IMPACTO DA ALTERAÇÃO DE DIMENSÃO VERTICAL NA DISFUNÇÃO TEMPOROMANDIBULAR: REVISÃO INTEGRATIVA

Introdução:A Disfunção Temporomandibular (DTM) é uma condição bastante frequente na população mundial e a identificação de fatores causais, junto ao seu tratamento é de suma relevância para a qualidade de vida dos indivíduos. Objetivo:Objetivou-se por meio de uma revisão sistemática da literatura de todos os tipos de estudos, avaliar se a perda de dimensão vertical impacta no aparecimento das disfunções temporomandibulares. Método:As estratégias de busca foram realizadas nas bases de dados “Cochrane Library”, “MEDLINE”, “Web of Science”, “Scopus”, “LILACS”, “Scielo” e “Google Acadêmico”, utilizando os seguintes descritores e/ou palavras: “Temporomandibular Joint Disorders"; "Craniomandibular Disorders”; “Occlusion Vertical Dimension”; “Occlusion Vertical Dimensions”; “Vertical Dimension of Occlusion”; “Vertical Dimension”. Resultados:Um total de 4 artigos foram incluídos nesta revisão.A maioria dos estudos demostram que na presença de uma DVO diminuída, o sistema estomatognático é capaz de adaptar-se, não provocando o aparecimento de DTM. Conclusões:Como conclusão, os resultados indicam que não há evidência científica suficiente que permita afirmar que a perda de dimensão vertical predispõe ao aparecimento de sinais e sintomas relacionados à disfunção temporomandibular.

Anxiety in craniomandibular disorders and bruxing behavior patients: The role of pain in single and multiple sites and severity of bruxing behavior. Part I

Objective: To assess the level of anxiety in patients with bruxing behavior and craniomandibular disorders (CMD). Methods: We evaluated 108 patients with bruxism and CMD, 20 patients with mild bruxism, 32 with moderate, 36 with severe and 20 extreme. We used the Test of Manifested Anxiety of Taylor (TMAS), clinical examination, a questionnaire of clinical-epidemiological data and the criteria for CMD: clinical examination, palpation of muscle and joints, the Visual Analogue Scale for pain. We also introduced an empirical scale to classify the level of anxiety as absent or mild, moderate, severe and very severe. Results: The level of anxiety increased from the mild to the moderate, severe, and extreme bruxing groups but the difference was only significant from the severe to the other three groups of bruxers (p <0.05). The level of pain also increased from the mild to the extreme group of bruxers but the difference was not statistically significant. When we analyzed the site of pain, there were differences but not significant (p><0.07). The correlation’s painful sites anxiety, severity of bruxing behavior - anxiety, and severity of bruxism number of painful sites, were significant (p><0.02, p><0.05, and p><0.0001, respectively). Conclusion: Using our empirical criteria, levels of moderate and severe anxiety predominated in the group of 108 CMD and bruxing behavior patients. >

The modulating effect of bruxism as a form of suppressed hostility on depression in a selected population of tension type headache (ttha) and craniomandibular disorders (cmds) individuals. O efeito modulador do bruxismo como uma forma de hostilidade reprimida numa população seleta com dor de cabeça por tensão muscular e distúrbios craniomandibulares (dcms).

AIMS: explore the hypothesis that bruxism and depression are forms of suppressed hostility in individuals presenting Craniomandibular Disorders (CMDs) and Tension-type Headache (TTHa). METHODS: We evaluated a group of 100 Craniomandibular Disorders and Tension-Type Headache individuals, a group of 38 CMDs and Facial Pain individuals and a group of 23 No Craniomandibular Disorders No Facial Pain individuals. Clinical examination, questionnaires, history of signs and symptoms, the Beck Depression Inventory (BDI) and the Cook-Medley Inventory (HO) were used to gather data. RESULTS: The frequency of Tension Type Headache was about 43.5% in the group of 230 Craniomandibular Disorder patients. Mean scores in hostility were 19.0, 17.7 and 17.2 in the groups presenting Tension-Type Headache and CMDs, CMDs and Facial Pain and No CMDs no Pain, respectively. Mean scores in depression were about 12.0, 9.1 and 5.7 respectively in the same groups. Mean scores in bruxism were about 12.9, 8.2 and 6.8, respectively in the same groups. The strongest correlation between bruxism and depression were observed in the TTHa group (r=0.4, p<0.0001) and in the Non CMD Non Pain group (r=0.48, p<0.02). CONCLUSION: Depression is a better indicator of hostility in subgroups presenting TTHa. Scores in bruxism and depression as a form of suppressed hostility are higher in CMDs and TTHa individuals than in controls without TTHa. Because scores in bruxism were higher in TTHa and CMDs individuals, there is a strong and positive association between bruxism and TTHa in individuals with concomitant Craniomandibular disorders.

The modulating effect of bruxism as a form of suppressed hostility on depression in a selected population of tension type headache (ttha) and craniomandibular disorders (cmds) individuals

AIMS: explore the hypothesis that bruxism and depression are forms of suppressed hostility in individuals presenting Craniomandibular Disorders (CMDs) and Tension-type Headache (TTHa). METHODS: We evaluated a group of 100 Craniomandibular Disorders and Tension-Type Headache individuals, a group of 38 CMDs and Facial Pain individuals and a group of 23 No Craniomandibular Disorders No Facial Pain individuals. Clinical examination, questionnaires, history of signs and symptoms, the Beck Depression Inventory (BDI) and the Cook-Medley Inventory (HO) were used to gather data. RESULTS: The frequency of Tension Type Headache was about 43.5% in the group of 230 Craniomandibular Disorder patients. Mean scores in hostility were 19.0, 17.7 and 17.2 in the groups presenting Tension-Type Headache and CMDs, CMDs and Facial Pain and No CMDs no Pain, respectively. Mean scores in depression were about 12.0, 9.1 and 5.7 respectively in the same groups. Mean scores in bruxism were about 12.9, 8.2 and 6.8, respectively in the same groups. The strongest correlation between bruxism and depression were observed in the TTHa group (r=0.4, p<0.0001) and in the Non CMD Non Pain group (r=0.48, p<0.02). CONCLUSION: Depression is a better indicator of hostility in subgroups presenting TTHa. Scores in bruxism and depression as a form of suppressed hostility are higher in CMDs and TTHa individuals than in controls without TTHa. Because scores in bruxism were higher in TTHa and CMDs individuals, there is a strong and positive association between bruxism and TTHa in individuals with concomitant Craniomandibular disorders.

Tmj Arthralgia: A Rarely Described Internal Joint Derangement And Characterization Regarding Factors Of Age , Pain Description, And Prevalence In Craniomandibular Disorders Individuals (CMDs)

Aims: Characterize Craniomandibular Disorders (CMDs) and arthralgia individuals regarding factors of age, joint noises, frequency of burning pain and severity of pain. Material and Methods: 25 CMD and arthralgia patients, 39 CMDs and capsulitis patients were retrieved from a large sample of CMD patients and were compared with a control Non CMD group. History of sign and symptoms, questionnaires, clinical examination, description of pain, diagnostic tests and criteria for CMDs were used. Results: Mean age in the experimental (CMD+arthralgia group) was about 40.2 years old. The frequency of joint noises was about 72% in the CMDs+arthralgia group as compared to the other two control groups (56.4% and 40.6%) . Bilateral reciprocal click was also more frequently in the experimental group than in the controls and the difference was statistically significant. The frequency of severe pain was much higher in the CMD+arthralgia than in the CMD+capsulitis group (80% and 10.2% respectively). The description of burning pain was observed exclusively in the CMD+arthralgia group. Finally, the frequency of pain increased from the Non CMD to the CMD+capsulitis and to the CMD+arthralgia group. Conclusions: The results of this study indicate that arthralgia is a more chronic disorder characterized by burning pain, more severe pain and higher frequency of joint noises, specifically unilateral reciprocal click.

Tmj Arthralgia: A Rarely Described Internal Joint Derangement And Characterization Regarding Factors Of Age , Pain Description, And Prevalence In Craniomandibular Disorders Individuals (CMDs)

Aims: Characterize Craniomandibular Disorders (CMDs) and arthralgia individuals regarding factors of age, joint noises, frequency of burning pain and severity of pain. Material and Methods: 25 CMD and arthralgia patients, 39 CMDs and capsulitis patients were retrieved from a large sample of CMD patients and were compared with a control Non CMD group. History of sign and symptoms, questionnaires, clinical examination, description of pain, diagnostic tests and criteria for CMDs were used. Results: Mean age in the experimental (CMD+arthralgia group) was about 40.2 years old. The frequency of joint noises was about 72% in the CMDs+arthralgia group as compared to the other two control groups (56.4% and 40.6%) . Bilateral reciprocal click was also more frequently in the experimental group than in the controls and the difference was statistically significant. The frequency of severe pain was much higher in the CMD+arthralgia than in the CMD+capsulitis group (80% and 10.2% respectively). The description of burning pain was observed exclusively in the CMD+arthralgia group. Finally, the frequency of pain increased from the Non CMD to the CMD+capsulitis and to the CMD+arthralgia group. Conclusions: The results of this study indicate that arthralgia is a more chronic disorder characterized by burning pain, more severe pain and higher frequency of joint noises, specifically unilateral reciprocal click.

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients

Objective: The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia. Materials and Method: The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari. Results: 24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients). Conclusion: Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.