Can ultrasonography be used to assess capsular distention in the painful temporomandibular joint?

Abstract Background To determine whether capsular distention in the painful temporomandibular joint (TMJ) can be assessed by ultrasonography, we compared the capsular width between painful TMJs and painless TMJ. The risk factors for TMJ pain were also investigated including capsular width and other clinical factors such as TMJ sounds that may affect the occurrence and persistence of TMJ pain. Methods TMJ ultrasonography was performed on 87 temporomandibular disorder (TMD) patients, including 47 unilateral and 29 bilateral TMJ pain patients, and 11 patients without TMJ pain. Results The capsular width was greater in the 105 painful joints than in the 69 painless joints. Considering individual anatomical variations, the differences between painful and painless joints in unilateral TMJ pain patients were also analyzed, revealing a greater width in painful joints. Capsular width was a risk factor for TMJ pain with an adjusted odds ratio of 1.496 (95% confidence interval 1.312–1.706; p < 0.001) and was significantly correlated with pain scores. Conclusion This correlation may suggest that pain intensity is associated with widened capsular width because of joint effusion or synovitis. Further studies are required to refine and establish the protocols for standard examinations using ultrasound imaging.

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Association of Test Anxiety with Temporomandibular Disorder in Health Professions Students: A Cross-Sectional Study

International Journal of Dentistry ◽

10.1155/2020/8833804 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Abdulaziz Alamri ◽

Suliman Shahin ◽

Eman A. Bakhurji ◽

Ahmed A. Alsulaiman ◽

Zainah Salloot ◽

...

Keyword(s):

Test Anxiety ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Temporomandibular Disorder ◽

Health Professions ◽

Female Gender ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

High Test

Objective. To assess the prevalence of temporomandibular disorder (TMD) and its association with text anxiety among undergraduate medical, dental, and pharmacy students in Dammam, Saudi Arabia. Material and Methods. This cross-sectional study included health professions students who responded to Fonseca’s questionnaire and Test Anxiety Inventory by Spielberger to evaluate TMD and test anxiety, respectively. TMD score was compared in different categories of students, and bivariate and multiple logistic regression analyses evaluated the influence of test anxiety on TMD. Results. The study included 884 participants (44.8% males and 55.2% females) with a mean age of 21.46 ± 1.36 years. Regarding items of Fonseca’s questionnaire, most students reported being tense/nervous (65.7%) and had headaches (57.5%). About 45.8% of the participants reported no TMD, and remaining had mild (40.4%), moderate (11.3%), and severe (2.5%) TMD. The mean TMD score was significantly higher in students with high test anxiety (25.6 ± 18.32) than those with low test anxiety (20.25 ± 16.97) ( P < 0.001 ). Mean test anxiety scores significantly differed among TMD categories ( P < 0.001 ) with the lowest score in the no TMD group and the highest in the moderate TMD group. Female gender (adjusted odds ratio 1.4, P 0.039) and high test anxiety (adjusted odds ratio 1.92, P < 0.001 ) were significantly associated with increased odds of having TMD. Conclusions. The study revealed a high prevalence of TMD among students. There was a significant association between test anxiety and TMD. The data obtained may guide preventive policies and program on test anxiety and TMD.

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IncobotulinumtoxinA Injection for Temporomandibular Joint Disorder

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489417693013 ◽

2017 ◽

Vol 126 (4) ◽

pp. 328-333 ◽

Cited By ~ 8

Author(s):

Amit A. Patel ◽

Michael Z. Lerner ◽

Andrew Blitzer

Keyword(s):

Temporomandibular Joint ◽

Temporomandibular Disorder ◽

Masticatory Muscles ◽

Pain Scale ◽

Pain Medication ◽

Saline Injection ◽

Pain Scores ◽

Patient Reported ◽

Joint Disorder ◽

Muscles Of Mastication

Objectives: Temporomandibular disorder (TMD) involves dysfunction of the temporomandibular joint and associated muscles of mastication causing pain with chewing, limitation of jaw movement, and pain. While the exact pathophysiology of TMD is not completely understood, it is thought that hyperfunction of the muscles of mastication places stress on the temporomandibular joint, leading to degeneration of the joint and associated symptoms. We hypothesize that chemodenervation of the muscles of mastication with IncobotulinumtoxinA (Xeomin) will decrease the stress on the temporomandibular joint and improve pain associated with temporomandibular joint and muscle disorder (TMJD). Methods: Twenty patients were randomized to IncobotulinumtoxinA (170 units) or saline injection of the masticatory muscles. Patient-reported pain scale (0-10) was recorded at 4-week intervals following injection for 16 weeks. Patients who received saline injection initially were assessed for reduction in pain at the first 4-week interval and if still had significant pain were rolled over into the IncobotulinumtoxinA arm. Results: Preinjection pain scores were similar between patients. While there was a statistically significant reduction in pain score in the placebo group one month, there was an overall larger drop in average pain scores in those patients injected with IncobotulinumtoxinA initially. All patients initially injected with placebo crossed over into the IncobotulinumtoxinA group. Similar results were seen when examining the composite masticatory muscle tenderness scores. There was no significant change in usage of pain medication. Conclusions: We demonstrate utility of IncobotulinumtoxinA in treating patients with TMD with pain despite pain medication usage and other conventional treatments.

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Effectiveness of TENS and home exercises as an adjunct to drug therapy in the management of myogenous masticatory pain: a comparative study

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2021019 ◽

2021 ◽

Vol 27 (3) ◽

pp. 40

Author(s):

Suresh Kandagal Veerabhadrappa ◽

Thurka Devi Anbananthan ◽

Chee Xin Ying ◽

Priyadarshini Hesarghatta Ramamurthy ◽

Seema Yadav ◽

...

Keyword(s):

Temporomandibular Disorder ◽

Prospective Clinical Study ◽

Pain Scores ◽

Maximum Pain ◽

Group A ◽

The Mean ◽

Group B ◽

Post Hoc ◽

Pain Patients ◽

One Way Anova

Introduction: Pain relief is the primary goal of treatment in patients with myogenous temporomandibular disorder. This study evaluated the effectiveness of TENS and Home exercises as an adjunct to drugs in relieving myogenous masticatory pain. Materials and methods: This prospective clinical study was conducted on 60 patients with myogenous masticatory pain. Patients were randomly allocated into three groups of 20 patients each. Patients in Group A received TENS and drugs, while patients in Group B received home exercises and drugs and Group C received drugs only. The drugs prescribed were Diclofenac 50 mg and Orphenadrine 100 mg, to be taken twice daily for 5 days. All patients were followed up for three weeks. The severity of pain was recorded using the Visual Analog Scale. Inter and intragroup differences in the pain scores were analyzed using one-way ANOVA along with post hoc Tukey's test, and Paired t-test, respectively. p < 0.05 was considered as statistically significant. Results: There was a significant reduction in the mean pain scores in all the three groups at 1st, 2nd, and 3rd post-treatment weeks as compared to the baseline scores with p < 0.001. However, when the pain scores were compared across groups, maximum pain reduction was observed in group A (0.2 ± 0.04), followed by group B (0.5 ± 0.06), and the least reduction was noticed in group C (2.1 ± 0.8). This result was significant with p < 0.001. Conclusion: Both TENS and Home exercises program were effective as adjuncts to drugs, in controlling myogenous masticatory pain, as compared to drugs alone.

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Psychopathology and Clinical Features in an Italian Sample of Patients with Myofascial and Temporomandibular Joint Pain: Preliminary Data

The International Journal of Psychiatry in Medicine ◽

10.2190/pm.37.3.f ◽

2007 ◽

Vol 37 (3) ◽

pp. 283-300 ◽

Cited By ~ 23

Author(s):

F. Nifosi ◽

E. Violato ◽

C. Pavan ◽

L. Sifari ◽

G. Novello ◽

...

Keyword(s):

Temporomandibular Joint ◽

Rating Scale ◽

Myofascial Pain ◽

Psychiatric Evaluation ◽

Global Severity Index ◽

Psychiatric Interview ◽

Group I ◽

Axis I ◽

Tmj Pain ◽

Pain Patients

Objective: Aim of this study was to provide data on the relationships between psychopathological variables and temporomandibular disorders (TMD). Sixty-three TMD patients were investigated using clinical and anamnestical psychiatric informations and psychopathological measures. Methods: Three groups of TMD patients were recruited according to the Research Diagnostic Criteria for TMD guidelines: a group of patients presenting myofascial pain alone (RDC/TMD axis I group I), a group with temporomandibular joint (TMJ) pain alone (RDC/TMD axis I group IIIa, IIIb), and a group presenting both myofascial and TMJ pain. Two secondary groups were identified on the basis of the presence/absence of myofascial pain. The study design provided a psychiatric interview and psychometric assessment including the Symptom Check List-90-Revised (SCL-90-R), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS). Results: -Psychiatric evaluation: Myofascial pain patients had higher scores for personal psychiatric history and a history of more frequent psychotropic drug use. -HDRS and HARS: The sample presented scores indicating mild depressive symptoms and moderate anxiety symptoms. -SCL-90-R: The global sample showed acute levels of psychological distress as measured by the GSI score (Global Severity Index). Myofascial pain patients scored higher than TMJ pain patients in the GSI ( p = .028), PAR (paranoia; p = .015), PSY (psychoticism; p = .032), and HOS (hostility; p = .034) subscales. Conclusions: TMD patients showed elevated levels of depression, somatization, and anxiety. These characteristics did not differ significantly between patients with myofascial or TMJ pain. Other specific psychopathological dimensions, detected with SCL-90-R, appeared to be closely associated to the myofascial component.

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Chronic Antibiotic Dependent Pouchitis Is Associated With Older Age at the Time of Ileal Pouch Anal Anastomosis (J-pouch) Surgery

Crohn's & Colitis 360 ◽

10.1093/crocol/otz029 ◽

2019 ◽

Vol 1 (3) ◽

Author(s):

Kimberly N Weaver ◽

Bharati Kochar ◽

Jonathan J Hansen ◽

Kim L Isaacs ◽

Animesh Jain ◽

...

Keyword(s):

Risk Factors ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Ileal Pouch ◽

Disease Duration ◽

Older Age ◽

Clinical Factors ◽

Anal Anastomosis ◽

J Pouch ◽

Pouch Surgery

Abstract Background Risk factors for the development of chronic antibiotic dependent pouchitis (CADP) are not well understood. Methods Using multivariable logistic regression, we compared clinical factors between 194 patients with acute antibiotic responsive pouchitis or CADP. Results Individuals with CADP were significantly older (40.9 vs 30.8 years, P < 0.001) and demonstrated a longer disease duration before IPAA (10.3 vs 7.0 years, P = 0.004). Age ≥55 years at the time of IPAA was significantly associated with CADP (adjusted odds ratio = 4.35, 95% confidence interval = 1.01–18.7). Conclusions Although older age should not represent a barrier to IPAA, further studies evaluating etiologies of this association are warranted.

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Clinical factors associated with failed trials of labor in late preterm and term twin pregnancies

Journal of Perinatal Medicine ◽

10.1515/jpm-2013-0256 ◽

2014 ◽

Vol 42 (4) ◽

Cited By ~ 3

Author(s):

Hyun-Joo Ko ◽

Jong Kwan Jun

Keyword(s):

Confidence Interval ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Perinatal Outcomes ◽

Neonatal Outcomes ◽

Late Preterm ◽

Clinical Factors ◽

Factors Associated ◽

Nicu Admission ◽

Twin Pregnancies

AbstractTo evaluate the perinatal outcomes and clinical factors of unsuccessful trials of labor (TOLs) in late preterm and term twin pregnancies.We enrolled 896 consecutive twin pregnancies delivered between 1999 and 2012 in a single center, which met the following inclusion criteria: a vertex first twin, live twins, and attempted TOLs after 34 weeks. Obstetric characteristics and perinatal outcomes were compared between vaginal delivery and cesarean delivery groups.Successful TOLs were carried out in 81% (726/896). Failed TOLs occurred in 15% (37/247) of late preterm twins and 20% (133/649) of term twins. Comparisons of neonatal outcomes between the groups showed no significant differences in NICU admission, ventilator use, and composite morbidity. On univariable analysis, nulliparity, preeclampsia, induced labor, excessive weight gain, and intertwin weight discordance of >30% showed significant associations with failed TOLs. Multivariable analyses revealed nulliparity (adjusted odds ratio 9.89, 95% confidence interval 4.64–21.1) and preeclampsia (adjusted odds ratio 2.17, 95% confidence interval 1.30–3.63) as significantly associated with failed TOLs.: In late preterm and term twins, trials of labor can be performed successfully without a significant increase in adverse neonatal outcomes. Nulliparity and preeclampsia are clinical factors associated with failed TOLs in twin pregnancies.

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Laboratory Evaluation and Clinical Characteristics of 2,132 Consecutive Unselected Patients with Venous Thromboembolism – Results of the Spanish Multicentric Study on Thrombophilia (EMET*-Study)

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655986 ◽

1997 ◽

Vol 77 (03) ◽

pp. 444-451 ◽

Cited By ~ 163

Author(s):

José Mateo ◽

Artur Oliver ◽

Montserrat Borrell ◽

Núria Sala ◽

Jordi Fontcuberta ◽

...

Keyword(s):

Venous Thrombosis ◽

Odds Ratio ◽

Protein C ◽

Protein S ◽

Laboratory Evaluation ◽

Clinical Factors ◽

Recurrent Thrombosis ◽

Heparin Cofactor Ii ◽

Crude Odds Ratio ◽

History Of

SummaryPrevious studies on the prevalence of biological abnormalities causing venous thrombosis and the clinical characteristics of thrombotic patients are conflicting. We conducted a prospective study on 2,132 consecutive evaluable patients with venous thromboembolism to determine the prevalence of biological causes. Antithrombin, protein C, protein S, plasminogen and heparin cofactor-II deficiencies, dysfibrinoge-nemia, lupus anticoagulant and antiphospholipid antibodies were investigated. The risk of any of these alterations in patients with familial, recurrent, spontaneous or juvenile venous thrombosis was assessed. The overall prevalence of protein deficiencies was 12.85% (274/2,132) and antiphospholipid antibodies were found in 4.08% (87/2,132). Ten patients (0.47%) had antithrombin deficiency, 68 (3.19%) protein C deficiency, 155 (7.27%) protein S deficiency, 16 (0.75%) plasminogen deficiency, 8 (0.38%) heparin cofactor-II deficiency and 1 had dysfib-rinogenemia. Combined deficiencies were found in 16 cases (0.75%). A protein deficiency was found in 69 of 303 (22.8%) patients with a family history of thrombosis and in 205/1,829 (11.2%) without a history (crude odds ratio 2.34, 95% Cl 1.72-3.17); in 119/665 (17.9%) patients with thrombosis before the age of 45 and in 153/1,425 (10.7%) after the age of 45 (crude odds ratio 1.81, 95% Cl 1.40-2.35); in 103/616 (16.7%) with spontaneous thrombosis and in 171/1,516 (11.3%) with secondary thrombosis (crude odds ratio 1.58, 95% Cl 1.21-2.06); in 68/358 (19.0%) with recurrent thrombosis and in 206/1,774 (11.6%) with a single episode (crude odds ratio 1.78,95% Cl 1.32-2.41). Patients with combined clinical factors had a higher risk of carrying some deficiency. Biological causes of venous thrombosis can be identified in 16.93% of unselected patients. Family history of thrombosis, juvenile, spontaneous and recurrent thrombosis are the main clinical factors which enhance the risk of a deficiency. Laboratory evaluation of thrombotic patients is advisable, especially if some of these clinical factors are present.

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Asociación entre hábitos parafuncionales de la cavidad bucal y los transtornos temporomandibulares en adolescentes

REVISTA ODONTOLOGÍA PEDIÁTRICA ◽

10.33738/spo.v10i2.167 ◽

2018 ◽

Vol 10 (2) ◽

Author(s):

Gabriel Muñoz Quintana

Keyword(s):

Oral Cavity ◽

Temporomandibular Joint ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Neuromuscular System ◽

Jaw Movements ◽

Nail Biting ◽

Palabras Clave ◽

Masticatory System ◽

Objective Being

La musculatura del sistema masticatorio y la articulación temporomandibular (ATM) están protegidos por reflejos nerviosos básicos y sistema neuromuscular a través de la coordinación de fuerzas musculares, todo lo que produce sobrecarga muscular repetitiva como los hábitos parafuncionales (HPF) pueden ocasionar trastornos temporomandibulares (TTM)1. Los HPF se caracterizan por movimientos anormales a la función mandibular normal sin objetivo funcional, al estar alterados constituyen una fuente productora de fuerzas traumáticas caracterizadas por dirección anormal, intensidad excesiva y repetición frecuente y duradera (Rolando Castillo Hernández, 2001)4. El objetivo del estudio fue identificar la asociación entre la presencia de hábitos parafuncionales de la cavidad bucal y los TTM en adolescentes de la ciudad de Puebla. Estudio observacional descriptivo. Se incluyeron 258 adolescentes, 132 (51.2%) mujeres y 126 (48.8%) hombres, con una edad promedio de 12.5±.73 y quienes fueron diagnosticados con los CDI/TTM y los HPF fueron auto-reportados por los pacientes. Se encontró una prevalencia de los TTM del 39.9% y una prevalencia de HPF del 86%. Los HPF más frecuentemente reportados fueron la succión labial y la onicofagia. Se encontró una asociación significativa (x2=7.31, p=0.007) entre los hábitos parafuncionales y los TTM en adolescentes. Palabras clave: Trastornos temporomandibulares, hábitos parafuncionales, adolescentes, articulación temporomandibular. Abstract The muscles of the masticatory system and temporomandibular joint (TMJ) are protected by basic nerve reflex and neuromuscular system through the coordination of muscle forces, all that repetitive muscle overload occurs as habit parafunctional (HPF) can cause temporomandibular disorder TMD)1. The characteristics of HPF are abnormal jaw movements without a functional objective. Being the jaw movements altered, they constitute a source of traumatic forces with an abnormal direction, excessive intensity and long-lasting and frequent duration. (Rolando Hernandez Castillo 2001)4. Objective: was to identify the association between the presences of parafunctional habits of the oral cavity and TMD in adolescents in the Puebla city in Mexico. Material and methods: Is a observational study, we included 258 adolescents 132 (51%) females and 126 (48.8%) were men, mean age 12.5±.73 and who were diagnosed with CDI/TTM and HPF were self- reported by patients. Results: The prevalence of TMD was 39.9% and a prevalence of 86% HPF. The most frequently reported HPF were lip sucking and nail biting. We found a significant association (x2= 7.31, p = 0,007) between HPF and TMD in adolescents. Key words: Parafunctional habits of oral cavity, temporomandibular disorders, temporomandibular joint. (Odontol Pediatr 2011;10(2): 90-94).

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Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study (Preprint)

10.2196/preprints.16061 ◽

2019 ◽

Author(s):

Jenevieve Opoku ◽

Rupali K Doshi ◽

Amanda D Castel ◽

Ian Sorensen ◽

Michael Horberg ◽

...

Keyword(s):

Cohort Study ◽

Health Outcomes ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Hiv Care ◽

Disease Stage ◽

People Living With Hiv ◽

Hiv Disease ◽

Persons Living With Hiv ◽

Living With Hiv

BACKGROUND HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn. OBJECTIVE The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC). METHODS Data from the DC Health (DCDOH) HIV surveillance system and the DC Cohort study were matched to identify people living with HIV who were DC residents and had consented for the study by the end of 2016. Analysis was performed to identify differences between DC Cohort and noncohort participants by demographics and comorbid conditions. HIV disease stage, receipt of care, and viral suppression were evaluated. Adjusted logistic regression assessed correlates of health outcomes between the two groups. RESULTS There were 12,964 known people living with HIV in DC at the end of 2016, of which 40.1% were DC Cohort participants. Compared with nonparticipants, participants were less likely to be male (68.0% vs 74.9%, P<.001) but more likely to be black (82.3% vs 69.5%, P<.001) and have a heterosexual contact HIV transmission risk (30.3% vs 25.9%, P<.001). DC Cohort participants were also more likely to have ever been diagnosed with stage 3 HIV disease (59.6% vs 47.0%, P<.001), have a CD4 <200 cells/µL in 2017 (6.2% vs 4.6%, P<.001), be retained in any HIV care in 2017 (72.9% vs 59.4%, P<.001), and be virally suppressed in 2017. After adjusting for demographics, DC Cohort participants were significantly more likely to have received care in 2017 (adjusted odds ratio 1.8, 95% CI 1.70-2.00) and to have ever been virally suppressed (adjusted odds ratio 1.3, 95% CI 1.20-1.40). CONCLUSIONS These data have important implications when assessing the representativeness of patients enrolled in clinic-based cohorts compared with the DC-area general HIV population. As participants continue to enroll in the DC Cohort study, ongoing assessment of representativeness will be required.

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Gamma models for estimating the odds ratio for a skewed biomarker measured in pools and subject to errors

Biostatistics ◽

10.1093/biostatistics/kxz028 ◽

2019 ◽

Author(s):

Dane R Van Domelen ◽

Emily M Mitchell ◽

Neil J Perkins ◽

Enrique F Schisterman ◽

Amita K Manatunga ◽

...

Keyword(s):

Odds Ratio ◽

Adjusted Odds Ratio ◽

Lower Cost ◽

Cost Effective ◽

Ratio Estimation ◽

Statistical Efficiency ◽

Function Model ◽

Processing Error ◽

Wide Range ◽

Pooled Samples

SUMMARYMeasuring a biomarker in pooled samples from multiple cases or controls can lead to cost-effective estimation of a covariate-adjusted odds ratio, particularly for expensive assays. But pooled measurements may be affected by assay-related measurement error (ME) and/or pooling-related processing error (PE), which can induce bias if ignored. Building on recently developed methods for a normal biomarker subject to additive errors, we present two related estimators for a right-skewed biomarker subject to multiplicative errors: one based on logistic regression and the other based on a Gamma discriminant function model. Applied to a reproductive health dataset with a right-skewed cytokine measured in pools of size 1 and 2, both methods suggest no association with spontaneous abortion. The fitted models indicate little ME but fairly severe PE, the latter of which is much too large to ignore. Simulations mimicking these data with a non-unity odds ratio confirm validity of the estimators and illustrate how PE can detract from pooling-related gains in statistical efficiency. These methods address a key issue associated with the homogeneous pools study design and should facilitate valid odds ratio estimation at a lower cost in a wide range of scenarios.

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