pain-related TMD.

2.
Can J Pain ; 6(1): 112-120, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35799959

RESUMO

Background: Temporomandibular disorders (TMDs) are common and cause persistent pain. Comorbidities are associated with TMDs and can affect the effectiveness of their treatments. The literature is lacking enough evidence on the difference between acute and chronic pain, particularly in TMDs. Investigating this difference could highlight potential risk factors for the transition from acute to chronic pain-related TMDs. Aim: To compare the likelihood of back and neck pain (BP, NP) between acute and chronic pain-related TMDs (AP-TMD, CP-TMD) as defined by pain duration and pain-related disability. . Methods: Participants with AP-TMDs (≤3 months) and CP-TMDs (>3 months) were recruited according to the diagnostic criteria and research diagnostic criteria of TMD. BP and NP were assessed using a self-reported checklist. CP-TMDs defined by disability (chronic disability) and depression and anxiety symptoms were assessed using validated instruments. Logistic regression analyses were employed. Results: This study enrolled 487 adults with AP-TMD (n = 118) and CP-TMD (n = 369). Relative to AP-TMD, participants with CP-TMD had twice the odds of reporting NP (odds ratio [OR] = 2.17 , 95% CI 1.27-3.71) but not BP (OR = 0.96, 95% CI 0.57-1.64). Participants with chronic disability were twice as likely to report NP (OR = 1.95 , 95% CI 1.20-3.17 ) but not BP (OR = 1.13, 95% CI 0.69-1.82) compared to those without. All analyses were adjusted for age, sex, and anxiety and depression symptoms. Conclusions: Within the limitations of this study, results suggest that central dysregulation or trigeminocervical convergence mechanisms are implicated in the process of pain-related TMD chronification and highlight the relevance of considering disability when defining CP-TMDs.


Contexte : Les troubles temporo-mandibulaires (TTM) sont fréquents et provoquent des douleurs persistantes. Des comorbidités sont associées aux TTM et peuvent affecter l'efficacité de leur traitement. Il n'y a pas suffisamment de données probantes dans la litt\érature sur la différence entre la douleur aiguë et la douleur chronique, en particulier dans les TTM. L'étude de cette différence pourrait mettre en évidence les facteurs de risque potentiels pour la transition des TTM liés à la douleur aiguë aux TTM liés à la douleur chronique.Objectif : Comparer la probabilité de douleur au dos et de douleur cervicale (DD, DC) entre les TTM liés à la douleur aiguë et les TTM liés à la douleur chronique (TTM-DA, TTM-DC), telles que définis par la durée de la douleur et l'incapacité liée à la douleur.Méthodes : Les participants atteints de TTM-DA (≤3 mois) et de TTM-DC (>3 mois) ont été recrutés selon les critères diagnostiques et les critères diagnostiques pour la recherche en matière de TTM. La douleur au dos et la douleur cervicale ont été évaluées à l'aide d'une liste de contrôle autodéclarée. Les TTM-DC définis par l'invalidité (invalidité chronique) et les symptômes de dépression et d'anxiété ont été évalués à l'aide d'instruments validés. Des analyses de régression logistique ont été utilisées.Résultats : Cette étude a inclus 487 adultes atteints de TTM-DA (n = 118) et de TTM-DC (n = 369). Comparativement aux patients atteints de TTM-DA, les participants atteints de TTM-DC étaient deux fois plus susceptibles de déclarer de la douleur cervicale (rapport de cotes [RC] = 2,17, IC à 95 % 1,27-3,71) mais pas de douleur au dos (RC = 0,96, IC à 95 % 0,57-1,64). Les participants ayant une incapacité chronique étaient deux fois plus susceptibles de déclarer de la douleur cervicale (RC = 1,95, IC à 95 % 1,20-3,17), mais pas de douleur au dos (RC = 1,13, IC à 95 % 0,69-1,82) que ceux n'en ayant pas. Toutes les analyses ont été ajustées en fonction de l'âge, du sexe, de l'anxiété et des symptômes de dépression.Conclusions : Dans les limites de cette étude, les résultats indiquent que la dysrégulation centrale ou les mécanismes de convergence trigéminocervicale sont impliqués dans le processus de chronicisation des TTM liés à la douleur et soulignent la pertinence de tenir compte de l'incapacité au moment de définir les TTM-DC.

4.
Eur J Dent Educ ; 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35543311

RESUMO

INTRODUCTION: The objective of this study was to assess an original learning intervention to train students and paediatric dentistry teachers in radiographic diagnostic accuracy of pulpo-periodontal complications in primary molars. MATERIALS AND METHODS: The learning intervention was based on 250 different randomly ordered radiographs of primary molars within three quizzes (A, B and C) for 5 sessions (S): quiz A (50 X-rays), B and C (100 X-rays) were, respectively, completed in S1 to assess the extent of agreement with 5 experts' diagnoses, in S2 and S3 (B at days 8 and 23) and in S4 and S5 (C at days 90 and 105). During S1 and at the end of S3 and S5, the participants (48 students and 16 teachers) were informed of correct diagnoses. A satisfaction questionnaire was completed by all the students. Alongside the descriptive analyses, generalised linear mixed model (GLMM) analyses assessed the odds of participants' correct diagnosis over the study duration. RESULTS: At S1, the odds of diagnostic accuracy among students were significantly lower than those among the teachers. After receiving feedback at S1, GLMM analyses showed that among all the participants, accuracy improved over time with the odds of correct diagnoses higher in S2-5 than in S1; and there were similar increases across sessions between teachers and students, except in S3, where the improvement among teachers tended to be greater than that among the students. All students were satisfied though one-third reported that quizzes with 100 radiographs felt too long. CONCLUSION: The online case-based learning was a good training format for dental education.

5.
J Am Dent Assoc ; 153(2): 144-157, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34973705

RESUMO

BACKGROUND: Patients often seek consultation with dentists for temporomandibular disorders (TMDs). The objectives of this article were to describe the methods of a large prospective cohort study of painful TMD management, practitioners' and patients' characteristics, and practitioners' initial treatment recommendations conducted by The National Dental Practice-Based Research Network (the "network"). METHODS: Participating dentists recruited into this study treated patients seeking treatment for painful TMDs. The authors developed self-report instruments based on well-accepted instruments. The authors collected demographics, biopsychosocial characteristics, TMD symptoms, diagnoses, treatments, treatment adherence, and painful TMDs and jaw function outcomes through 6 months. RESULTS: Participating dentists were predominately White (76.8%) and male (62.2%), had a mean age of 52 years, and were general practitioners (73.5%) with 23.8% having completed an orofacial pain residency. Of the 1,901 patients with painful TMDs recruited, the predominant demographics were White (84.3%) and female (83.3%). Patients' mean age was 44 years, 88.8% self-reported good to excellent health, and 85.9% had education beyond high school. Eighty-two percent had pain or stiffness of the jaw on awakening, and 40.3% had low-intensity pain. The most frequent diagnoses were myalgia (72.4%) and headache attributed to TMDs (51.0%). Self-care instruction (89.4%), intraoral appliances (75.4%), and medications (57.6%) were recommended frequently. CONCLUSIONS: The characteristics of this TMD cohort include those typical of US patients with painful TMDs. Network practitioners typically managed TMDs using conservative treatments. PRACTICAL IMPLICATIONS: This study provides credible data regarding painful TMDs and TMD management provided by network practitioners across the United States. Knowledge acquired of treatment recommendations and patient reports may support future research and improve dental school curricula.


Assuntos
Transtornos da Articulação Temporomandibular , Adulto , Dor Facial/terapia , Feminino , Cefaleia/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autocuidado , Transtornos da Articulação Temporomandibular/terapia
6.
J Oral Rehabil ; 49(3): 273-282, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34731502

RESUMO

BACKGROUND: Temporomandibular disorder (TMD) pain is common among adolescents. The association between painful TMD and other comorbidities has been demonstrated. However, the difference between short-term (<6 months) and long-term (≥ 6 months) painful TMD is not yet clear. OBJECTIVE: The aim of this study was to assess the association between comorbidities and short- and long-term painful TMD among adolescents. METHODS: In this cross-sectional study, adolescents were recruited from Montreal (Canada), Nice (France) and Arceburgo (Brazil). Self-reported painful TMD, comorbidities, school absence and analgesic intake were assessed using reliable instruments. Multivariable logistic regression analyses were conducted to assess the study aims. RESULTS: The prevalence of short- and long-term painful TMD was estimated at 22.29% and 9.93% respectively. The number of comorbidities was associated with short- (OR = 1.71, 95%CI = 1.53-1.90) and long-term painful TMD (OR = 1.79, 95%CI = 1.55-2.08) compared to controls. Frequent headaches (ORshort-term  = 4.39, 95%CI = 3.23-5.98, ORlong-term  = 3.69, 95%CI = 2.45-5.57) and back pain (ORshort-term  = 1.46, 95%CI = 1.06-2.03, ORlong-term  = 1.69, 95%CI = 1.11-2.59) were associated with both painful TMD groups. Frequent neck pain (OR = 2.23, 95%CI = 1.53-3.26) and allergies were only associated with short-term painful TMD (OR = 1.54, 95%CI = 1.13-2.10). Frequent stomach pain was related to long-term (OR = 2.01, 95%CI = 1.35-3.26), and it was the only comorbidity significantly more frequent among the long than short-term TMD (OR = 1.82, 95%CI: 1.14-2.90). These analyses were adjusted by sex, age and city. CONCLUSION: In this multi-centre study, both short- and long-term painful TMD are associated with frequent headaches and back pain, whereas frequent neck pain and allergies are related to only short-term and frequent stomach pain with long-term painful TMD.


Assuntos
Transtornos da Articulação Temporomandibular , Adolescente , Brasil/epidemiologia , Comorbidade , Estudos Transversais , Dor Facial/epidemiologia , Dor Facial/etiologia , Humanos , Cervicalgia/epidemiologia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/epidemiologia
7.
Expert Rev Neurother ; 21(7): 817-831, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34210227

RESUMO

Introduction: The search for an ideal biomarker for migraine has persisted for a long time. There is plentiful evidence of potential biomarkers for migraine found in cerebrospinal fluid, blood, and saliva.Areas covered: Herein, the authors highlight and discuss the most promising candidates in the literature. An electronic search was performed for studies published between 2010 and 2020 in MEDLINE, PubMed, and EMBASE, related to potential biomarkers in migraine patients, found in cerebrospinal fluid, saliva, and serum, focusing on biomarkers that can be related to treatment and clinical outcomes.Expert opinion: An ideal biomarker, or a panel of biomarkers, could revolutionize the way we address and propose treatments for this disease. Once severe presentations and phenotypes have been identified using a reliable biomarker, patients could be treated at earlier disease stages with more specific medications. The most important biomarkers with the most significant levels of evidence comprised calcitonin gene-related peptide (CGRP), glutamate, nerve growth factor, some inflammatory (CRP, TNF-α, interleukins) and oxidative stress markers. CGRP was associated with episodic, chronic migraine and response to treatment. Pituitary adenylate cyclase-activating polypeptide is an emerging neuropeptide involved in migraine diagnostics and severity. New genetic and epigenetic biomarkers will be candidates for future research.


Assuntos
Transtornos de Enxaqueca , Biomarcadores , Peptídeo Relacionado com Gene de Calcitonina , Humanos , Transtornos de Enxaqueca/diagnóstico , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase
8.
J Clin Med ; 10(14)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34300304

RESUMO

The impact of comorbidities in fibromyalgia (FM) and temporomandibular disorders (TMD) have been well documented, but whether TMD sub-diagnoses myalgia (MYA) and myofascial pain with referral (MFP) differ regarding comorbidity is unclear. We aimed to elucidate this by studying the presence and associations of comorbidities in FM, MFP and MYA. An extended version of the Diagnostic Criteria for TMD axis II questionnaire was used to examine demographics, pain and comorbidities in 81 patients with FM, 80 with MYA, and 81 with MFP. Patients with MFP and FM reported a higher percentage of irritable bowel syndrome (IBS), depression, anxiety, somatic symptoms, perceived stress, and insomnia compared to MYA. Patients with FM had more IBS, depression, and somatic symptom disorder versus MFP. After adjusting for confounding variables, participants with anxiety, somatic symptoms disorder, pain catastrophizing, and perceived stress, as well as a greater number of comorbidities, were more likely to have MFP than MYA, whereas FM participants were more associated with IBS, somatic symptoms and insomnia compared to MFP. The number of comorbidities was significantly associated with widespread pain but not pain duration, body mass index or being on sick leave. In conclusion, patients with MFP were more similar to those with FM regarding comorbidity and should be differentiated from MYA in clinical settings and pain management.

9.
J Med Cases ; 12(5): 202-204, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33984093

RESUMO

In this complex context of coronavirus disease 2019 (COVID-19), headache medicine has been completely affected by this new reality, with new types of headaches directly or indirectly related to COVID-19 being detected. Personal protective equipment (PPE) was recommended for workers in many professions that did not previously require wearing masks leading to new headaches, or the exacerbation of past headaches, especially among health workers. A 57-year-old female working in a secondary care hospital had a history of migraine twice/month without aura and allodynia symptom checklist (ASC12) scored as 7 before COVID-19 outbreak. She began to work with PPE (surgical masks, face shield and surgical cap) and migraines became daily (bifrontal, pulsatile, with photophobia, nausea, vomiting and of severe intensity, visual analog scale: 7), starting after 1 h of wearing protective equipment and lasted for at least 6 h during the day. There was no adequate response to treatment. The headache frequency retuned to twice/month after the patient stayed home 45 days due to another condition. It is hypothesized here that people with allodynia symptoms when exposed to PPE are more susceptible to the development of new headaches or to the worsening of existing primary headaches. The relationship between previous allodynia determined with the ASC12 questionnaire and new headaches, or past primary headaches that have become worse during the COVID-19 pandemic in workers using PPE, should be better investigated in order to clarify this hypothesis. Cutaneous allodynia could be related with the sensitivity to PPE and headache progression.

10.
Int J Paediatr Dent ; 31(3): 299-310, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33220074

RESUMO

BACKGROUND: Worldwide, numerous surveys have investigated practices and knowledge about caries management in adults, but few are available for children. AIM: The present cross-sectional survey aimed to assess the restorative thresholds (RTs) in primary and permanent molars in children used by a population of dentists treating children and practicing in France. DESIGN: The study population consisted of French dentists treating children (Fr-DTCs) who were registered in the French Society of Pediatric Dentistry (n = 250). A specific questionnaire was developed. Descriptive and statistical analyses were performed. RESULTS: Response rate was 80.4% (n = 201). Considering that an appropriate RT is at the stage of a moderate lesion (occlusal: International Caries Detection and Assessment System 4; approximal: lesion involving the external third of dentine), more than 50% of respondents showed a tendency for iatrogenic treatment, except for occlusal carious lesions in primary molars. Inappropriate invasive strategies were more often reported for occlusal lesions in permanent than primary molars. Moreover, for both molar types, these inappropriate RTs were more often chosen for approximal than occlusal lesions. CONCLUSIONS: The present survey suggested that Fr-DTCs tend to overtreat in terms of caries management in both primary and permanent molars.


Assuntos
Cárie Dentária , Restauração Dentária Permanente , Adulto , Criança , Estudos Transversais , Cárie Dentária/terapia , Dentina , Odontólogos , Humanos , Dente Molar
11.
J Oral Rehabil ; 47(4): 417-424, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31834958

RESUMO

BACKGROUND: Painful temporomandibular disorder (TMD) is common among adolescents. Presence of painful comorbidities may worsen painful TMD and impact treatment effectiveness. OBJECTIVE: The aim of this study was to assess the association between painful TMD and comorbidities. METHODOLOGY: In this cross-sectional study, adolescents were recruited in Montreal (Canada), Nice (France) and Arceburgo (Brazil). Reliable instruments were used to assess painful TMD and comorbidities. Multivariable logistic and linear regression analyses were conducted to assess the study aims. RESULTS: The prevalence of self-reported painful TMD was estimated at 31.6%; Arceburgo (31.6%), Montreal (23.4%) and Nice (31.8%). Painful TMD was more common among girls than boys (OR = 1.96). Painful TMD was associated with a higher number of comorbidities (OR = 1.77); Arceburgo (OR = 1.81), Montreal (OR = 1.80) and Nice (OR = 1.72). A stronger association was found between painful TMD and headaches (OR = 4.09) and a weaker one with stomach pain (OR = 1.40). Allergies were also related to painful TMD (OR = 1.43). CONCLUSION: Painful TMD was associated with comorbidities. Headaches were consistently associated with painful TMD. Other associations were modified by sex and/or covariates related to the cities where participants were recruited.


Assuntos
Transtornos da Articulação Temporomandibular , Adolescente , Brasil , Canadá , Estudos Transversais , Dor Facial , Feminino , França , Humanos , Masculino , Dor
12.
Trials ; 20(1): 530, 2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31445509

RESUMO

BACKGROUND: Guidelines in pediatric restorative dentistry recommend the use of preformed pediatric stainless steel crowns (SSCs) in cases of severe tooth decay of at least two surfaces. This clinically effective and safe restorative option is frequently refused by parents for esthetic reasons; they prefer conventional restorations using esthetic filling materials (composites, glass ionomer) if lesion severity limited to two surfaces permits. Recently, manufacturers have proposed esthetic preformed pediatric zirconia crowns (ZCs) but these have been assessed in only two randomized clinical trials (RCT) with follow-ups of 6 and 12 months. Only one of these RCTs was carried out on primary molars to test ZCs (NuSmile ZR) without a groove in its inner surface. The primary objective of this proposed RCT is to assess the effectiveness of ZCs compared with SSCs. Our hypothesis is that the effectiveness of ZCs will be equivalent to that of SSCs. METHODS: In this split-mouth, 2-year RCT, pairs of primary molars in 101 child participants will be randomized and restored with SSCs (ESPE, 3M) and ZCs (EZCrowns, Sprig Oral Health Technologies) characterized by grooves on their inner surface. Primary molars will first be allocated to SSCs, and 1 to 2 weeks later the other primary molar of the same pair will be restored by ZC. The primary outcome is the success defined by the "absence of major clinical and radiographic failure" (e.g., pain, pulp infection, dental abscess or periradicular pathology visible on radiographs). The secondary outcomes include the retention and fracture rates, the gingival condition, the wear of the antagonist of the treated teeth, as well as both parental and child satisfaction. DISCUSSION: This study will investigate two types of preformed pediatric crowns for the management of severe decay on primary molars. The results may help practitioners choose the better therapeutic option and to explain to parents the advantages and disadvantages of these two therapies. TRIAL REGISTRATION: NCT03296709 . Registered on  27 September 2017.


Assuntos
Coroas , Assistência Odontológica para Crianças , Cárie Dentária/cirurgia , Restauração Dentária Permanente/instrumentação , Dente Molar/cirurgia , Dente Decíduo/cirurgia , Zircônio , Adolescente , Fatores Etários , Criança , Pré-Escolar , Cárie Dentária/diagnóstico , Planejamento de Prótese Dentária , Falha de Restauração Dentária , Restauração Dentária Permanente/efeitos adversos , Feminino , França , Humanos , Masculino , Estudos Multicêntricos como Assunto , Satisfação do Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do Tratamento
13.
J Oral Rehabil ; 46(9): 862-882, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31155735

RESUMO

OBJECTIVES: The aim of this systematic review (SR) was to answer the following question: "In adult patients with temporomandibular disorder (TMD)-related pain, what is the placebo or nocebo effect of different therapies?" METHODS: A SR was performed with randomised clinical placebo-controlled trials on diagnosed painful TMD studies from five main databases and from three grey literature. Studies included must have sample older than 18 years, with painful TMD, which diagnosis was done by Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD). RESULTS: Out of 770 articles obtained, 42 met the inclusion criteria for qualitative and 26 for quantitative analysis. Meta-analysis indicated mean variation on pain intensity for placebo therapy was higher on laser acupuncture with 45.5 mm point reduction, followed by avocado soya bean extract with 36 mm and amitriptyline 25 mg with 25.2 mm. Laser showed a 29% of placebo effect, as well medicine with 19% and other therapies with 26%. Possible nocebo effect of 8% pain increase was found for intra-articular injection of Ultracain. CONCLUSIONS: Based on the available data, the placebo response could play a major effect on TMD pain management and may be responsible from 10% to 75% of pain relief. Laser acupuncture, avocado soya bean and amitriptyline promoted the higher placebo effect. Possible nocebo effect was found only for Ultracain injection with 8%. CLINICAL RELEVANCE: Clinicians could apply such evidence to optimise pain management and judgement about treatment efficacy, and researches may find it useful when designing their investigations.


Assuntos
Efeito Nocebo , Transtornos da Articulação Temporomandibular , Adulto , Humanos , Dor , Manejo da Dor , Medição da Dor
14.
Caries Res ; 52(4): 312-322, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29495020

RESUMO

A split-mouth randomized clinical trial was carried out to assess the effectiveness of sealants in preventing carious ICDAS (International Caries Detection and Assessment System) 3-6 lesions within a 2-year follow-up. We evaluated the effectiveness of 2 types of resin-based sealants, with and without fluoride, their retention rates, and the caries risk factors related to their outcomes. The study included 663 tooth pairs in 400 children (aged 5-15 years) considered to be at high individual caries risk (ICR) and presenting permanent molars free of caries or affected by ICDAS 1-2 lesions. In the first randomization, molars were either randomized to the treatment group receiving a dental sealant or the control group (nontreatment), and in the second randomization the sealant material to be used in the intervention group was selected. Uni- and multivariate Cox proportional hazard models were employed. At the 2-year follow-up, 483 tooth pairs were assessed: sealed molars had 83% (adjusted HR = 0.17; 95% CI: 0.15-0.20) less risk of developing ICDAS 3-6 lesions than molars without sealant. The magnitude of the protective effect was lower among teeth with ICDAS 1-2 lesions or with occlusal deep fissures than without. If the total retention rate of sealants was 70% at 2 years, sealant loss was not associated with the risk of caries (HR = 1.29, 95% CI: 0.92-1.79, p = 0.14). Sealants allow the prevention of new ICDAS 3-6 lesions or progression of noncavitated carious lesions in children at high ICR, and the effect of the sealant was similar regardless of whether it contained fluoride or not.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Resinas Sintéticas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Dente Molar , Modelos de Riscos Proporcionais , Fatores de Risco
15.
Prog Neuropsychopharmacol Biol Psychiatry ; 87(Pt B): 159-167, 2018 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-28522289

RESUMO

Chronic pain is a common pain condition. Some psychiatric disorders, such as anxiety and depression, are also common in the general population. Epidemiological studies found that some psychiatric disorders are more commonly found among persons with chronic pain (e.g., headache, back pain) than those without chronic pain. Why those psychiatric disorders co-occur with chronic pain, however, is not well understood. Further, studies demonstrated that some psychiatric disorders, such as depression, increase the risk of chronic pain as well as its persistence. It is also recognized that chronic pain has a negative impact on the persistence of psychiatric disorders. The observations from clinical studies suggest that chronic pain is not a common comorbidity among individuals with other psychiatric disorders, such as dementia and schizophrenia. It is not clear if this is a consequence of any specific biological mechanism, or methodology problems in the studies. This paper provides an overview on the distribution of chronic pain and psychiatric disorders, followed by a review of studies that have demonstrated the association between psychiatric disorders and chronic pain.


Assuntos
Transtornos Mentais/epidemiologia , Dor/epidemiologia , Humanos , Transtornos Mentais/complicações , Dor/complicações
16.
Gen Dent ; 61(6): 26-31, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24064159

RESUMO

This study tested a jaw support device for patients receiving dental care while suffering from temporomandibular joint pain. This crossover randomized trial used 31 subjects with jaw pain. Subjects underwent 2 consecutive dental scaling sessions of 30 minutes each. For each subject, the device was used for 1 of the sessions. Subjects completed questionnaires regarding jaw pain and jaw fatigue before and after each session. Multivariate analyses were performed to assess the device's effectiveness in preventing the aggravation of pain and fatigue during dental treatment. Statistically significant differences were found for jaw pain (P = 0.001), and fatigue (P = 0.04), indicating the effectiveness of the device. Based on the results, supporting the mandible of patients with temporomandibular disorders during dental treatments may prevent further pain.


Assuntos
Raspagem Dentária/métodos , Aparelhos Ortopédicos , Transtornos da Articulação Temporomandibular/terapia , Adulto , Estudos Cross-Over , Raspagem Dentária/efeitos adversos , Raspagem Dentária/instrumentação , Dor Facial/etiologia , Dor Facial/prevenção & controle , Fadiga/etiologia , Fadiga/prevenção & controle , Feminino , Humanos , Masculino , Mandíbula , Medição da Dor , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações
17.
J Orofac Pain ; 27(3): 271-5, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23882460

RESUMO

AIMS: To translate the Pictorial Representation of Illness and Self Measure (PRISM) instrument from German to Portuguese (Brazilian) and adapt it to the Brazilian cultural context, and then assess its reliability and validity in orofacial pain patients. METHODS: The PRISM was translated to Portuguese then back-translated to German. The translated PRISM was evaluated by a multidisciplinary committee and administered as a pre-test to 30 Portuguese-speaking orofacial pain patients. Psychometric properties were obtained after testing 116 orofacial pain patients. Validity was obtained through correlation analyses of scores obtained from PRISM and other psychometric tests, including the Numerical Pain Scale (NPS), Insomnia Severity Index (ISI), and Hospital Anxiety and Depression Scale (HAD). RESULTS: The adapted instrument showed high levels of reliability, proven by means of the test-retest procedure, and calculation of the Intraclass Correlation Coefficient (ICC = 0.991). Significant correlations were found between PRISM and the other tests. Correlation with NPS was moderate (-0.42), whereas correlations with ISI (-0.24), HAD-anxiety (-0.25), and HAD-depression (-0.22) were weak. CONCLUSION: The cross-cultural adaptation process of PRISM was successful and the adapted version offers reliable and valid psychometric properties in the Brazilian context.


Assuntos
Comparação Transcultural , Autoavaliação Diagnóstica , Dor Facial/diagnóstico , Testes Psicológicos , Adulto , Brasil , Estudos Transversais , Dor Facial/psicologia , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Medição da Dor , Fotografação , Estudos Prospectivos , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Estresse Psicológico
18.
Dent Clin North Am ; 57(2): 233-62, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23570804

RESUMO

Gender is the biggest risk factor in the development of temporomandibular disorders (TMD) and orofacial pain. Gender differences in pain thresholds, temporal summation, pain expectations, and somatic awareness exist in patients with chronic TMD or orofacial pain. There are gender differences in pharmacokenetics and pharmacodynamics of medications used to treat pain. A better understanding of the mechanisms that contribute to the increased incidence and persistence of chronic pain in females is needed. Future research will elucidate the sex effects on factors that protect against developing pain or prevent debilitating pain. Gender-based treatments for TMD and orofacial pain treatment will evolve from the translational research stimulated by this knowledge.


Assuntos
Dor Facial/tratamento farmacológico , Dor Facial/fisiopatologia , Fatores Sexuais , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/fisiopatologia , Dor Crônica/fisiopatologia , Feminino , Humanos , Masculino , Limiar da Dor , Farmacocinética , Fatores de Risco , Saúde da Mulher
19.
Int Dent J ; 62(3): 154-60, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22568741

RESUMO

OBJECTIVES: The aim of this study was to create and validate a drawing to help adults establish when to replace a manual toothbrush. METHODS: This cohort study had two phases. Phase I (3 months, 50 subjects) aimed to create a drawing of average wear in a toothbrush based on a wear index (WI) of 68% for the tested toothbrush. This was validated in Phase II (3 months, 30 participants). Pictures of worn brushing surfaces were generated using an image acquisition system. Images in each study phase were superimposed to provide a single reference outline to indicate when a toothbrush should be replaced. Residual plaque index values for identical brushing protocols were recorded using new and worn toothbrushes in Phase I and compared using Student's paired t-test. Student's t-test was used to compare duration of tooth-brushing and WI values in both phases. RESULTS: After brushing according to a uniform protocol, the residual plaque index at baseline was significantly lower than that at the last use of the toothbrush (P < 0.01). The drawings generated in Phases I and II were similar in terms of WI (P = 0.33) and period of use (P = 0.12). CONCLUSIONS: This simple drawing may help adults establish when they should replace a toothbrush.


Assuntos
Arte , Dispositivos para o Cuidado Bucal Domiciliar , Escovação Dentária/instrumentação , Adolescente , Adulto , Idoso , Estudos de Coortes , Índice de Placa Dentária , Falha de Equipamento , Reutilização de Equipamento , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
20.
Pain ; 152(10): 2377-2383, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21871734

RESUMO

Although most cases of temporomandibular muscle and joint disorders (TMJD) are mild and self-limiting, about 10% of TMJD patients develop severe disorders associated with chronic pain and disability. It has been suggested that depression and catastrophizing contributes to TMJD chronicity. This article assesses the effects of catastrophizing and depression on clinically significant TMJD pain (Graded Chronic Pain Scale [GCPS] II-IV). Four hundred eighty participants, recruited from the Minneapolis/St. Paul area through media advertisements and local dentists, received examinations and completed the GCPS at baseline and at 18-month follow-up. In a multivariable analysis including gender, age, and worst pain intensity, baseline catastrophizing (ß 3.79, P<0.0001) and pain intensity at baseline (ß 0.39, P<0.0001) were positively associated with characteristic of pain intensity at the 18th month. Disability at the 18-month follow-up was positively related to catastrophizing (ß 0.38, P<0.0001) and depression (ß 0.17, P=0.02). In addition, in the multivariable analysis adjusted by the same covariates previously described, the onset of clinically significant pain (GCPS II-IV) at the 18-month follow-up was associated with catastrophizing (odds ratio [OR] 1.72, P=0.02). Progression of clinically significant pain was related to catastrophizing (OR 2.16, P<0.0001) and widespread pain at baseline (OR 1.78, P=0.048). Results indicate that catastrophizing and depression contribute to the progression of chronic TMJD pain and disability, and therefore should be considered as important factors when evaluating and developing treatment plans for patients with TMJD.


Assuntos
Catastrofização/psicologia , Dor Crônica/psicologia , Transtorno Depressivo/psicologia , Transtornos da Articulação Temporomandibular/psicologia , Adulto , Catastrofização/epidemiologia , Dor Crônica/epidemiologia , Estudos de Coortes , Comorbidade/tendências , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Músculos da Mastigação/fisiopatologia , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto Jovem
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