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1.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 772-777, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045790

RESUMO

Objective: To evaluate the MRI and cone beam CT (CBCT) image registration methods of the temporomandibular joint (TMJ), and to explore the clinical application of the registered images and clinical diagnostic data for examining the relationship between the articular disc and condyle. Methods: Three patients with TMJ disc disposition were recruited at the Department of Oral and Maxillofacial Surgery, School of Stomatology, Wuhan University from January to March 2018. One patient was male, aged 30, and the others were females, aged 21 and 26 respectively. Three-dimensional (3D) images of CBCT and MRI of the TMJ were reconstructed and registered by using Mimics software. The images were then evaluated after the registration. The evaluation indicators selected were the area and volume of the articular disc, the position of the articular disc or the distance between the highest point of the condyle (point C) to the center point of the articular disc (point D), the distance between the last point of the joint disc (point P) to point C, as well as the angle between line CD and FH plane (∠DCF) at either opened- or closed-mouth condition. Results: The registration images of TMJ, at the closed- and opened-mouth positions of the 3 patients, showed the anatomical structures and interrelationships of the articular disc, articular nodules, joint fossa and condyle. Combined with clinical diagnosis, the difference of CD distances at the normal articular disc position was the minimum (1.94 mm), the difference of CD distances was small at the anterior disc displacement with non-reduction and larger with reduction. When the joint disc was in the opened-mouth position, ∠DCF angle was minimal (3.81°). The patients with anterior disc displacement with non-reduction showed the largest ∠DCF angle (48.03°). Conclusions: The position of the articular disc relative to the condyle and articular nodules, either at closed- or opened-mouth conditionds, could be accurately displayed after the image registration and fusion. The registration image not only could fully show the shape and position of the articular disc in different status from a 3D perspective, but also might provide basis for clinical study of TMJ disc displacement.


Assuntos
Disco da Articulação Temporomandibular , Transtornos da Articulação Temporomandibular , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adulto Jovem
2.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 794-798, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045794

RESUMO

Temporomandibular disorders (TMD) is one of the most common diseases in the orofacial region. The occurrence, development and outcome of TMD are affected by many factors. Among various risk factors, the psychological factors, especially anxiety, depression and somatic symptoms, are getting more and more attention in the etiology, diagnosis and treatment of TMD. Psychological factors are associated with the occurrence of TMD, and the accurate diagnostic criteria is conducive to the assessment of the patient's psychological state. If necessary, an appropriate psychological treatment according to a patient's psychological status can effectively improve the effect of clinical treatment. This article, based on domestic and international literatures, reviews the research progress of the correlation between the psychological factors and the etiology, diagnosis and treatment of TMD, in order to provide new ideas for clinicians to diagnose and treat TMD.


Assuntos
Transtornos da Articulação Temporomandibular , Ansiedade , Humanos , Fatores de Risco , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/terapia
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1270-1273, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018219

RESUMO

Temporomandibular joints (TMJ) like a hinge connect the jawbone to the skull. TMJ disorders could cause pain in the jaw joint and the muscles controlling jaw movement. However, the disease cannot be diagnosed until it becomes symptomatic. It has been shown that bone resorption at the condyle articular surface is already evident at initial diagnosis of TMJ Osteoarthritis (OA). Therefore, analyzing the bone structure will facilitate the disease diagnosis. The important step towards this analysis is the condyle segmentation. This article deals with a method to automatically segment the temporomandibular joint condyle out of cone beam CT (CBCT) scans. In the proposed method we denoise images and apply 3D active contour and morphological operations to segment the condyle. The experimental results show that the proposed method yields the Dice score of 0.9461 with the standards deviation of 0.0888 when it is applied on CBCT images of 95 patients. This segmentation will allow large datasets to be analyzed more efficiently towards data sciences and machine learning approaches for disease classification.


Assuntos
Côndilo Mandibular , Transtornos da Articulação Temporomandibular , Tomografia Computadorizada de Feixe Cônico , Humanos , Côndilo Mandibular/diagnóstico por imagem , Crânio , Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem
4.
J Appl Oral Sci ; 28: e20190608, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32901693

RESUMO

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.


Assuntos
Transtornos da Articulação Temporomandibular , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Dor , Inquéritos e Questionários
5.
J Oral Facial Pain Headache ; 34: s15-s28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32975538

RESUMO

AIMS: To assess cohort retention in the OPPERA project and to compare the degree of overlap between pairs of chronic overlapping pain conditions (COPCs) using a cross-sectional analysis of data from 655 adults who completed follow-up in the OPPERA study. METHODS: Subjects were classified for the absence or presence of each of the five COPCs. The extent of overlap beyond chance was quantified using odds ratios, which were calculated using binary logistic regression models. RESULTS: While overlap was the norm, its magnitude varied according to COPC: 51% of people with headache had one or more overlapping COPCs, and this proportion increased to 90% for people with fibromyalgia. The degree of overlap between pairs of COPCs also varied considerably, with odds ratios being greatest for associations between musculoskeletal conditions (fibromyalgia, temporomandibular disorders, and low back pain) and less pronounced for overlap involving headache or IBS. Furthermore, univariate associations between some pairs of COPCs were nullified after adjusting for other COPCs. CONCLUSION: There was greater overlap between fibromyalgia and either temporomandibular disorders or low back pain than between other pairs of COPCs. While musculoskeletal conditions exhibited some features that could be explained by a single functional syndrome, headache and irritable bowel syndrome did not.


Assuntos
Dor Crônica , Síndrome de Fadiga Crônica/epidemiologia , Fibromialgia/epidemiologia , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/epidemiologia , Transtornos da Articulação Temporomandibular/epidemiologia , Adulto , Dor nas Costas , Comorbidade , Estudos Transversais , Cefaleia/epidemiologia , Humanos
6.
J Oral Facial Pain Headache ; 34: s43-s56, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32975540

RESUMO

AIMS: To investigate associations between experimental pain sensitivity and five chronic pain conditions among 655 participants in the OPPERA study. METHODS: Quantitative sensory tests were used to measure sensitivity to three modalities of nociception: blunt pressure pain, mechanical pinprick pain, and thermal heat pain. Participants were also classified according to the presence or absence of five chronic pain conditions: temporomandibular disorders, headache, low back pain, irritable bowel syndrome, and fibromyalgia. RESULTS: Univariate analyses found each modality to be significantly associated with at least one pain condition, most consistently for pressure pain sensitivity (8 of 15 instances) and least consistently for heat pain sensitivity (5 of 35 instances). Yet, multivariable analyses that evaluated the independent contributions of all five pain conditions found few significant associations (12 of 75 instances). Instead, pain sensitivity consistently varied according to the total number of pain conditions a person experienced, implying that the combination of pain conditions influences each nociceptive modality. CONCLUSION: When evaluating nociceptive sensitivity in a chronic pain patient, comorbid pain conditions should be considered, as the more salient feature underlying sensitivity is likely the number rather than the type(s) of pain conditions.


Assuntos
Dor Crônica , Fibromialgia , Transtornos da Articulação Temporomandibular , Humanos , Limiar da Dor , Estudos Prospectivos
7.
J Oral Facial Pain Headache ; 34: s57-s72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32975541

RESUMO

AIMS: To investigate whether TMD-related characteristics are indeed specific to TMD or whether they are also associated with other chronic overlapping pain conditions (COPCs). METHODS: In this cross-sectional study, 22 characteristics related broadly to TMD (eg, jaw kinesiophobia, overuse behaviors, and functional limitation) were measured in 178 painful TMD cases who were also classified according to four COPCs: headache, low back pain, irritable bowel syndrome, and fibromyalgia. Differences in mean subscale scores were compared according to individual chronic pain conditions and according to number of COPCs. RESULTS: Headache, low back pain, irritable bowel syndrome, and fibromyalgia were each associated (P < .05) with higher values of at least one TMD-relevant characteristic. In the multivariable analysis, TMD was independently associated with 20 of the 22 characteristics (P < .01), and other COPCs were associated variably. A critical threshold existed between the number of COPCs and TMD characteristics: all characteristics were elevated for subjects with ≥ 3 COPCs (P ≤ .01). CONCLUSION: The overlap between COPCs and characteristics typically regarded as specific to painful TMD has implications for treatment targeted at both the local TMD condition and the broader pain disorder underlying the COPC(s). In TMD patients, the overall burden of pain from COPCs may create a shift in the pain-processing systems that underlie these TMD-relevant characteristics.


Assuntos
Dor Crônica , Transtornos da Articulação Temporomandibular/complicações , Doença Crônica , Estudos Transversais , Dor Facial/etiologia , Cefaleia/etiologia , Humanos
8.
J Oral Facial Pain Headache ; 34: s85-s100, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32975543

RESUMO

AIMS: To characterize psychologic functioning across five chronic overlapping pain conditions (COPCs)-temporomandibular disorders, fibromyalgia, low back pain, headache, and irritable bowel syndrome-and their overlaps. METHODS: Participants were 655 adults in the OPPERA study. Psychologic variables were standardized in separate logistic regression models to compare their relative strength of association with each COPC. Random forest regression was used to explore the association of all psychologic measures with COPCs simultaneously. Linear regression analyses examined whether the count of COPCs was associated with psychologic measures. RESULTS: In univariate and multivariable analyses, measures of somatic symptom burden showed the strongest associations with individual COPCs and with the number of COPCs. Additional psychologic variables that showed significant associations with individual COPCs and their overlap included negative mood, perceived stress, and pain catastrophizing. CONCLUSION: These findings highlight the importance of psychologic functioning in the assessment and management of these overlapping pain conditions.


Assuntos
Dor Crônica , Transtornos da Articulação Temporomandibular , Adulto , Doença Crônica , Humanos , Medição da Dor , Transtornos Somatoformes
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 603-607, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878392

RESUMO

Temporomandibular disorders (TMDs) have attracted the attention of the clinicians of stomatology and other related disciplines because of the high prevalence and close relationship with multiple disciplines. Medical imaging is of great value in the diagnosis and differential diagnoses for TMDs. Based on the author's clinical practice experience and some related research work, combined with the relevant literatures, the indications, advantages and disadvantages of various commonly used imaging modalities were described. Simultaneously, the importance and limitations of imaging diagnosis for TMDs were discussed and emphasized in the present article.


Assuntos
Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Humanos , Prevalência , Radiografia
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 608-612, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878393

RESUMO

The document represented the consensus amongst the professionals from the Society of TMD & Occlusion, Chinese Stomatological Association and provided guidelines with the MRI examination specification and diagnostic criteria of temporomandibular joint disc displacement.


Assuntos
Luxações Articulares/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Consenso , Humanos , Imagem por Ressonância Magnética , Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/diagnóstico por imagem
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 613-616, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878394

RESUMO

The document represented the consensus amongst the professionals from the Society of TMD & Occlusion, Chinese Stomatological Association and provided guidelines with the cone-beam CT examination specification and diagnostic criteria of temporomandibular disorders.


Assuntos
Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Consenso , Humanos , Côndilo Mandibular
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 624-628, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878396

RESUMO

Objective: To evaluate the altered brain volume of the patients with painful temporomandibular disorders (TMD) using voxel-based morphometry (VBM). Methods: One hundred forty-six TMD patients ï¼»age (36.8±15.8) years, male/female=44/102ï¼½ and 193 normal controls (NC) ï¼»age (43.3±15.6) years, male/female = 92/101ï¼½ were performed with 3 dimensional brain structural images at 3.0 T MR scanner from November 2011 to December 2019 in Department of Radiology, Hainan Hospital and General Hospital of Chinese PLA. The brain structural images were segmented into gray matter, white matter and cerebrospinal fluid, and the gray matter images were performed with two-samples t-test with total intracranial volume, age and gender as covariates. Results: The gray matter volume (GMV) presented significantly higher in TMD group ï¼»(632.4±65.4) mlï¼½ than that in NC group ï¼»(596.1±76.3) mlï¼½ (t=4.70, P<0.05). The brain regions with increased GMV for TMD located in left inferior temporal gyrus, bilateral fusiform gyrus, bilateral middle temporal gyrus and right lingual gyrus compared with NC. Conclusions: The temporal lobe was the targeting brain region for TMD patients with increased GMV, which should further be investigated to elucidate the neuromechanism.


Assuntos
Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Substância Branca , Encéfalo , Substância Cinzenta/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino
13.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 629-633, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878397

RESUMO

Objective: To evaluate the histological changes of the retrodiscal tissue in the patients with temporomandibular disorders (TMD). Methods: Thirty-three TMD patients were performed with temporomandibular joint (TMJ) MRI examinations from April 2018 to April 2020 in TMD clinic, Hainan Hospital of General Hospital of Chinese PLA. The patients groups were classified according to the disc position as follows: normal position (NP) (29 TMJ), disk displacement with reduction (DDwR) (14 TMJ) and disk displacement without reduction (DDwoR) (23 TMJ). The gray-level co-occurrence matrix (GLCM) analysis was applied with the retrodiscal tissue on the open oblique sagittal proton weighted images. The texture parameters included as follows: angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. The statistical methods mainly included Kruskal-Wallis H test, one-way analysis of variance and receiver operating characteristic curve (ROC), to analyze the texture characteristic parameters of the retrodiscal tissue are statistically significant. Results: There was no significant difference of the retrodiscal tissue's ASM, contrast, correlation and IDM among 3 groups (P>0.05). The entropy in NP group (3.98±0.44) and DDwR group (4.20±0.52) presented significant higher than that in DDwoR group (3.70±0.38) (P<0.05). ROC analysis for the entropy demonstrated that the area under the curve was 0.70 when differentiating NP and DDwR (cut-off value 0.38, sensitivity 82.61%, specificity 55.17%), and was 0.79 when differentiating DDwR and DDwoR (cut-off value 0.47, sensitivity 82.61%, specificity 64.29%). Conclusions: Texture entropy could be primarily used to evaluate the histological and pathological changes of the retrodiscal tissue in the TMD patients.


Assuntos
Luxações Articulares/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Projetos Piloto , Articulação Temporomandibular , Disco da Articulação Temporomandibular/diagnóstico por imagem
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 634-638, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878398

RESUMO

Objective: To evaluate the meaning of arthrography with cone-beam CT(CBCT) imaging in the diagnosis of temporomandibular disorders(TMD). Methods: Four hundred and forty-eight cases of temporomandibular upper joint cavity arthrography with CBCT imaging were retrospectively analyzed. The distribution of disc displacement with reduction or without reduction, disc perforation, enlargement or tearing of joint capsule were analyzed. The characteristics of arthrography with CBCT imaging were also described. Results: There were 384 female and 64 male among the 448 cases of TMD with CBCT arthrographic images. The median age was 31.5 years, range from 14 to 81 years old. As about the age distribution, there were 63 cases in the group of ≤20 years old, 150 cases in the group of >20 and ≤30 years old, 86 cases in the group of >30 and ≤40 years old, 59 cases in the group of >40 and ≤50 years old, 58 cases in the group of>50 and ≤60 years old, and 32 cases in the group of >60 years old. There were 356 cases with disc displacement, in which there were 328 cases of disc displacement without reduction, and 28 cases of disc displacement with reduction. There were 152 cases with disc perforation, and 12 cases with articular capsule tearing or laxation. Conclusions: Arthrography with CBCT imaging was a meaningful approach to diagnose the TMD with structure disorders.


Assuntos
Luxações Articulares/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrografia , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Articulação Temporomandibular/diagnóstico por imagem , Disco da Articulação Temporomandibular/diagnóstico por imagem , Adulto Jovem
15.
Eur J Paediatr Dent ; 21(3): 219-226, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893656

RESUMO

AIM: Asymptomatic TMJ arthritis in juvenile idiopathic arthritis (JIA) patients may cause damage and deformity of the joint. The clinical manifestation of early-stage TMJ arthritis is not characteristic. Clinical findings commonly appear in a late stage of TMJ involvement, but they can also be masked by antirheumatic therapy. The absence of clinical symptoms, and the lack or insufficient clinical signs do not provide reliable information about the TMJ involvement. The aim of the study was to conduct a systematic review of the evidence for clinical symptoms and signs of early-stage TMJ arthritis, as well as for correlation between clinical parameters and TMJ abnormalities imaging in JIA patients. METHODS: Study design: A systematic review of papers published from 1998 to 2019 regarding early clinical and imaging findings of TMJ arthritis in JIA patients. RESULTS: The search resulted in 292 studies. Eleven publications were included in the review. CONCLUSION: Clinical signs and symptoms do not allow to detect the early stage of TMJ arthritis in JIA patients. To monitor individual orofacial development, periodic TMJ clinical examination should be a part of an evaluation of JIA children's growth. There is a need to develop clinical management guidelines, as well as diagnosis standards of clinical and imaging TMJ examination for JIA children, considering their developmental age.


Assuntos
Artrite Juvenil , Transtornos da Articulação Temporomandibular , Criança , Diagnóstico Precoce , Humanos , Imagem por Ressonância Magnética , Articulação Temporomandibular
16.
Braz Dent J ; 31(4): 360-367, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32901710

RESUMO

The aim of this study was to construct a predictive model that uses classification tree statistical analysis to predict the occurrence of temporomandibular disorder, by dividing the sample into groups of high and low risk for the development of the disease. The use of predictive statistical approaches that facilitate the process of recognizing and/or predicting the occurrence of temporomandibular disorder is of interest to the scientific community, for the purpose of providing patients with more adequate solutions in each case. This was a cross-sectional analytical population-based study that involved a sample of 776 individuals who had sought medical or dental attendance at the Family Health Units in Recife, PE, Brazil. The sample was submitted to anamnesis using the instrument Research Diagnostic Criteria for Temporomandibular Disorders. The data were inserted into the software Statistical Package for the Social Sciences 20.0 and analyzed by the Pearson Chi-square test for bivariate analysis, and by the classification tree method for the multivariate analysis. Temporomandibular disorder could be predicted by orofacial pain, age and depression. The high-risk group was composed of individuals with orofacial pain, those between the ages of 25 and 59 years and those who presented depression. The low risk group was composed of individuals without orofacial pain. The authors were able to conclude that the best predictor for temporomandibular disorder was orofacial pain, and that the predictive model proposed by the classification tree could be applied as a tool for simplifying decision making relative to the occurrence of temporomandibular disorder.


Assuntos
Dor Facial , Transtornos da Articulação Temporomandibular , Adulto , Brasil , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Fatores de Risco
17.
Swiss Dent J ; 130(9): 668-675, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32869964

RESUMO

Assessment of mandibular mobility is an integral part of many dental examinations. Yet, information on the maximum range of mandibular motion in large groups of patients with temporomandibular disorders (TMDs) is limited. Therefore, we analyzed the corresponding data of 500 TMD patients who had presented at the University Center for Dental Medicine Basel. All measurements had been carried out by one examiner. The average maximal values for unassisted jaw opening, protrusion, and movement to the right and left were 49.3 mm (SD: 9.1), 8.8 mm (SD: 2.3), 9.4 mm (SD: 2.5), and 11.8 mm (SD: 3.1), respectively. Since activities such as chewing, talking, oral hygiene or even yawning require neither very wide openings nor extensive lateral or protrusive excursions, we would like to propose the following general threshold values for impaired mandibular function: maximum interincisal distance < 30 mm; maximum laterotrusion as well as maximum protrusion < 5 mm. These cut-off values, which are lower than those traditionally suggested in the dental literature, appear to be sufficient to carry out functionally undisturbed mandibular movements. By lowering the traditionally higher thresholds, the spectrum of anatomical and functional variability is increased. In this way, patients and non-patients may be protected against medicalization, overdiagnosis, and overtreatment.


Assuntos
Transtornos da Articulação Temporomandibular , Humanos , Mandíbula , Mastigação , Movimento , Amplitude de Movimento Articular , Articulação Temporomandibular
18.
J Oral Facial Pain Headache ; 34(3): 199-205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870948

RESUMO

AIMS: To investigate the effectiveness of a novel jaw-opening-force measuring device as a screening tool to aid in the diagnosis of temporomandibular disorders (TMD). METHODS: Symptomatic TMD patients (n = 58) and control TMD-free participants (n = 56) were screened by an oral medicine specialist according to the Diagnostic Criteria for TMD (DC/TMD). TMD patients were divided into three subcategories based on TMD symptoms (myofascial pain, disc displacement, and both combined). Jaw-opening forces were measured in both groups with an adjustable head device connected to a 1,000-N-load cell. Seven attempts were recorded at 10-second intervals by a data-capturing system. The geometric mean force values were obtained after discarding the first and last attempts. RESULTS: TMD-free participants had greater jaw-opening forces than TMD patients both without and with adjustments for age, sex, height, and weight (both P < .001). The geometric mean ± standard deviation values for TMD patients were 18.5 ± 1.62 N and 47.7 ± 1.53 N for TMD-free participants. Differences in jaw-opening forces among the three TMD subcategories were not statistically significant; however, patients with disc displacement (23.7 ± 1.46 N) had greater jaw forces than patients with myofascial pain (17.0 ± 1.74 N) and both myofascial pain and disc displacement (17.0 ± 1.56 N). CONCLUSION: This study demonstrated that differences in jaw-opening forces could be used as a diagnostic tool for TMD. Future studies should explore the potential of this device to measure improvement in jaw-opening forces following TMD treatment.


Assuntos
Transtornos da Articulação Temporomandibular , Humanos
19.
J Oral Facial Pain Headache ; 34(3): 206-216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870949

RESUMO

Within the orofacial pain discipline, the most common group of afflictions is temporomandibular disorders (TMD). The pathologic and functional disorders included in this condition closely resemble those that are seen in the orthopedic medicine branch of the medical profession, so it would be expected that the same principles of orthopedic diagnosis and treatment are applied. Traditional orthopedic therapy relies on a "Two Pathway" approach involving conservative and/or surgical treatments. However, over the course of the 20th century, some members of the dental community have created another way of approaching these disorders- referred to in this paper as the "Third Pathway"-based on the assumption that signs and symptoms of TMD are due to a "bad" relationship between the mandible and skull, leading to a variety of irreversible occlusal or surgical corrective treatments. Since no other human joint is discussed in these terms within the orthopedic medicine communities, it has become progressively clear that the Third Pathway is a unique and artificial conceptual creation of the dental profession. However, many clinical studies have utilized the medically oriented conservative/surgical Two-Pathway model to diagnose and treat TMD within a biopsychosocial model of pain. These studies have shown that TMD comprise another domain of orthopedic illness that requires a medically oriented approach for good outcomes while avoiding the irreversible aspects of the Third Pathway. This review presents historical and current evidence that the Third Pathway is an example of unorthodox medicine that leads to unnecessary overtreatment and further proposes that it is time to abandon this approach as we move forward in the TMD field.


Assuntos
Transtornos da Articulação Temporomandibular , Dor Facial , Humanos , Mandíbula
20.
J Oral Facial Pain Headache ; 34(3): 265-272, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870955

RESUMO

AIMS: To examine the associations of self-reported presence of tinnitus with subtypes of temporomandibular disorders (TMD) as assessed by Axis I of the Diagnostic Criteria for TMD (DC/TMD) and with psychologic characteristics as assessed by Axis II. METHODS: This retrospective controlled study included 108 consecutive TMD patients referred to the Tel Aviv University Orofacial Pain Clinic. Each patient received full Axis I and Axis II diagnoses according to the DC/TMD. The patients were asked about currently experiencing tinnitus. Pearson chi-square test and Fisher exact test were used to test the associations between categorical variables. Mann-Whitney test was used to assess differences in continuous variables between categories. A P value < .05 was considered statistically significant. RESULTS: Thirty-three (30.6%) TMD patients reported experiencing tinnitus. There was a significantly higher prevalence of myofascial pain with referral (P = .008) and nonspecific physical symptoms (P = .014) among the TMD patients who reported tinnitus. In addition, those patients reported significantly longer pain duration compared to TMD patients without tinnitus (P = .039). CONCLUSION: This study emphasizes the necessity of assessing both Axes I and II according to the DC/TMD in future studies and supports creating a standardized tinnitus screener tailored to TMD patients for future studies on tinnitus in TMD patients.


Assuntos
Transtornos da Articulação Temporomandibular , Zumbido , Dor Facial , Humanos , Estudos Retrospectivos , Autorrelato
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