Presence Of Temporomandibular Disorders Research Articles

High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity?

To investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population. Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD. We enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression. IBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.

Temporomandibular Disorders in Patients Undergoing Mandibular Advancement Device Therapy for Obstructive Sleep Apnea: A Systematic Review

Background: Mandibular advancement device (MAD) therapy is a popular and effective treatment for snoring and obstructive sleep apnea (OSA). However, there have been several reports in the literature of patients developing temporomandibular disorders (TMDs).
 Objective: The objective of this review is to evaluate the prevalence of TMD, both in the initial phase of therapy and at follow up appointments, amongst patients wearing a MAD for OSA.
 Methods: The authors conducted a systematic review of published articles in which the presence of TMDs in patients undergoing MAD therapy for OSA was investigated. Eligible studies met the following criteria: a diagnosis of TMD following mandibular advancement using a custom-made and titratable MAD using either the Diagnostic Criteria for TMD (DC/TMD), Helkimo Anamnestic Dysfunction Index or reproducible clinical signs/symptoms.
 Results: The average prevalence of TMD during the initial phase of MAD therapy was found to be 25%. The prevalence of TMD reduced in the follow up periods. The adherence to MAD, especially long term, appears to be variable and from our results, it appears an average of 20% of patients discontinue MAD therapy over six to one hundred and twenty months, and this number has been reported to be as high as 62.5%.
 Conclusions: There was some difficulty in comparing the studies due to the differences in follow up time, methodology, sample size and diagnostic criteria. Longer clinical follow-up studies, with an objective method of monitoring patient adherence and with a larger sample size are needed to evaluate the long-term effects of MADs

Concomitant Migraine and Temporomandibular Disorders are Associated With Higher Heat Pain Hyperalgesia and Cephalic Cutaneous Allodynia.

The aim of this study was to assess differences in the levels of hyperalgesia and cutaneous allodynia (CA) among women with migraine, temporomandibular disorders (TMD), or both. Eighty women participated in the study. Mean ages for the control group, TMD group, migraine group, and migraine+TMD group were 26.15 (95% confidence interval [CI], 28.73 to 23.57), 31.65 (95% CI, 37.82 to 25.48), 35.05 (95% CI, 40.37 to 29.73), and 34.20 (95% CI, 37.99 to 30.41) years, respectively. The 12-item Allodynia Symptom Checklist was administered to assess CA. All participants underwent the Quantitative Sensory Test to determine the cold-pain and heat-pain thresholds. Mechanical pain thresholds were assessed using Semmes-Weinstein monofilaments. One-way analysis of variance and χ tests were used for statistical analysis. Alpha was set at 0.05 level for statistical significance. For all sites evaluated, the mean cold-pain threshold values were significantly lower in the TMD, migraine, and TMD+migraine groups compared with the control group. However, the mean heat-pain threshold values in the extracephalic region were significantly smaller only for the TMD+migraine group compared with the control group (41.94°C; 95% CI, 40.54 to 43.34 vs. 44.79°C; 95% CI, 43.45 to 46.12; P=0.03). Mechanical hyperalgesia in orofacial and neck sites was significantly lower in the TMD and TMD+migraine groups compared with the control group. Mean total 12-item Allodynia Symptom Checklist score in the TMD+migraine group was significantly higher than in the migraine group (9.53; 95% CI, 7.45 to 11.60 vs. 6.95; 95% CI, 5.35 to 8.55; P=0.02). More pronounced levels of hyperalgesia and CA were found in patients with both TMD and migraine. Thus, it is suggested that the concomitant presence of TMD and migraine may be related to intensification of central sensitization.

Genetic Polymorphisms of Catechol-O-Methyltransferase: Association with Temporomandibular Disorders and Postoperative Pain.

To evaluate the association between catechol-O-methyltransferase (COMT) gene polymorphisms and temporomandibular disorders (TMD), TMD pain, psychosocial impairment related to TMD, and postoperative pain. A total of 90 patients with a diagnosis of painful TMD and 92 matched controls were investigated for the presence of TMD, TMD pain, and psychosocial variables by the Research Diagnostic Criteria for TMD. In a prospective cohort study of 40 subjects who underwent extraction of at least one fully impacted mandibular third molar, subjects had 6 months post-surgery follow-up of postoperative pain. DNA extracted from peripheral blood was genotyped for three COMT polymorphisms (rs4680, rs6269, and rs165774) by real-time TaqMan method. The association between COMT polymorphisms and clinical variables was determined by calculating odds ratios (OR) and their 95% confidence intervals (CI). Homozygous AA genotype and heterozygous variant A allele carriers (genotype AG/AA) for rs165774 polymorphism were associated with increased risk of TMD compared to wild type (wt) GG genotype (OR = 9.448, P = .006; OR = 2.088, P = .017, respectively). In addition, AA genotype was associated with increased risk of arthralgia (OR = 4.448, P = .011), myofascial pain (OR = 3.543, P = .035), and chronic TMD pain (OR = 6.173, P = .006), compared to wt genotype. AA genotype for rs6269 polymorphism was related to less postoperative chronic TMD pain (P = .025) and lower postoperative acute pain at the extraction site (P = .030). No associations with depression and somatization were observed. AA genotype of rs165774 could be a significant risk factor for the development of TMD and TMD pain, while AA genotype of rs6269 presents less postoperative chronic TMD pain and acute pain at a dental extraction site.

Association between temporomandibular disorders and music performance anxiety in violinists.

Professional violin playing has been associated with a predisposition to develop temporomandibular disorder (TMD). There are a number of risk factors, including physical trauma from the playing posture and the presence of parafunctional habits. Music performance anxiety (MPA) may also be a factor, as it has been associated with playing-related musculoskeletal disorders (PRMD). To evaluate a possible association between the presence of TMD and the level of MPA in violin players. An observational study using a written questionnaire that retrieved data related to TMD symptoms (Fonseca Anamnestic Questionnaire), MPA level (Kenny Music Performance Anxiety Inventory, K-MPAI), instrument practice time, chinrest type, sex and age. Descriptive, bivariate and logistic regression analyses were conducted. Ninety-three professional or semi-professional violinists performing in and around Lisbon, Portugal, completed the questionnaire (73% response rate). TMD was present in 50 violinists (58%). There was a statistically significant association between the presence of TMD and high MPA levels (P < 0.001) and the most anxious violinists were six times (95% confidence interval 2.51-15.33; P < 0.001) more likely to report TMD symptoms when compared with the least anxious players. Violin players had a high prevalence of reported TMD symptoms, which was significantly associated with high MPA levels. It may therefore be necessary to address psychological and physical factors simultaneously in musicians who do not improve with physical therapy alone.

Risk factors related to aggressive condylar resorption after orthognathic surgery for females: retrospective study

Objective: The aim of the present study was to identify the risk factors for aggressive condylar resorption (ACR) after orthognathic surgery.Methods: A total of 25 female patients with osteoarthritis (OA) scheduled for orthognathic surgery were divided into two groups: those who exhibited ACR (ACR (+), n = 8) and those who did not exhibit ACR (ACR (−), n = 17) after surgery. Clinical indices were used to determine the extent of mandibular advancement, the presence of temporomandibular disorder (TMD), and relevant medical treatment histories (including the use of oral contraceptive (OC) medication. TMJ dysfunction was clinically evaluated in terms of pain, the presence of sounds (clicks or crepitus), and disc displacement, joint effusion (JE), and synovial hyperplasia (SH); these were further investigated with the aid of magnetic resonance imaging (MRI). The cephalographic findings were compared with the normal profiles of Japanese subjects.Results: The mean (with SD) extent of mandibular advancement was 11.4 mm (2.4) in ACR (+) and 4.1 mm (1.8) in ACR (−). The TMD medical history of ACR (+) was much more extensive than that of ACR (−); all patients in ACR (+) had a history of OC use. More patients in ACR (+) than in ACR (−) had TMJ dysfunction and disc displacement, JE, and SH on MRI. Preoperative cephalograms showed that ACR (+) patients exhibited counterclockwise rotation of the mandible and retrognathism that was attributable to a small sella–nasion–B (SNB) angle, a wide mandibular plane angle, and a negative inclination of the ramus.Conclusions: The present findings suggest that the development of ACR after orthognathic surgery to treat mandibular retrognathism may be associated with coexisting TMJ pathologic abnormality.

Patología temporomandibular asociada a masticación unilateral en adultos jóvenes

ObjectiveThe aim of this study was to determine the relationship between the habitual chewing side and the presence of temporomandibular disorders (TMD) in young adults. Materials and methodsAn analytical case-control and simple blind study was performed on 70 young adult subjects (22-26 years) from the Faculty of Dentistry of the University of Chile. The masticatory functional angle (MFA) was used to determine the habitual chewing side in all subjects, as well as applying the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) in order to determine the type of TMD and the most prevalent side. Data were analysed using Chi squared test and Fisher's exact test (95% CI). ResultsA total of 56 subjects (80.0%) were unilateral chewers and 14 (20.0%) were bilateral chewers. A diagnosis of TMD was made in 34 (48.6%) subjects according to RDC/TMD, while 36 individuals (51.4%) showed no evidence of any disorder. There were no differences between unilateral chewing and the presence of TMD (p=0.63). There was a high trend between unilateral chewing and presence of joint disease (groups ii and iii, RDC/TMD) (p=0.06). ConclusionDespite a high trend between unilateral chewing and joint disease observed, the relationship between the type of chewing and TMD has not been established. No relationship was found between the chewing side and its coincidence with the disease side. This could be because of the different factors involved in TMD.

Disfunção temporomandibular e dor craniocervical em profissionais da área da enfermagem sob estresse no trabalho

RESUMO Objetivo: verificar a presença e severidade de Disfunção Temporomandibular, presença de cefaleia e cervicalgia e o limiar de dor muscular de músculos cervicais em profissionais de enfermagem sob estresse no trabalho. Métodos: 43 mulheres foram avaliadas quanto à presença e severidade de Disfunção Temporomandibular pelo instrumento Critérios de Diagnóstico para Pesquisa de Desordem Temporomandibular e pelo Índice Temporomandibular, respectivamente. Além disso, foram avaliadas quanto ao limiar de dor à pressão nos músculos cervicais por algometria e quanto à presença de cefaleia e cervicalgia. Resultados: disfunção Temporomandibular foi encontrada em 30,23% da amostra, com valor médio de escore de gravidade de 0,52. Entre as participantes com Disfunção Temporomandibular, 69,23% apresentavam depressão, 61,64% graduação I de dor crônica e Sintomas Físicos não Específicos incluindo e excluindo itens de dor em 46,15% e 61,64%, respectivamente. Cefaleia foi referida por 55,81% e cervicalgia por 60,47%. Não houve associação entre Disfunção Temporomandibular, cefaleia e cervicalgia. Os limiares de dor dos músculos cervicais apresentaram-se baixos tanto nos indivíduos com diagnóstico de Disfunção Temporomandibular quanto nos sem este diagnóstico, sem diferença significativa. O músculo esternocleidomastóideo apresentou-se com os menores limiares de dor à pressão. Conclusão: alta incidência de Disfunção Temporomandibular, cefaleia e cervicalgia foram detectadas nesta amostra. Disfunção Temporomandibular não influenciou a presença de cefaleia e/ou cervicalgia. A alta frequência de dor cervical e os baixos limiares de dor no músculo esternocleidomastóideo em todas as participantes demonstram o comprometimento dos músculos cervicais, resultante de possíveis posturas inadequadas e tensão muscular relacionadas ao estresse.

Temporomandibular Disorder in University Students of the &amp;lt;i&amp;gt;Parque das Rosas Campus, Universidade Est&amp;#225;cio de S&amp;#225;&amp;lt;/i&amp;gt; That Practice Sports

The stomatognathic system (SS) is a functional unit of the body that depends on the balance of several tissues. It consists of various structures, including the temporomandibular joint. Temporomandibular disorder (TMD) can occur due to alterations in the SS. The Fonseca Anamnestic Index (FAI) is a scale used to evaluate and to characterize the TMD Type: no DTM, mild, moderate and severe. The aim is to evaluate the prevalence of signs and symptoms related to TMD in university students of the Parque das Rosas Campus, Universidade Estácio de Sá that practice sports. This investigation was approved (CAAE number 325678413.9.0000.5284). Two hundred eighth students (110 male and 98 female, aged 19 - 35 years) accepted to be in this investigation. All the participants answered a General Questionnaire (GQ) and the FAI. The GQ had questions about the age, sex and the presence of TMD. The FAI was used. A statistical difference (p > 0.05) was not found about the presence of TMD. Among the female, an elevated number of the students with signal or symptoms related to the temporomandibular with statistic significance (p < 0.05) was observed. In the population without TMD, the prevalence of this disorder is higher between male than female. Considering the FAI, among the female students, there is a prevalence of the Mild Type. Considering the evaluation of the type of TMD among the male and female students no difference was found between male and female to the types mild and moderate, however, the prevalence of the severe Type is higher in female than in male with statistical significance. In conclusion, TMD is a relevant clinical condition with an important prevalence among the university students. Moreover, the type of the TMD could be considered due to prevalence of the Type Severe among the women.

Coincidence and Awareness of the Relationship Between Temporomandibular Disorders and Jaw Injury, Orthodontic Treatment, and Third Molar Removal in University Students.

To determine whether there is an association between temporomandibular disorders (TMD) and a history of facial/jaw injury (FJI), orthodontic treatment (OT), or third molar removal (TMR) in university students, and to evaluate the students' awareness of a possible relationship between jaw pain or other TMD symptoms, FJI, OT, and TMR, and the presence of TMD. This cross-sectional study involved 1,381 Oporto District university students. The Portuguese version of the Research Diagnostic Criteria for TMD was used for TMD diagnosis. FJI, OT, and TMR histories were evaluated by questionnaire. Univariate associations between categorical variables were tested by using chi-square tests. Multivariate logistic regression was applied to predict independent factors associated with TMD. Of the 1,381 students (mean age ± standard deviation [SD]: 21.7 ± 3.9 years), 39.3% had TMD, 23.2% had a history of FJI, 44.5% had undergone OT, and 26.2% had undergone TMR. Univariate analyses showed significant associations between OT and TMD (P = .044) and between TMR and TMD (P = .003). Multivariate regression analyses using FJI, OT, TMR, OT × TMR interaction, sex, and age in the first step showed TMR (Odds Ratio [OR] = 1.30; P = .041), sex (OR = 1.59; P = .001), and age (OR = 1.04; P = .013) as significant. A positive correlation between TMD and awareness of the relationship between jaw pain or TMD symptoms and a history of FJI or OT (P < .001 and P = .002, respectively) was documented. TMR, female sex, and older age were risk factors independently associated with TMD. The results also suggest that patients' awareness of potential risk factors for TMD should be taken into account on an individual basis.

Temporomandibular Disorders in Patients Undergoing Mandibular Advancement Device Therapy for Obstructive Sleep Apnea: A Systematic Review

Background: Mandibular advancement device (MAD) therapy is a popular and effective treatment for snoring and obstructive sleep apnea (OSA). However, there have been several reports in the literature of patients developing temporomandibular disorders (TMDs). Objective: The objective of this review is to evaluate the prevalence of TMD, both in the initial phase of therapy and at follow up appointments, amongst patients wearing a MAD for OSA. Methods: The authors conducted a systematic review of published articles in which the presence of TMDs in patients undergoing MAD therapy for OSA was investigated. Eligible studies met the following criteria: a diagnosis of TMD following mandibular advancement using a custom-made and titratable MAD using either the Diagnostic Criteria for TMD (DC/TMD), Helkimo Anamnestic Dysfunction Index or reproducible clinical signs/symptoms. Of the thirty-six articles published in this area, eleven were included in this review. These were assessed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: The average prevalence of TMD during the initial phase of MAD therapy was found to be 25%. The prevalence of TMD reduced in the follow up periods. The adherence to MAD, especially long term, appears to be variable and from our results, it appears an average of 20% of patients discontinue MAD therapy over six to one hundred and twenty months, and this number has been reported to be as high as 62.5% (over 58 months). Conclusions: There was some difficulty in comparing the studies due to the differences in follow up time, methodology, sample size and diagnostic criteria. Longer clinical follow-up studies, with an objective method of monitoring patient adherence such as home monitoring devices, and preferably with a larger sample size

Autonomic function in chronic fatigue syndrome with and without painful temporomandibular disorder

Background: Chronic fatigue syndrome (CFS) is heterogeneous in nature, yet no clear subclassifications currently exist. There is evidence of dysautonomia in almost 90% of patients and CFS is often co-morbid with conditions associated with autonomic nervous system (ANS) dysfunction, such as temporomandibular disorders (TMD). The present study examined the point prevalence of TMD in a sample of people with CFS and explored whether co-morbidity between the conditions is associated with greater ANS dysfunction than CFS alone. Method: Fifty-one patients and 10 controls underwent screening for TMD. They completed a self-report measure of ANS function (COMPASS-31) and objective assessment of heart rate variability during rest and standing (derived using spectral analysis). Frequency densities in the high-frequency (HF) and low-frequency (LF) band were calculated. Results: Patients with CFS were divided into those who screened positive for TMD (n = 16, 31%; CFS + TMD) and those who did not (n = 35, 69%; CFS − TMD). Both CFS groups had significantly higher self-rated ANS dysfunction than controls. CFS + TMD scored higher than CFS − TMD on the orthostatic and vasomotor subscales. The CFS + TMD group had significantly higher HF and significantly lower LF at rest than the other two groups. In discriminant function analysis, self-report orthostatic intolerance and HF units correctly classified 75% of participants. Conclusions: Almost one-third of CFS patients screened positive for TMD and this was associated with greater evidence of parasympathetic dysfunction. The presence of TMD shows potential as an effective screen for patients with CFS showing an autonomic profile and could help identify subgroups to target for treatment.

Elderly caregivers at long-stay institutions: quality of life and temporomandibular dysfunction

Aim: To assess the profile, quality of life and the presence of Temporomandibular Disorders (TMD) in elderly caregivers. Methods: Thirty-nine caregivers who worked in six long-stay institutions for the elderly in three different municipalities participated in the study. The research instruments were the WHOQOL-BREF, the Fonseca questionnaire and the socio-demographic questionnaire. The Kruskal-Wallis test with the Dunn’s correction was performed at a level of 5%. Results: Females accounted for 94.9% of the sample. The average monthly wage was R$ 832.00. The average working week was 39 hours. The WHOQOL dominions showed the following averages: 74.25 Physical; 70.33 Psychological; 65.79 Social Affairs; 58.38 Environment. Mild DTM was present in 43.6% of the caregivers, of which 7.7% were moderate, 5.2% severe, 23.0% of the professionals were asymptomatic and 20.5% did not answer. The association between TMD and the quality of life showed p=0.6752. Conclusions: It was concluded that there was no relationship between the quality of life and symptoms of temporomandibular dysfunction among the caregivers of elderly in this study.

Temporomandibular disorder and anxiety, quality of sleep, and quality of life in nursing professionals

To evaluate the association between temporomandibular disorder (TMD) and anxiety, quality of sleep, and quality of life in nursing professionals at the Hospital de Clínicas de Uberlândia of the Universidade Federal de Uberlandia--HCU-UFU (Medical University Hospital of the Federal University of Uberlândia), four questionnaires were given to nursing professionals. The questionnaires were completed by 160 of these professionals. The Fonseca's questionnaire was used to evaluate the presence and severity of TMD, the IDATE was used to evaluate anxiety, the SAQ was used to evaluate quality of sleep, and the SF-36 was used to evaluate quality of life. Forty-one nurses (25.6%) reported having no TMD (Fonseca's questionnaire score ≤ 15), 66 (41.3%) had mild TMD (Fonseca's questionnaire score 20-40), 39 (24.4%) had moderate TMD (Fonseca's questionnaire score 45-65), and 14 (8.8%) had severe TMD (Fonseca's questionnaire score ≥ 70). According to Fonseca's questionnaire, the presence of TMD was associated with trait anxiety, but the TMD severity was associated with state anxiety classification (mild, moderate, severe). The SAQ score differed significantly from Fonseca classification. The Fonseca's questionnaire score correlated negatively with the score of each dimension of the SF-36 (r = -0.419 to -0.183). We conclude that TMD is common among nursing professionals; its presence was associated with trait anxiety, and its severity was associated with state anxiety. Hence, the presence of TMD may reduce quality of sleep and quality of life.

Correlação entre sinais e sintomas da Disfunção Temporomandibular (DTM) e severidade da má oclusão

Introdução O papel da oclusão como fator etiológico das disfunções temporomandibulares (DTMs) tem sido um assunto polêmico e ainda controverso. Objetivo Avaliar a correlação entre sinais e sintomas da disfunção temporomandibular e a severidade da má oclusão. Método Foram avaliados 135 estudantes de Odontologia da UFPB. A presença de DTM foi estimada através do Índice Anamnésico de Fonseca (DMF) e de questões objetivas sobre seus sintomas. Os estudantes também foram submetidos a um protocolo resumido de avaliação clínica de DTM. A avaliação dos fatores oclusais foi realizada através do Índice de Prioridade de Tratamento (IPT) aplicado a modelos de gesso dos arcos dentários superior e inferior. As diferenças entre as médias do IPT relacionadas aos sinais e sintomas de DTM foram determinadas por meio dos testes t e One-way ANOVA. As correlações entre os fatores oclusais e a DTM foram determinadas a partir de correlação de Pearson. Resultado A severidade da má oclusão, segundo o IPT, não influenciou no surgimento de DTM e de sinais clínicos musculares ou articulares, e na necessidade de tratamento. A má oclusão de classe II, trespasse vertical acentuado e dentes girados foram estatisticamente correlacionados à necessidade de tratamento e aos sinais clínicos de DTM. Conclusão Em modelos multifatoriais, como na fisiopatologia da DTM, a oclusão pode desempenhar um papel de cofator na predisposição ou perpetuar as diferentes formas de DTM, não devendo ser considerada fator principal.

Ascertaining of temporomandibular disorders (TMD) with clinical and instrumental methods in the group of young adults

Introduction. During the diagnostic process, the clinical examination of the masticatory system combined with jaw movement measurements can indicate the presence of temporomandibular disorders (TMD) symptoms. Aim. The aim of the present study was to determine the presence of clinical symptoms of TMD in a group of subjects aged 19–27 years and to analyze the measurable parameters obtained from examinations carried out using the Arcus®digma.Material and methods. Eighty four dentate subjects from 19 to 27 years were recruited from students. Objective signs were studied with Helkimo Anamnetic index (Ai) and the subjective symptoms were evaluated with Gsellmann’s Occlusal Index (OI). Functional examination of the masticatory system was performed using Helkimo Clinical Dysfunction index (Di). Pain symptoms were determined in clinical examination using visual analogue scale. Software of Arcus®digma allowed the analysis of Bennett’s angle and movement, the horizontal condylar inclination, retrusion, anterior guidance and Immediate Side Shift.Results. Occasional pain occurred in 39% of students and correlated with increase of OI index, subjects with higher Di displayed higher values of OI. Comparison of Bennett’s angle values for the right and left TMJ showed the significant asymmetry, similarly like the values of Bennett’s movement and retrusion between the left and right TMJ.Conclusions. Bennett’s angle, Bennett’s movement and retrusion were significant parameters in instrumental evaluation of TMD symptoms. The questionnaire and clinical examination supplemented with axiographic recordings revealed the presence of TMD symptoms in students who were not fully aware of TMJ disorders.

Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder.

This study aimed to establish the prevalence of pain in the craniomandibular and cervical spine region in individuals with Temporomandibular Disorders (TMD) and to analyze the effects of these disorders on the bilateral activation of anterior temporalis (AT) and masseter (MA) muscles during the masticatory cycle. The participants were 55 female volunteers aged 18-30 years. The presence of TMD and craniomandibular and cervical spine pain was evaluated by applying the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire and using a combination of tests for the cervical region. The muscle activity of AT and MA during the masticatory cycle was assessed using the symmetry and antero-posterior coefficient indices. The AT activity during the masticatory cycle is more asymmetric in individuals with TMD. The craniomandibular pain, more prevalent in these individuals, influenced these results. Individuals with TMD showed changes in the pattern activity of AT. The craniomandibular nociceptive inputs can influence the increase in asymmetry of the activation of this muscle.

Avaliação da relação entre disfunção temporomandibular e dimensão vertical de oclusão em crianças de 7 A 12 anos

Objetivo verificar se existe relação entre a presença de disfunção temporomandibular (DTM) relacionada à variabilidade da dimensão vertical de oclusão em crianças e adolescentes na faixa etária de 7 a 12 anos. Métodos foram avaliadas 96 crianças e adolescentes do Instituto Rogacionista em São Paulo. A pesquisa diagnóstica da disfunção temporomandibular foi por meio do Índice de Helkimo e exame clínico posterior. Para a mensuração dos dados referentes à dimensão vertical foram empregadas as distâncias comissura labial - canto externo do olho e base do nariz – mento. A comparação dos valores médios das medidas antropométricas entre os gêneros e os grupos com e sem disfunção temporomandibular foi realizada empregando-se a análise de variância (ANOVA) complementada pelo teste least significance diference. Resultados a dimensão vertical de oclusão demonstrou medidas distintas nas crianças e adolescentes em todas as faixas etárias avaliadas, foram observadas alterações significantes dessa medida nas idades de 10 e 12 anos de ambos os gêneros. Conclusão pode -se concluir que na amostra estudada houve relação direta entre a presença de DTM e Dimensão vertical de oclusão (DVO), correlação positiva entre as medidas comissura labial – canto do olho externo e Násio – Mento no sexo feminino e alterações significantes na dimensão vertical de oclusão nas idades de 10 e 12 anos para ambos os sexos.

Signs and symptoms of Temporomandibular Disorders in the elderly

This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (p<0.0001). Additionally, a significant association among TMD severity and palpation of the TMJ (p=0.0168), of masticatory muscles (p<0.0001), and of cervical muscles (p<0.0001) was verified. Also, there was a significant association between the frequency of headaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

Saliva cortisol levels and depression in individuals with temporomandibular disorder: preliminary study

BACKGROUND AND OBJECTIVES: Temporomandibular disorders are common in general population and their etiology is also linked to psychological factors. Cortisol is a hormone the secretion of which may be increased during emotional changes. This study aimed at evaluating the presence of depression and saliva cortisol levels in patients with temporomandibular disorders. METHODS: Participated in the research 48 students, being 36 females and 12 males, aged between 19 and 32 years. Participants were previously evaluated by means of the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire and were classified in two groups: with temporomandibular disorders and without temporomandibular disorders. To establish the presence of depression the Symptom Checklist 90 - Revised test was applied. Saliva was collected between 9:00 a.m. and 9:25 a.m. and saliva cortisol levels were analyzed by spectrophotometry. RESULTS: The Symptom Checklist 90 - Revised has suggested that 64% of patients with temporomandibular disorder were depressed as compared to 43% of individuals without temporomandibular disorder. Saliva cortisol level was 0.272µg/dL for the temporomandibular disorder group and of 0,395µg/dL for the group without temporomandibular disorder, with no statistical difference. CONCLUSION: Within the limits of the study, it was possible to conclude that there is no association among saliva cortisol levels, depression and the presence of temporomandibular disorders.