ABSTRACT
The objective of this study was to determine the association between temporomandibular disorders (TMD) with depression, somatization and sleep disorders in the city of Maringá, Brazil. A total of 1,643 participants were selected from the Brazilian Unified Health System (SUS). Of these, the test group consisted of 84 participants who had moderate or severe limitations due to TMD pain and the control group consisted of 1,048 participants with no pain. There was a highly statistically significant difference (p<0.001) between cases and controls regarding depression (82.1 versus 37.4%), somatization (84.5 versus 31.4%), and sleep disorders (84.6 versus 36.4%), in moderate to severe levels. The levels of moderate to severe depression, somatization and sleep disorders were significantly higher in TMD subjects with high TMD pain disability. The risk of developing TMD increased 4 to 5 times when the individual has moderate to severe levels of depression, somatization, and sleep disorders.
O objetivo deste estudo foi determinar a associação entre disfunções temporomandibulares (DTM) com depressão, somatização e distúrbios do sono na cidade de Maringá, Brasil. Foram selecionados 1.643 participantes atendidos no Sistema Único de Saúde (SUS). Desses, o grupo caso foi formado por 84 participantes que apresentaram limitações moderada ou grave devido à dor na DTM e o grupo controle foi formado por 1.048 participantes com ausência de dor. Verificou-se diferença estatisticamente significativa (p<0,001) entre casos e controles em relação à depressão (82,1 versus 37,4%), somatização (84,5 versus 31,4%) e distúrbios do sono (84,6 versus 36,4%), em níveis moderados a graves. Os níveis de depressão moderada a grave, somatização e distúrbios do sono foram significativamente mais altos em indivíduos com DTM com alta incapacidade devido à dor por DTM. O risco de desenvolver DTM aumentou quatro a cinco vezes quando o indivíduo apresenta níveis moderados a graves de depressão, somatização e distúrbios do sono.
El objetivo de este estudio fue determinar la asociación entre los trastornos temporomandibulares (TMD) con la depresión, la somatización y los trastornos del sueño en la ciudad de Maringá, Brasil. Un total de 1.643 participantes fueron seleccionados del Sistema Único de Salud (SUS) de Brasil. (SUS). De estos, el grupo de casos fue formado por 84 participantes que presentaban limitaciones moderadas o graves debido al dolor TMD y el grupo de control estaba formado por 1.048 participantes sin dolor. Hubo una diferencia estadísticamente significativa (p <0,001) entre casos y controles con respecto a depresión (82,1 frente a 37,4%), somatización (84,5 frente a 31,4%) y trastornos del sueño (84,6 frente a 36,4%), en niveles moderados a severos. Los niveles de depresión moderada a grave, somatización y trastornos del sueño fueron significativamente más altos en personas con TMD con alta discapacidad por dolor en TMD. El riesgo de desarrollar TMD aumenta de 4 a 5 veces cuando el individuo tiene niveles moderados a severos de depresión, somatización y trastornos del sueño.
Subject(s)
Temporomandibular Joint Disorders , Sleep Wake Disorders , Somatoform Disorders , Risk Factors , DepressionABSTRACT
Abstract Introduction The prevalence of tinnitus is higher in individuals with temporoman- dibular joint disorder (TMD) than in the general population. Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) is the method of choice for investigation, and it has been hypothesized that specific MRI findings might be observed in TMD with comorbid tinnitus. Objective To comparatively describe MRI findings in patients with TMD with and without tinnitus, identifying the most common TMJ alterations and determining whether a correlation exists between severity of TMD and tinnitus. Methods A cross-sectional study of 53 adult patients with bilateral or unilateral TMD (30 with and 23 without tinnitus). The association between tinnitus and morphological aspects of TMD (changes in condylar morphology, articular eminence morphology, and disc morphology), disc displacement (with/without reduction), condylar translation, and intra-articular effusion was analyzed on MRI images. Results The mean patient age was 46.12 ± 16.1 years. Disc displacement was the most common finding in both groups (24 patients with tinnitus versus 15 without; p = 0.043). Only the frequency of disc displacement with reduction was significantly different between groups. Conclusion Additional imaging techniques should be explored to detect specific aspects of the relationship between tinnitus and TMD.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Temporomandibular Joint/diagnostic imaging , Tinnitus/diagnostic imaging , Magnetic Resonance Imaging , Temporomandibular Joint Disorders/diagnostic imaging , Audiometry, Evoked Response , Audiometry, Pure-Tone , Temporomandibular Joint/pathology , Tinnitus/diagnosis , Tinnitus/etiology , Severity of Illness Index , Temporomandibular Joint Disorders/complications , Temporomandibular Joint Disorders/pathology , Cross-Sectional StudiesABSTRACT
Introduction The prevalence of tinnitus is higher in individuals with temporomandibular joint disorder (TMD) than in the general population. Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) is the method of choice for investigation, and it has been hypothesized that specific MRI findings might be observed in TMD with comorbid tinnitus. Objective To comparatively describe MRI findings in patients with TMD with and without tinnitus, identifying the most common TMJ alterations and determining whether a correlation exists between severity of TMD and tinnitus. Methods A cross-sectional study of 53 adult patients with bilateral or unilateral TMD (30 with and 23 without tinnitus). The association between tinnitus and morphological aspects of TMD (changes in condylar morphology, articular eminence morphology, and disc morphology), disc displacement (with/without reduction), condylar translation, and intra-articular effusion was analyzed on MRI images. Results The mean patient age was 46.12 ± 16.1 years. Disc displacement was the most common finding in both groups (24 patients with tinnitus versus 15 without; p = 0.043). Only the frequency of disc displacement with reduction was significantly different between groups. Conclusion Additional imaging techniques should be explored to detect specific aspects of the relationship between tinnitus and TMD.
ABSTRACT
PURPOSE: This before and after study evaluated the effects of a mandibular advancement device (MAD) on sleep bruxism (SB) activity and its associated signs and symptoms. MATERIALS AND METHODS: Nineteen young adults (39.9 ± 12.9 years, 58% women) with a clinical history of SB without sleep or neurologic disorders and no spontaneous temporomandibular disorder pain were selected. SB activity was assessed after a habituation period of 2 weeks. The results of a 3-month treatment with a thermoplastic monoblock MAD were compared to baseline using electromyogram polysomnography and the BiteStrip, a portable EMG device. Sleep disorders were assessed and validated against the polysomnography sleep assessment questionnaire (SAQ). Additionally, common signs and symptoms of SB were evaluated with the research diagnostic criteria for temporomandibular disorders. Occlusal force was compared to baseline using a cross-arch force transducer. RESULTS: There was a significant improvement in both SB activity and sleep scores (including SB episodes per hour) according to the BiteStrip and the SAQ, respectively. There was also a significant reduction in the signs and symptoms of SB, including grinding and/or clenching, temporomandibular joint (TMJ) sounds, muscle pain, and occlusal force. None of the SB subjects experienced MAD breakage, but in 24% of patients, the MAD treatment had to be interrupted due to TMJ/muscle pain and/or discomfort. CONCLUSION: The MAD treatment resulted in the reduction of SB activity, SB signs and symptoms, sleep disorders, and occlusal force.
