Abstract
BACKGROUND AND OBJECTIVES: To relate biopsychosocial variables of Research Diagnostic Criteria for Temporomandibular Disorders to groups of patients with temporomandibular disorders, temporomandibular disorders and migraine and a control group. METHODS: This is a cross-sectional observational study where 280 consecutive patients were evaluated and distributed in three groups: group I (140 control individuals); group II (65 individuals with muscle temporomandibular disorders) and group III (75 individuals with migraine and muscle temporomandibular disorders). Exclusion criteria were individuals with clinical history of muscle inflammatory processes, muscle spasms, contractures and acute temporomandibular joint traumatic injury. RESULTS: Group III individuals had association with severe depression (p<0.001), level 4 in pain severity (p=0.004), unspecific physical symptoms without severe pain (p<0.0001) and unspecific symptoms with severe pain (p<0.00001). There has been significant difference between females and males in group III (Z=2.59; p=0.001), with longer pain duration among females. The percentage of females in group III was significantly higher as compared to males (p=0.004). CONCLUSION: The relationship between variables and the three groups has shown a higher number of individuals with more severe symptoms in group III. So, it is understood that migraine is a morbid condition often associated to temporo mandibular disorders, worsening symptoms referred by patients. There is the need for multidisciplinary evaluation of these individuals to optimize treatment and minimize morbidity, costs and the number of medical visits.
Highlights
Temporomandibular disorder (TMD) is a term encompassing a broad spectrum of clinical orofacial joint and muscles problems
This is a case-control study where 280 patients were evaluated between January 2013 and January 2014, who were divided in three groups: groups: myofascial pain (group I) – 140 normal individuals of general population (this population was selected in the Blood Center of Escola Paulista de Medicina, Universidade Federal de São Paulo / Hospital São Paulo( (EPM-UNIFESP-HSP); group II (TMD) – 65 individuals with muscle TMD without migraine and followed up by the Temporomandibular Disorder and Orofacial Pain outpatient setting, EPM-UNIFESP-HSP; and group III – 75 individuals with migraine and temporomandibular disorder assisted by the Neuroheadache Outpatient Setting, EPMUNIFESP-HSP
Chi-square test has shown significant difference between genders when compared with regard to the distribution of subjects in the three groups (p=0.004), showing that the percentage of group III components, in females, was significantly higher as compared to males (Table 1)
Summary
Temporomandibular disorder (TMD) is a term encompassing a broad spectrum of clinical orofacial joint and muscles problems It is especially characterized by pain, temporomandibular joint (TMJ) noises and irregular or limited jaw function, representing a significant reason for non-dental pain in the orofacial region[1]. It is the third most prevalent chronic pain, being more frequent among youngsters and adults (20 to 50 years of age), affecting predominantly females in a female/ male proportion between 3:1 and 9:12,3. Axis II is a biopsychosocial evaluation and was developed to screen psychological status of patients and classify them in a chronic pain scale. It is understood that migraine is a morbid condition often associated to temporo-
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