Exploring the Association Between Physical Fitness (High Intensity and Low Intensity) and the Incidence of Temporomandibular Disorders: A Comparative Study.

BACKGROUND: Temporomandibular joint disorders affect the temporomandibular joint (TMJ), masticatory muscles, and associated structures. Symptoms include TMJ pain, limited jaw movement, muscle tenderness, and referred pain. Physical activity can alleviate musculoskeletal pain. This study explored the link between physical fitness (high and low intensity) and temporomandibular disorder (TMD) incidence. METHODOLOGY: Sixty patients were divided into three groups in this comparative study. Group I underwent 30 minutes of high-intensity aerobic training. Group II had 30 minutes of low-intensity yoga sessions weekly. Group III received health education. TMD was diagnosed using the Fonseca Anamnestic Index (FAI). Pain intensity was measured using the Visual Analogue Scale (VAS) and the Pain Self-Efficacy Questionnaire (PSEQ). RESULTS: Of the participants, 38.1% were males and 61.9% were females. TMD severity was mild (25.0%), moderate (55.0%), and severe (20.0%). High-intensity training groups had higher TMD symptom severity than low-intensity groups (p = 0.001). VAS scores increased in group I and decreased in group II (significant). PSEQ scores decreased in group I and increased significantly in group II. Group III showed no significant differences in PSEQ scores. CONCLUSION: High-intensity training resulted in moderate TMD symptoms. Low-intensity training was beneficial for TMD pain. The study recommends combining low-intensity physical workouts with medications to alleviate TMD.

Psychometric properties of the Fonseca Anamnestic Index (FAI) for temporomandibular disorders: Turkish version, responsiveness, reliability, and validity study.

PURPOSE: Many assessment tools have been proposed for use in clinical practice and research on individuals with temporomandibular disorders (TMD). It aimed to translate the Fonseca Anamnestic Index into Turkish (FAI/T) and examine the responsiveness, reliability and validity of the FAI/T in this study. MATERIALS AND METHODS: Two hundred forty-nine individuals (207 female/42 male) with TMD were included in this study according to the RDC/TMD (muscle disorders, disc displacement, arthralgia and mixed disorders (muscle disorders and disc displacement)). Reliability was evaluated with test-retest reliability, internal consistency, and reproducibility. Validity was assessed with structural validity, construct validity, content validity, and face validity. In addition, responsiveness and floor and ceiling effects were also examined. RESULTS: The ICC value (0.906) and Cronbach's α (0.951) of the (FAI/T) were excellent. Following Explarotary Factor Analysis, two factors were extracted, accounting for 51.859% of the total variation. Structural validity, construct validity, content validity, and face validity analyses proved the validity of the FAI/T. The responsiveness analysis showed that the Turkish FAI and its subscales were able to detect change over time. CONCLUSIONS: The FAI/T has shown excellent reliability and good validity. The FAI/T can assess the symptoms of Turkish-speaking persons with TMD.Clinical Trials registration number: NCT04274985.

Turkish version of Fonseca Anamnestic Index has been translated into Turkish from English version.Turkish version of Fonseca Anamnestic Index has excellent reliability and good validity.The Turkish version of the Fonseca Anamnestic Index and its subscales are able to detect change over time.Turkish clinicians and researchers could easily use the Turkish version of the Fonseca Anamnestic Index to assess the Turkish population with temporomandibular disorders.

Does childhood maltreatment play a role in temporomandibular disorders?

The aim of this study was to find out if experiences of maltreatment in childhood have an effect on the occurrence of temporomandibular joint disorders (TMD). The study was conducted on 380 volunteer adults (252 females and 128 males), with a mean (SD) age of 27.63 (9.06) years. The level of TMD was assessed using the Fonseca Anamnestic Index (FAI). Childhood Trauma Questionnaires (CTQ) were completed by the participants and their marital status and educational level were recorded. FAI scores were significantly higher in females than in males. There was no statistically significant difference between gender and total CTQ score. Moreover, there was no statistically significant difference between educational status, marital status, and total CTQ score. FAI scores correlated positively with total CTQ scores in all individuals. Similarly FAI scores correlated positively with total CTQ scores in males and females. Childhood maltreatment is associated with TMDs. Dentists should be aware that possible collaboration with psychiatrists and/or psychologists when treating patients with TMD could increase the success of their treatment.

A Study to Assess Etiology and Prevalence of Signs and Symptoms of Temporomandibular Disorder.

Aim: The purpose of this epidemiological research was to determine how common temporomandibular disorder (TMD) symptoms are. Materials and Methods: Among the outpatient population, a sample of 100 people was chosen at random. A patient survey was presented to each person, and points were allotted based on their responses. Participants were categorized as having no symptoms of TMD, mild TMD, moderate TMD, or severe TMD based on their total score. Results: One hundred adults aged 18 and above were selected from the general public to take part in the research. Temporomandibular disorder was present in no more than 30% of those studied, in the mild range in 50%, in the moderate range in 15%, and in the severe range in 5%. 0.602 was determined to be the dependability of Fonseca's questionnaire. Conclusion: The Fonseca questionnaire is a useful instrument for gauging the extent to which TMD symptoms are present in a given population. The screening questionnaire may be received in a short amount of time and for little money, making it a good option for public health services.

Temporomandibular Disorder Prevalence and Its Association with Lifestyle Habits in Biomedicine Students-A Cross-Sectional Study.

This study aimed to examine the frequency of temporomandibular disorder among biomedical students and relate its occurrence to lifestyle habits. A cross-sectional collection of data was carried out and included a total of 676 examinees through a questionnaire that had 73 questions: general information and lifestyle habits, the Fonseca Anamnestic index (FAI), the Jaw Function Limitation Scale (JFLS), and the Perceived Stress Questionnaire (PSQ). The statistical analyses between three or more groups were conducted using the one-way analysis of variance (ANOVA) with post hoc Scheffé test or Kruskal-Wallis test with post hoc Dunn's test for quantitative variables. The comparison of qualitative variables was conducted using the Chi-square test, while the correlations were determined using Spearman's correlation test. The analysis showed that a higher frequency of moderate or severe TMD was observed in subjects who were smokers (p < 0.001) compared to non-smokers. Subjects who consumed more coffee had moderate to severe TMD compared to subjects who consumed a lesser amount (p < 0.001). Furthermore, a positive correlation between the amount of stress and the severity of TMD was found. Our study implies that students of biomedical studies have an increased risk for TMD and that there is a link with their lifestyle habits.

TMD diagnosis: Sensitivity and specificity of the Fonseca Anamnestic Index.

OBJECTIVE: To verify whether the Fonseca Anamnestic Index (FAI) has adequate sensitivity and specificity to be used in the diagnosis of temporomandibular disorder (TMD). METHODS: Two hundred-sixty-five participants with symptoms of TMDs were assessed through the FAI and through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and then classified as sick or non-sick. The sensitivity, specificity, and predictive values of the FAI in relation to the RDC/TMD were calculated using the STATA 14.0 software. RESULTS: Most of the patients were female, white, without a steady job, and the average age was 37.57 years. The FAI showed high sensitivity (97.21%) but obtained a low specificity (26.00%). The positive and negative predictive values were 84.96% and 68.42%, respectively. CONCLUSION: The FAI is very sensitive in identifying patients who actually have TMD but not very specific in identifying non-TMD patients, being indicated only for initial screening of patients.

Evaluation of temporomandibular disorders, quality of life, and oral habits among dentistry students.

OBJECTIVE: To evaluate temporomandibular disorders (TMD), quality of life, and oral habits in dentistry students. METHODS: The study was performed with 480 students (287 females, 193 males). The Fonseca Questionnaire, Oral Health Impact Profile-14 (OHIP-14), and Oral Behaviors Checklist (OBC) were used. RESULTS: The mean scores of the fifth-year students from Fonseca TMD, OHIP-14, and OBC were statistically significantly higher than those of the students in other years of study. The mean Fonseca score of female students was higher than those of the males. There was a statistically significant difference regarding the OHIP-14 scores based on the Fonseca TMD scores. A statistically significant difference regarding OBC was present based on the Fonseca TMD scores. CONCLUSION: The prevalence of TMDs was higher among the senior dentistry students. Necessary measures should be taken in the dentistry educational system to raise students' quality of life, improve joint disorders, and eliminate current oral habits.

The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders.

OBJECTIVE: To determine the reliability and diagnostic accuracy of the Turkish version of the Fonseca anamnestic index (FAI-T). METHODS: The cultural equivalence of the FAI was established according to the International Network for Orofacial Pain and Related Disorders Methodology. The test-retest reliability, internal consistency, and diagnostic accuracy of the FAI-T was carried out in a sample of 66 controls and 139 patients with TMD. Diagnostic accuracy of the FAI-T was evaluated against the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS: Internal consistency analysis resulted in a Cronbach's alpha coefficient of 0.805. The intraclass correlation coefficient (ICC) values of each index question ranged from 0.739 to 0.897. FAI had a high level of accuracy (area under the ROC curve of 0.928). CONCLUSION: The results provide considerable evidence that the FAI-T can be used as a screening tool for the identification of TMD in Turkish-speaking populations.

Assessment of the severity of temporomandibular disorders in females: Validity and reliability of the Fonseca anamnestic index.

OBJECTIVE: To evaluate the validity and reliability of the Fonseca anamnestic index (FAI) over time in Turkish females. METHODS: Four hundred-fourteen patients who visited the otorhinolaryngology clinic were initially included in the study between January 1, 2018 and January 1, 2019. The Turkish version of the FAI is a self-report instrument that was completed by all of the patients after a brief explanation from the clinician. Cronbach's alpha was calculated using data from the first questionnaire. RESULTS: The results of the first assessment showed 243 patients had no TMD (58.7%), 40 had mild TMD (9.7%), 87 had moderate TMD (21%), and 44 had severe TMD (10.6%). At the second assessment, the respective values were 243 (58.7%), 37 (8.9%), 98 (23.7%), and 36 (8.7%). The internal consistency of the first test was high. CONCLUSION: The FAI can be used to collect a large amount of data easily, at minimal cost.

Crisis de los Colegios Mayores de la Universidad de Salamanca (siglos XVIII–XX). Su vinculación con la Diputación (siglo XIX) / Crisis of the Colleges of the University of Salamanca (XVIII-XX centuries). Its link with the Diputación (XIX century)

Este trabajo constituye un relato histórico de los Colegios Mayores salmantinos. Para ello, se han revisado algunos documentos existentes en el Archivo de la Universidad de Salamanca y copias notariales de documentos inéditos custodiados por la Diputación Provincial. A pesar de que la historia de estos Colegios Mayores suele formar parte de numerosos trabajos relativos a la historia de la Universidad salmantina, el examen de dichos documentos le ha permitido al autor realizar rigurosos comentarios, que aportan originalidad en el conocimiento de este tema. (AU)

This review constitutes a historical account of the Salamanca Major Colleges. To do this, some existing documents in the Archive of the University of Salamanca and notarized copies of unpublished documents kept by the Provincial Council have been reviewed. Despite the fact that the history of these Halls of Residence is usually part of the numerous works related to the history of the University of Salamanca, the examination of these documents has allowed the author to make rigurous comments that provide originality in the knowledge of this subject. (AU)

Review of Various Clinical Assessment Indices and Orthodontic Management for Temporomandibular Joint Disorders.

The term "temporomandibular disorders" (TMDs) refers to a variety of problems involving the muscles of the masticatory system and the jaw. The most common symptoms of TMD are pain in the face, headaches, clicking or popping in the joints, and difficulties with jaw function. The severity of TMD can be measured with a number of different scales, including the Helkimo, Craniomandibular Index (CMI), Mandibular Functional Impairment Questionnaire (MFIQ), Fonseca scale and Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) scales. The former focuses on the patient's chief complaint, while the latter takes into account secondary symptoms such as limited mobility, impaired temporomandibular joint (TMJ) function, muscle pain, and discomfort during mandibular motion. According to the severity of the issue, the results can be used to categorise the situation. To effectively treat TMD, one must first determine their index score and then formulate a treatment strategy based on that score.

Patient-Reported Quality of Life versus Physical Examination in Treating Temporomandibular Disorders with Intra-Articular Platelet-Rich Plasma Injections: An Open-Label Clinical Trial.

Temporomandibular disorders, often manifested by articular pain, limitation of the mouth opening range, and unpleasant acoustic symptoms originating from inside the joint, have been associated with reduced quality of life. These symptoms, among others, can be treated with intra-articular injections of various substances, including repeated platelet-rich plasma (PRP) administration. The reported study was designed as an uncontrolled open-label clinical trial of consecutive cases. The participants completed a Fonseca questionnaire and evaluated acoustic symptoms, and spontaneous and provoked pain on VAS, and were subjected to a physical examination before, during, and after PRP therapy. The total Fonseca questionnaire results were statistically significantly (p < 0.05) correlated with 340 out of 348 (98%) other variables. The fully subjective assessment of the presence and intensity of acoustic symptoms coming from the temporomandibular joints was correlated with the physical examination results (0.45-0.63) and the maximum mouth opening with the maximum pain-free mouth opening (0.73-0.87). There were no correlations observed between the patient's and the physician's assessment of mandibular mobility. The Fonseca questionnaire seems to cover the entire spectrum of temporomandibular disorders, making it a balanced tool for assessing the quality of life in TMDs. However, it is worth considering extending the standard 3-point response scale to an 11-point one. The patient is somewhat able to perform a self-diagnosis with regard to the acoustic symptoms, but it is not possible for them to determine without measurement whether the range of mandibular mobility is appropriate..

Comparison of the Relationship between Temporomandibular Disorder and Oral Habits or Quality of Life in Dentistry Students in Different Years of Education.

OBJECTIVE: To evaluate the prevalence of temporomandibular disorder (TMD) in dental faculty students in different years of education and investigate the relationship between TMD and oral habits or quality of life. METHODS: The Fonseca Anamnestic Index (FAI) questionnaire was used to determine the prevalence and severity of TMD, the Oral Behaviors Checklist (OBC) questionnaire served to determine the severity of harmful oral habits/parafunctions and the Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to evaluate the quality of life in a total of 452 dentistry students (269 women and 183 men) in different years of education. RESULTS: With regard to incidence of TMD, a total of 215 women had TMD (215/269, 79.9%), which was significantly higher than that in men (87/183, 47.5%) (P < 0.001). According to the OBC and OHIP-14 questionnaire results, harmful oral habits and quality of life showed a low to moderately significant correlation with TMD (P < 0.05). CONCLUSION: The Fonseca, OHIP-14 and OBC questionnaires allow early and inexpensive determination of oral habits that increase the prevalence of TMD. The prevalence of TMD in dentistry students at the clinical education stage is higher than those who have not progressed to the clinical education stage.

Prevalence and Severity of Temporomandibular Disorders in Rheumatoid Arthritis Patients.

Introduction The temporomandibular joint (TMJ) is an important joint that plays major functions, including dental occlusion, mastication, and facial expressions. Different diseases can affect the TMJ, including chronic inflammatory arthritis. Rheumatoid arthritis (RA) is the most common inflammatory arthritis worldwide associated with TMJ dysfunction. In this study, we assess the prevalence of TMJ among RA patients based on the Fonseca Anamnestic Index. Methods Eighty-one patients with rheumatoid arthritis were interviewed by a trained physician to fulfill the Fonseca Anamnestic Index questionnaire. All participants underwent a medical file review to collect their sociodemographic data, RA duration, co-existing comorbidities, and different lab results. Result According to the Fonseca score, 29.6% had no temporomandibular disorder (TMD) among RA patients, while 39.5% had mild TMD. Only 6% had severe TMD. The female sex and increased body weight were associated with TMJ disease.  Conclusion The majority of rheumatoid arthritis patients (70%) suffer from some degree of temporomandibular joint disorder.

Evaluation of temporomandibular disorder symptoms and oral health-related quality of life in adolescent orthodontic patients with different dental malocclusions.

Objective: To estimate the prevalence of temporomandibular disorders in adolescent orthodontic patients with different dental malocclusions and to assess the relationship between oral health-related quality of life.Methods: This study was carried out on 648 randomly selected individuals 14-19 years of age. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), Fonseca Questionnaire, and Oral Health Impact Profile-14 (OHIP-14) forms were used.Results: The GCPS, TMD Pain, Fonseca, OHIP-14, PHQ-9, GAD-7, OBC, and PHQ-15 mean scores of female participants were statistically significantly higher than males (p < 0.05).There was a significant difference among the malocclusion groups in terms of their mean scores in GCPS, Fonseca, and OHIP-14 (p < 0.05).The age values and JFLS, TMD Pain, Fonseca, OHIP-14, PHQ-9, GAD-7, and PHQ-15 were statistically significant correlations in the positive direction.Conclusion: The DC/TMD form allows both a physical assessment of Axis I and II that examines psychosocial status and pain-related disorders and a more comprehensive assessment. The mean OHIP-14 and Fonseca questionnaire scores of Class III groups were found to be significantly higher.

Crisis de los Colegios Mayores de la Universidad de Salamanca (siglos XVIII–XX). Su vinculación con la Diputación (siglo XIX) / Crisis of the Colleges of the University of Salamanca (XVIII-XX centuries). Its link with the Diputación (XIX century)

Este trabajo constituye un relato histórico de los Colegios Mayores salmantinos. Para ello, se han revisado algunos documentos existentes en el Archivo de la Universidad de Salamanca y copias notariales de documentos inéditos custodiados por la Diputación Provincial. A pesar de que la historia de estos Colegios Mayores suele formar parte de numerosos trabajos relativos a la historia de la Universidad salmantina, el examen de dichos documentos le ha permitido al autor realizar rigurosos comentarios, que aportan originalidad en el conocimiento de este tema. (AU)

This review constitutes a historical account of the Salamanca Major Colleges. To do this, some existing documents in the Archive of the University of Salamanca and notarized copies of unpublished documents kept by the Provincial Council have been reviewed. Despite the fact that the history of these Halls of Residence is usually part of the numerous works related to the history of the University of Salamanca, the examination of these documents has allowed the author to make rigurous comments that provide originality in the knowledge of this subject. (AU)

Accuracy of the Fonseca Anamnestic Index for identifying pain-related and/or intra-articular Temporomandibular Disorders.

Objectives: This study established the diagnostic accuracy of the Fonseca Anamnestic Index (FAI) in relation to the Diagnostic Criteria for TMD (DC/TMD) standard.Methods: A total of 866 TMD patients and 57 TMD-free controls were instructed to answer the FAI and DC/TMD Symptom Questionnaire (SQ). Participants were subsequently categorized into no (NT), pain-related (PT), and/or intra-articular (IT) TMDs using the DC/TMD protocolized examination/algorithms. Receiver operating characteristics (ROC) curves, best cut-off points, and accuracy measures were determined.Results:The FAI demonstrated high accuracy for detecting all TMDs, PT, and IT (AUC = 0.96-0.98). The best cut-off points were 22.50 for all TMDs/IT and 27.50 for PT. Sensitivity of the FAI was high (94.23-98.21%), but specificity was moderate (87.72%) for all diagnostic categories.Discussion:The diagnostic accuracy of the FAI for identifying pain-related and intra-articular TMDs was high. FAI scores ≥25 points should be used to screen for TMDs.

Prevalence of TMJ Disorders among Patients Attending the King Faisal University Dental Clinics, KSA.

AIM: To assess the prevalence of signs and symptoms of temporomandibular disorders (TMDs) in a sample population of Al-Hasa by Fonseca's questionnaire. MATERIALS AND METHODS: A group of 240 patients was randomly selected from outpatients, attending the dental clinical complex of King Faisal University. The participants were grouped based on gender and age-groups: 14 to 20, 21 to 40, 41 to 60, and 61 ≤ years. Each participant was provided with a questionnaire and points were given accordingly for each question. The sum of points was used to classify the severity of TMD. The obtained data were analyzed with SPSS 21 and the significance level of p was fixed at ≤ 0.05. RESULTS: Among all participants examined, 131 participants had no TMD (54.6%), 79 had mild TMD (32.9%), 19 had moderate TMD (7.9%), and 11 had severe TMD (4.6%). TMD problem increases with age and significance level (p = 0.007) and females had more TMD problems than males (p = 0.008). CONCLUSION: The Fonseca's questionnaire is an effective tool for screening the signs and symptoms of TMDs, in a short period, and classifies patients according to their severity. According to the study results, approximately 45.4% of the patients had some degree of TMD problems. The present study is cross-sectional with a limited number of participants and it should be followed by a longitudinal study in the near future to validate. CLINICAL SIGNIFICANCE: Early detection of TMD problems will help in treatment planning and prognosis.

The International Health Division of the Rockefeller Foundation and the training of health professionals in Brazil: the case of Olympio da Fonseca (1920s) / A international health division da fundação rockefeller e a formação de profissionais para a saúde no brasil: o caso de olympio da fonseca (década de 1920)

Our proposal, in this paper, is to discuss the role of the International Health Division (IHD) of the Rockefeller Foundation (RF) in the training of health personnel through the fellowship program of the North American philanthropic institution and, more specifically, the Foundation’s work in training professionals linked to Brazil, highlighting the case of Olympio da Fonseca. Olympio da Fonseca was an important Brazilian researcher. Among the positions held by Fonseca, we can highlight the direction of the Oswaldo Cruz Institute, between 1949 and 1953, and the organization and direction of the Brazilian Institute for Research in the Amazon (1954-1955). Several sources allow us to reflect on the professional trajectory of the doctor and his training from the RF fellowship, such as the record produced by the Foundation (Fellowship card) and an interview granted by Olympio da Fonseca to the Center for Research and Documentation of Contemporary History of Brazil (Centro de Pesquisa e Documentação de História Contemporânea do Brasil - CPDOC) of the Getúlio Vargas Foundation (FGV) in 1977.(AU)

Nossa proposta, neste artigo, é discutir a atuação da International Health Division (IHD) da Fundação Rockefeller (FR) na formação de pessoal para a saúde através do programa de concessão de bolsas de estudos da instituição filantrópica norte-americana e, mais especificamente, a atuação da Fundação na formação de profissionais vinculados ao Brasil, destacando o caso de Olympio da Fonseca. Olympio da Fonseca foi um importante pesquisador brasileiro. Entre os cargos ocupados por Fonseca, podemos destacar a direção do Instituto Oswaldo Cruz, entre 1949 e 1953, e a organização e direção do Instituto Nacional de Pesquisas da Amazônia (1954-1955). Diversas fontes nos permitem refletir sobre a trajetória profissional do médico e sua formação a partir da bolsa da FR, como a ficha produzida pela Fundação (Fellowship card) e uma entrevista concedida por Olympio da Fonseca ao Centro de Pesquisa e Documentação de História Contemporânea do Brasil (CPDOC) da Fundação Getúlio Vargas (FGV) em 1977.(AU)

Evaluation of temporomandibular disorders and oral health-related quality of life with obese patients.

Objective: The aim of this study was to investigate the relationship between temporomandibular disorders and oral health impact profile in healthy, overweight, and obese patients.Methods: This study was carried out on 1528 individuals divided into three groups as healthy, overweight, and obese patients. Diagnostic Criteria for Temporomandibular Disorders, Fonseca's questionnaire, and Oral Health Impact Profile-14 (OHIP-14) forms were used.Results: Gender, classification, pain, temporomandibular joint noise, and open-lock of the jaw of healthy, overweight, and obese groups were found to be related. The differences in the Fonseca and the OHIP-14 total scores according to the groups were found to be statistically significant. The correlation between the Fonseca total score and age was positive and significant.Conclusion: In the obese patients, both total Fonseca and OHIP-14 values were found to be higher. Also, the presence of pain in the obese patients was found to be higher.