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ABSTRACT:The aim of this study was to evaluate the prevalence and severity of temporomandibular disorders (TMD) in Brazilian college students. A questionnaire was administered to 2,396 students. Seventy-three percent of women (mean age 21.94 ± 5 years) and 27% of men (mean age 22.41 ± 4.8 years) answered the questionnaire. The anamnestic index was used to classify the volunteers according to TMD severity degree. The results showed a higher percentage of men without TMD (43.74%) (p < 0.05, Chi-square test). The women exhibited some degree of severity (73.03%) at a higher frequency than men (56.26%). No significant differences were observed between sexes for a same TMD severity degree (p > 0.05). The results indicated TMD prevalence in Brazilian college students similar to that presented in other studies found in the literature reviewed. Longitudinal studies are recommended to follow the prevalence and health care needs in this population. DESCRIPTORS: Temporomandibular joint disorders; Epidemiology; Questionnaires; Prevalence. RESUMO:O objetivo deste estudo foi avaliar a prevalência e a severidade da disfunção temporomandibular (DTM) em universitários brasileiros. Participaram do estudo 2.396 estudantes. Responderam ao questionário 73% de mulheres (21,94 ± 5 anos) e 27% de homens (22,41 ± 4,8 anos). O índice anamnésico foi utilizado para classificar os voluntários por nível de severidade da DTM. Os resultados mostraram uma maior porcentagem de homens sem DTM (43,74%) (p < 0,05 teste Qui-quadrado). As mulheres mostraram algum nível de severidade (73,03%) com maior freqüência que os homens (56,26%). Não foram evidenciadas diferenças de freqüência entre os sexos classificados com DTM de mesma severidade. Os resultados indicam que a prevalência de DTM em universitários brasileiros é semelhante à de outros trabalhos presentes na literatura. Estudos longitudinais são necessários para acompanhar a prevalência e a necessidade de tratamento nessa população. DESCRITORES: Transtornos da articulação temporomandibular; Epidemiologia; Questionários; Prevalência. INTRODUCTIONThe expression Temporomandibular disorders (TMD) is a generic designation for a subgroup of orofacial pain disorders. This classification comprises the pain complaints in the temporomandibular joint (TMJ) region, muscle fatigue, especially of the masticatory muscles, impaired jaw movement, and articular sounds. The multifactorial TMD etiology is related to emotional tension, occlusal interferences, teeth loss, postural deviation, masticatory muscular dysfunction, internal and external changes in TMJ structure, and the various associations of these factors 6,17 .TMD prevalence studies have demonstrated a large amount of people with signs and symptoms in clinical and subclinical degrees. Thus, we have found a high TMD prevalence in non-patients, i.e., among those who do not seek for health care attention 22 . A non-patient prevalence study indicates closely 75% of subjects with just one TMD sign, and 33% with at least one symptom 7 . Another estimate related ...

Temporomandibular disorders (TMD) are characterized by several signs and symptoms, such as pain and changes in the electrical activity of masticatory muscles. Considering that transcutaneous electrical nerve stimulation (TENS) is a resource indicated to promote analgesia, the objective of this study was to evaluate the effect of TENS on pain and electromyographic (EMG) activity of the jaw elevator muscles in TMD patients. This study evaluated 35 female volunteers: 19 TMD patients (mean age = 23.04 ± 3.5) and 16 normal subjects (mean age = 23.3 ± 3.0). Transcutaneous electrical nerve stimulation (conventional mode, 150 Hz) was applied once to each group for 45 minutes. Surface electromyography (gain of 100 times and 1 kHz sampling frequency) and the visual analogue scale (VAS) were applied before and immediately after TENS application. Both VAS data and root mean square (RMS) values were analyzed using Student's t-test. The TMD group, compared to the control group, showed higher EMG activity of the jaw elevator muscles at rest. No difference was observed between the groups regarding maximum voluntary clenching (MVC). In TMD patients, TENS reduced both pain and EMG activity of the anterior portion of the temporal muscle, increasing the activity of the masseter muscles during MVC. It is possible to conclude that a single TENS application is effective in pain reduction. However, it does not act homogeneously on the features of the electric activity of the muscles evaluated. DESCRIPTORS: Temporomandibular joint; Electromyography; Masticatory muscles; Transcutaneous electric nerve stimulation; Facial pain. RESUMO:A desordem temporomandibular (DTM) é caracterizada por diversos sinais e sintomas, como dor e alteração do sinal eletromiográfico dos músculos da mastigação. Considerando que a estimulação elétrica nervosa transcutânea (TENS) é um recurso indicado para promover analgesia, o objetivo deste trabalho foi avaliar o efeito da TENS na dor e na atividade eletromiográfica (EMG) dos músculos elevadores da mandíbula em indivíduos com DTM. Foram selecionados 35 voluntários do sexo feminino, 19 portadores de DTM (média de 23,04 anos ± 3,5) e 16 normais (média de 23,3 anos ± 3,0). A TENS (modo convencional, 150 Hz) foi aplicada uma vez em ambos os grupos, por 45 min. O exame EMG de superfície (ganho de 100 vezes e freqüência de amostragem de 1 kHz) e a escala visual analógica (EVA) foram realizados antes e imediatamente depois da aplicação da TENS. Os dados da EVA e os valores da "root mean square" (RMS) foram analisados pelo teste t de Student. Observou-se que, na situação de repouso, os indivíduos com DTM apresentam um aumento da atividade EMG dos músculos elevadores da mandí-bula em relação aos do grupo controle. Na contração voluntária máxima (CVM), não foram observadas diferenças entre os grupos. Nos portadores de DTM, a TENS reduziu a dor, a atividade EMG da porção anterior do músculo temporal e aumentou a atividade dos músculos masseteres durante a CVM. É possível concluir que apenas uma aplicação da TENS...

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Forward head posture may cause alterations in the stomatognathic system, including changes in the muscle activity of the masticatory muscles and dental occlusion alterations. Considering the need for further understanding of the relationship between the stomatognathic system and the cervical region, the purpose of this study was to analyse the head posture and the electromyographic (EMG) activity of the anterior portion of temporal and masseter muscles bilaterally among bruxist's subjects with different dental occlusion classifications using the Angle method. The study consisted of 20 female volunteers, between the ages of 17 and 27 years. They were separated into two groups (class I and class II occlusions) according to a dentist-performed evaluation. An assessment of forward head posture was conducted using a photographic technique (angular calculus) combined with a clinical analysis. In the EMG analyses, active differential surface electrodes (Ag) were utilized and were placed bilaterally on the belly of masseter and temporal muscles, perpendicular to the muscles fibres. The EMG signal recorded during bilateral isotonic mastication, was presented using the Root Mean Square and was processed by Matlab software. The results indicated that the EMG responses of temporal and masseter muscles tend to be modified by occlusion alteration class II. Subjects with class II occlusion tended to present more occurrence of forward head posture with alterations in the muscle activity pattern between masseter and temporal muscles.

A study on the impact of pain in patients with temporomandibular joint disorder (TMD) was carried out. Twenty two patients (20 women, two men, 28 years of age on average) with TMD who looked for specialized physiotherapy care were submitted to a brazilian version of McGill Pain Questionnaire (Br-MPQ), which includes questions about life quality, as follows: 1) social loss; 2) daily life activities; 3) third party’s perception; 4) pain tolerance; 5) sensation of being sick; 6) sensation of being useless; 7) life satisfaction. The results showed that pain related to the TMD significantly affected work activities (59.09%), school activities (59.09%), sleeping (68.18%) and appetite/feeding (63.64%). The authors conclude that pain from TMD has a negative impact on the patients’ life quality and that, although unspecific, the questionnaire used allowed for an adequate evaluation of the impact.

In this study, the effects of acupuncture in comparison with flat occlusal plane appliance were evaluated in patient with myogenic temporomandibular dysfunction (TMD). The sample consisted of 40 women with TMD and unbalanced energy predominance of Yang Liver Ascension, selected using the Renying and Cunkou pulses, randomly divided into two groups: acupuncture and splint. The effect of treatments on the masseter and anterior temporal muscles was evaluated after 4 weeks of treatment, by means of electromyographic activity (root mean square) and pain pressure threshold. Pain intensity was measured using the visual analog scale, and range of mouth opening was evaluated using a millimeter ruler. All evaluations were performed at the beginning and end of the treatment. Visual analog scale score was reduced equally in the two groups (p < 0001), and the increase in range of mouth opening was significant in both groups. A significant difference was detected only in pain pressure threshold of the left masseter in the acupuncture group (p < 0.05). Only root mean square in the at rest position of the right temporal muscle diminished in the final stage of the splint group (p < 0.05). Both treatments reduced the pain intensity of myogenic TMD in the short term and may be considered strategies for control of chronic pain related to TMD.