This study to assessed the prevalence of signs and symptoms of temporomandibular disorders (TMD) by means of the frequency distribution of data for 218 dentistry students from a Brazilian public university using the Fonseca's questionnaire. The group consisted of 96 men and 122 women, with an average age of 20 years. Of the students, 53.21% showed some level of TMD: 35.78% mild TMD 11.93% moderate and 5.5% severe. Women were the most affected group, with 63.11% showing some level of TMD, against 40.62% of men. When considering only severe TMD, women are approximately 9 times more affected than men. Students with any level of TMD showed marked characteristics: 76.72% considered themselves tense people; 71.55% reported to clench or grind their teeth; 65.52% reported clicking of the temporomandibular joint; 64.66% reported frequent headache and 61.21% neck pain. In conclusion, clinical signs and symptoms of TMD can occur in young population and this information is of great importance for the early diagnosis of the dysfunction.
The aim of this study was to determine the frequency and to characterize the symptoms and clinical signs of temporomandibular disorders (TMD) related to each severity category of Fonseca's anamnestic index in a sample of Brazilian young adults (mean age 21.61+/-1.91 years, 87% females and 13% males), by the application of an anamnestic index proposed by Fonseca (1992) and by clinical examination considering mandibular range of motion and tenderness to palpation of stomatognathic system structures. A significant number of participants were classified with mild TMD (43.2%) and moderate TMD (34.8%). Pain frequency during mastication, temporomandibular joint (TMJ) pain, and TMJ sounds were shown to be good predictors of TMD severity. Neck pain, headache, difficulty during mouth opening and lateral deviation, and tenderness to palpation of masticatory sites and during protrusion accompanied the TMD severity but failed to demonstrate differences between moderate and severe groups, showing a poor ability to determine TMD severity progression. This study suggests that not only the frequency of signs and symptoms of TMD should be determined, but also symptom severity and its relationship to the presence of clinical signs in order to discriminate patients with real treatment needs in nonpatient samples.
ObjectiveConsidering the high incidence of Temporomandibular Disorders (TMD) in the
population aged 15-30 years and the fact that students are exposed to stressful
psychosocial factors, the purposes of this study were: to verify clinical symptoms
and jaw functionality in college students with TMD according to the
anxiety/depression (A/D) level and to evaluate the correlation between A/D and
functionality, maximum mouth opening (MMO) and pain and muscle activity. Material and MethodsNineteen students with TMD diagnosed according to the Research Diagnostic Criteria
for Temporomandibular Disorders underwent two assessments during an academic
semester. The evaluations were based on questionnaires (MFIQ - Mandibular Function
Impairment Questionnaire; HADS - Hospital Anxiety and Depression Scale), clinical
measurements (MMO without pain, MMO and assisted MMO; palpation of joint and
masticatory muscles), and electromyography. The HADS scores obtained in the two
assessments were used to classify all data as either "high" or "low" A/D. Data
normality, differences and correlations were tested with the Shapiro-Wilk test,
Student's t-test (or the Wilcoxon test), and Spearman test, respectively. The
alpha level was set at 0.05. ResultsNone of the clinical variables were significantly different when comparing low and
high A/D data. In low A/D there was a significant correlation between HADS score
and: MFIQ (P=0.005, r=0.61), and MMO without pain (P=0.01, r=-0.55). ConclusionsVariation in A/D level did not change clinical symptoms or jaw functionality in
college students with TMD. Apparently, there is a correlation between TMJ
functionality and A/D level, which should be further investigated, taking into
account the source of the TMD and including subjects with greater functional
limitation.
Na literatura especializada, encontram-se variados instrumentos para avaliação da disfunção temporomandibular (DTM), sob a forma de índices, questionários, protocolos, escalas de avaliação e critérios de diagnóstico. Este estudo, dividido em duas partes, visou caracterizar os principais instrumentos de avaliação da DTM disponíveis na literatura, para auxiliar o clínico e o pesquisador na correta escolha da ferramenta apropriada para contemplar seus objetivos clínicos ou científicos. Nesta parte I são apresentados dois índices clínicos e três questionários (anamnésicos e funcionais); na parte II, um questionário funcional e dois conjuntos de critérios diagnósticos. Os índices são ferramentas que organizam a avaliação de sinais e sintomas, pela obtenção de pontuações. Os questionários são melhor aplicados para traçar perfis populacionais em estudos epidemiológicos. Para avaliação dos eventuais impactos da DTM nas atividades de vida diária, os questionários funcionais são mais adequados. Finalmente, há poucos conjuntos de critérios sistematizados para obter o diagnóstico da disfunção. A utilização de uma ou outra ferramenta depende de sua aplicabilidade e dos objetivos do profissional que a irá utilizar.
Aim:The purpose of this study was to assess in a sample of female community cases the relationship between the increase of percentage of cervical signs and symptoms and the severity of temporomandibular disorders (TMD) and vice-versa.Material and Methods:One hundred women (aged 18-26 years) clinically diagnosed with TMD signs and symptoms and cervical spine disorders were randomly selected from a sample of college students.Results:43% of the volunteers demonstrated the same severity for TMD and cervical spine disorders (CSD). The increase in TMD signs and symptoms was accompanied by increase in CSD severity, except for pain during palpation of posterior temporal muscle, more frequently observed in the severe CSD group. However, increase in pain during cervical extension, sounds during cervical lateral flexion, and tenderness to palpation of upper fibers of trapezius and suboccipital muscles were observed in association with the progression of TMD severity.Conclusion:The increase in cervical symptomatology seems to accompany TMD severity; nonetheless, the inverse was not verified. Such results suggest that cervical spine signs and symptoms could be better recognized as perpetuating rather than predisposing factors for TMD.
Objective: To estimate the pressure pain threshold (PPT) of the craniocervical muscles in women with episodic migraine (EM) n=15 and chronic migraine (CM) n=14, and in healthy volunteers (C) n=15. Method: A blinded examiner obtained the PPT bilaterally, by pressure algometry, for the following muscles: frontalis, temporalis, masseter, trapezius and sternocleidomastoid. ANOVA (p<0.05) was used for statistical purposes. Results: Contrasted to controls, individuals with EM had significantly decreased PPT
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