Painful temporomandibular disorders, self reported tinnitus, and depression are highly associated

Objetivo Investigar a associação entre disfunção temporomandibular (DTM) dolorosa, auto-relato de zumbido e níveis de depressão. Método A amostra foi composta por 224 indivíduos com idades de 18 a 76 anos. O Research Diagnostic Criteria for Temporomandibular Disorders , eixo I, foi usado para classificar a DTM e o eixo II para obtenção do auto-relato de zumbido e dos níveis de depressão. Para a análise dos dados, foi aplicado o teste odds ratio (OR) com intervalo de confiança (IC) de 95%. Resultado Somente a presença de DTM dolorosa estava significativamente associada aos níveis de depressão moderado/severo (OR=9,3, 95%; IC: 3,44-25,11). A presença concomitante de DTM dolorosa e auto-relato de zumbido aumentaram a magnitude da associação com os níveis de depressão moderado/severo (OR=16,3; 95% IC: 6,58-40,51). Conclusão Disfunção temporomandibular dolorosa, altos níveis de depressão e auto-relato de zumbido estão fortemente associados. Entretanto, o desenho do estudo não permite estabelecer uma relação causal entre essas três entidades.

Disfunção temporomandibular na visão de profissionais e acadêmicos de odontologia

This paper presents the results of an applied qualitative study with dental students and professionals who work with people suffering from temporomandibular disorder. The aim was to investigate the way that dental practitioners and students perceive patients affected by this disorder, how they feel faced with the patients' suffering, and the importance they assign to a multidisciplinary approach, highlighting the treatments used. It is noteworthy that various factors are involved in the temporomandibular disorder framework, including emotional factors, as cited by the majority of the respondents. The data obtained indicated that the knowledge of the professionals and students related to caring for people with temporomandibular disorders was appropriate, however, important inadequacies were highlighted, such as the fact that professionals do not investigate the life history of the person in their psychosocial context.

Severity of temporomandibular disorders in women: validity and reliability of the Fonseca Anamnestic Index

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

Treatment of Comorbid Migraine and Temporomandibular Disorders: A Factorial, Double-Blind, Randomized, Placebo-Controlled Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Regional 3D superimposition to assess temporomandibular joint condylar morphology

Objectives: To investigate the reliability of regional three-dimensional registration and superimposition methods for assessment of temporomandibular joint condylar morphology across subjects and longitudinally.Methods: The sample consisted of cone beam CT scans of 36 patients. The across-subject comparisons included 12 controls, mean age 41.3 +/- 12.0 years, and 12 patients with temporomandibular joint osteoarthritis, mean age 41.3 +/- 14.7 years. The individual longitudinal assessments included 12 patients with temporomandibular joint osteoarthritis, mean age 37.8 +/- 16.7 years, followed up at pre-operative jaw surgery, immediately after and one-year post-operative. Surface models of all condyles were constructed from the cone beam CT scans. Two previously calibrated observers independently performed all registration methods. A landmark-based approach was used for the registration of across-subject condylar models, and temporomandibular joint osteoarthritis vs control group differences were computed with shape analysis. A voxel-based approach was used for registration of longitudinal scans calculated x, y, z degrees of freedom for translation and rotation. Two-way random intraclass correlation coefficients tested the interobserver reliability.Results: Statistically significant differences between the control group and the osteoarthritis group were consistently located on the lateral and medial poles for both observers. The interobserver differences were <= 0.2 mm. For individual longitudinal comparisons, the mean interobserver differences were <= 0.6 mm in translation errors and 1.2 degrees in rotation errors, with excellent reliability (intraclass correlation coefficient >0.75).Conclusions: Condylar registration for across-subjects and longitudinal assessments is reliable and can be used to quantify subtle bony differences in the three-dimensional condylar morphology.

Headache Associated With Temporomandibular Disorders Among Young Brazilian Adolescents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Epidemiology of Severity of Temporomandibular Disorders in Brazilian Women

Aims: To evaluate the severity of temporomandibular disorders (TMD) of women in the municipality of Araraquara (Brazil) as well as the contribution of the perception of oral health, mandibular functional limitation, and sociodemographic variables on the severity of TMD. Methods: The participants were interviewed by telephone. Information regarding age, marital status, economic level, education, and use and type of dental prostheses was surveyed. To evaluate TMD severity, mandibular functional limitation and perception of oral health, Fonseca's Anamnesic Index (IAF), the Mandibular Function Impairment Questionnaire (MFIQ), and the General Oral Health Assessment Index (GOHAI) were used. To evaluate the contribution of these variables on TMD severity, a structural equation model (SEM) was fitted to the data and assessed by usual goodness-of-fit indices. Results: A total of 701 women with a mean age of 44.36 years (SD = 16.31) participated. According to the IAF, 59.6% (95% confidence interval = 56.00%-63.2%) of the women were classified as having TMD, of which 63.9% presented light, 26.8% moderate, and 9.3% severe TMD. Mandibular functional limitation was low in 91.0% of the women, moderate in 7.1%, and severe in 1.9%. Goodness-of-fit for the structural model was adequate. The predictors explained 43% of the variation in the TMD severity, with significant contributions of the variables dental prostheses (beta = -.008; P = .006), perception of oral health (beta = -.43; P < .001), and mandibular functional limitation (beta = .014; P = 014). Conclusion: The severity of TMD among Brazilian women was greater in non-users of dental prostheses and was also associated with greater mandibular functional limitation and poor perception of oral health.

Fatores de risco para a disfunção temporomandibular em adolescentes: estudo caso-controle

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Distúrbios funcionais da oclusão e sua correlação com radiografias transcranianas da articulação temporomandibular, em pacientes portadores de fissuras labiopalatais

Anamnesis, clinical examinations and temporomandibular joint transcraneal radiographs for 22 adults with cleft lip and palate were carried out in order to evaluate the occlusion and correlate it with radographic findings. The conclusions were: 72.8% of the patients have at least one sign or symptom of craniomandibular disorders (CMD); although the occlusal conditions were severely altered, most of the signs and symptoms were classified as mild; the greater frequency of the signs and symptoms occurred among women; in the radiographic evaluation, all of the assymptomatic patients had both condyles with normal contour and all of the patients with altered contour had at least one sign or symptom; the bilateral centered position of the condyles in the fossa e did not warrant the absence of signs and symptoms; some patients with bilateral condyles positioned posteriorly or caudally or even assimetrically, did not present signs and symptoms of dysfunction; the radiographic findings should be correlated with clinical findings; and a great number of patients were not observed with clinical board of C:MD caused by the occlusion. Key words: Radiography; temporomandibular joint; temporomandibular joint syndrome; cleft palate; dental occlusion

Disfunção craniomandibular e sua correlação com radiografia transcraniana da articulação temporomandibular: estudo comparativo entre indivíduos portadores de sintomas severos pelo índice de helkimo e indivíduos assintomáticos

Pós-graduação em Odontologia Restauradora - ICT

Avaliação Postural em Sujeitos com Disfunção Temporomandibular Submetidos a Tratamento de Terapia Manual

Individuals with temporomandibular disorders (TMD) often have signs and symptoms such as intra-articular pain, muscle spasm, neck pain radiating from others who interfere with this balance. Over time can lead to postural changes and correction of the cervical spine, anterior head and shoulder asymmetry. The aim was to verify the effects of manual therapy on posture in subjects with TMD. Materials and methods: 30 volunteers (mean: 21.43± SD:1.43) of both sexes who had TMD classified according to axis I of the Research Diagnostic Criteria participated in this study. These were photographed in the anterior frontal and sagittal planes for analysis of the following angles (acromion clavicular joint, sternoclavicular joint, orbicular external, corners of the mouthand and protruding head). After, the volunteers were divided into groups ATM (manual therapy in the treatment of temporomandibular joint), Cervical (manual therapy in the treatment of cervical joint) and Control. The Kolmogokov-Smirnov test, followed by ANOVA, considering a significance level of 5% was used. Results: Groups ATM, Cervical and Control were considered homogeneous with respect to the values of the angles measured. These also showed no significant difference between the 1st, 5th and 10th sessions, so the manual therapy techniques applied to the TMJ and Cervical groups were not sufficient to change postural alignment. Conclusion: The postural alignment, the TMD patients evaluated in this study did not change after attending the sessions proposals with manual therapy techniques in the cervical and TMJ.

Bruxismo do sono e disfunção temporomandibular: avaliação clínica e polissonográfica

O objetivo deste estudo foi buscar um melhor entendimento sobre a dor músculo-esquelética crônica da face e sua relação com o bruxismo do sono. Quarenta pacientes foram avaliados de acordo com o Research Diagnostic Criteria for Temporomandibular Disorders: Grupo A - 20 pacientes com DTM, com média de idade de 32,7 anos e duração média da dor de 4,37 anos; Grupo B - 20 pacientes sem DTM, com média de idade de 30,8 anos. As variáveis do sono e do bruxismo foram avaliadas em exame polissonográfico. As características clínicas foram estatisticamente diferentes entre os dois grupos: o grupo A apresentou maior freqüência de auto-relato de dor matinal (p=0,0113) e estalido articular (p=0,0269), maior grau de sintomas físicos não específicos (p=0,001) e de limitações da função mandibular (p=0,001). Não houve diferença estatisticamente significativa para as variáveis do bruxismo: número de episódios de bruxismo por hora, número de surtos por episódio e por hora, duração total, porcentagem em cada estágio do sono, tipo e amplitude dos episódios. A arquitetura do sono mostrou-se dentro dos parâmetros de normalidade, sem nenhuma diferença estatisticamente significativa entre os dois grupos. Conclusões: as características clínicas dos pacientes com bruxismo do sono, com e sem DTM, são diferentes, mas as características do sono e do bruxismo são similares. Mais estudos são necessários para esclarecer as razões pelas quais alguns pacientes com bruxismo do sono desenvolvem dor milfascial crônica e outros não.

Correlação entre autoestima e grau de severidade da disfunção temporomandibular em sujeitos controle e afetados

INTRODUCTION: Temporomandibular disorders (TMD) have association with psychological manifestations. OBJECTIVE: The aims of this study were to correlate the severity of TMD and the level of self-esteem, and to investigate sex‑related differences. MATERIAL AND METHOD: We evaluated 57 subjects of both gender, with mean age of 20.28 ± 2.07 years, through the Fonseca Anamnesis Index (FAI) and Rosenberg Self-esteem Scale (RSS). Correlations between variables were performed using the Spearman correlation coefficient; comparisons between the genders were performed using the Mann-Whitney test. It was considered a significance level of 5%. RESULT: No differences were found for the comparisons between the gender in the FAI (p = 0.79) and the RSS (p = 0.90). RSS correlates with the FAI in women (p = 0.01), but in men this result does not occur (p = 0.07). CONCLUSION: We concluded that women are more likely to have emotional disturbances resulting from changes in the temporomandibular joint than men.

Articulação temporomandibular: anatomia, dinâmica e disfunções temporomandibulares

This study gathered some of the most relevant researches already undertaken regarding the Temporomandibular Joint, presenting descriptions of its anatomy and dynamics, and relating them to the main aspects of joint dysfunctions. Literature recognizes that the Temporomandibular Joint, responsible for lower jaw movements, comprehends the skull base and the jaw bone. Its anatomy and dynamics are of great importance in order to understand the functions of Stomatognathic System as well as to study Temporomandibular Joint Dysfunction. The elements that compose this synovial joint and the bilateral characteristic confer eminent importance to the ATM before the skeleton head, the ability to perform broad movements and high complexity in its operation. It is accepted that the overload of one anatomical structure from the TMJ or other components of the Stomatognathic System leads to Temporomandibular Joint Dysfunctions. These disorders have different etiologies, ranging from malocclusion to emotional stress, and various forms of treatment, which are related in this study