Prevalence of Function-Dependent Temporomandibular Joint and Masticatory Muscle Pain, and Predictors of Temporomandibular Disorders among Patients with Lyme Disease

Magdalena Osiewicz,Jolanta Pytko-Polończyk,Ghizlane Aarab,Jacek Czepiel,Daniele Manfredini,Grażyna Biesiada,Aleksander Garlicki,Frank Lobbezoo

doi:10.3390/jcm8070929

Abstract

The aim was to determine the occurrence of temporomandibular disorders (TMDs) in patients with Lyme disease (LD), and to estimate the contribution of factors that may identify TMD among LD patients. In seventy-six (N = 76) adult patients with LD (mean age 57.6 ± 14.6 years) and 54 healthy non-Lyme volunteers with a mean age of 56.4 ± 13.5 years, possible function (i.e., non-pain) diagnoses were established using the Research Diagnostic Criteria of Temporomandibular Disorders (RDC/TMD). Pain diagnoses were established by means of the function-dependent dynamic and static tests. The two groups did not significantly differ in the frequency of disc displacements diagnoses and function-dependent pain diagnoses. LD showed a significantly higher frequency (p < 0.001) of osteoarthrosis than the control group. For the prediction of pain diagnoses in LD patients, the single regression analyses pointed out an association with age, sleep bruxism (SB), and awake bruxism (AB). Two predictors (i.e., SB (p = 0.002) and AB (p = 0.017)) were statistically significant in the final multiple variable model. The frequency of TMD in patients with LD based on function-dependent tests was not significantly different from that in the control group. This investigation suggests that the contribution of bruxism to the differentiation between patients with Lyme and TMD is high.

Highlights

Lyme disease (LD) is the most common tick-borne disease caused by bacteria spirochetes of the Borrelia species, classified as Borrelia burgdorferi (Bb) strain [1,2]
The infection was confirmed by examining the presence of specific antibodies in serum and/or cerebrospinal fluid (CSF) using ELISA test (Biomedica, Vienna, Austria), and the borderline or positive results in serum were confirmed with the use of Western-blot test
In the LD group, moderate or severe SOM was shown in 73.7% of patients, whilst in the control group the frequency was 7.4% (p < 0.001)

Summary

Introduction

Lyme disease (LD) is the most common tick-borne disease caused by bacteria spirochetes of the Borrelia species, classified as Borrelia burgdorferi (Bb) strain [1,2]. Most cases of LD are reported in the northern hemisphere, mainly in the US and Europe [3,4,5,6]. Vector ticks are spirochetes of the genus Ixodes. An average LD incubation period takes from 3 to 30 days, it might be prolonged up to 3 months. The typical clinical picture of LD may include skin, joints, heart, and/or nervous system symptoms, less often symptoms involving the eyes [7]. Depending on the symptoms and their time of onset, LD is classified in Lyme neuroborreliosis (LN) or Lyme arthritis (LA), and in early localized, early disseminated, or late disseminated infection

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