Abstract
Objective The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs.Material and Methods 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05).Results Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810).Conclusions Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.
Highlights
Temporomandibular disorders (TMDs) are a group of musculoskeletal disorders that affect the stomatognathic system[1]
In the gross odds ratios (OR) calculation performed with univariate analysis comparing Groups 1 and 2, only the variables visual analogue scale (VAS) pain scores, maximal interincisal distance (MID), and gender demonstrated to be statistically significant (p-value
Mean VAS pain scores found in this study (5.73±1.84) is similar to that found in a previous study with disc displacement with reduction (DDWR) patients (6:26±1:51)[18]
Summary
Temporomandibular disorders (TMDs) are a group of musculoskeletal disorders that affect the stomatognathic system[1]. There is a significant reduction of life quality of patients with specific subtypes of TMDs, such as articular disc displacement with reduction (DDWR)[3] and myofascial pain (MFP)[4]. Patients with two TMDrelated pain diagnoses have more impairment of life quality than subjects with one diagnosis[4]. DDWR is one of the most common internal derangements of the TMJ5. In patients with DDWR, when the mouth is closed, the articular disc is anteriorly displaced in relation to the condyle and, when the mouth is open, the disc returns to its original position, in the intermediate area between the condyle and the articular tubercle[1,6,7]. Most cases of DDWR are not painful, pain, when present, is due to TMJ arthralgia[7]. Arthralgia is the TMJ inflammation, generating pain and sensitivity[1,7]. DDWR responds for about 30% of all TMDs, increasing to about 50% when combined with muscle conditions[8,9]
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