Can high pain intensity and catastrophizing interfere with the cognitive performance of women with chronic pain related TMD? A cross-sectional study

Interventions based on pain education and self-management are dependent on factors such as attention, memory, concentration, and executive function. Objective: To explore the relationship between cognitive performance and the variables pain intensity, central sensitization, catastrophizing, and hypervigilance in women diagnosed with chronic pain-related TMD. Methodology: This is a cross-sectional study. A total of 33 women (mean age: 38±4.6 years; range: 18 to 66 years) with chronic pain-related TMD (myalgia and/or arthralgia) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Specific questionnaires were used to evaluate cognitive performance, overall pain intensity, central sensitization, hypervigilance, and pain catastrophizing. The data were analyzed using Pearson’s correlation coefficient and backward stepwise multiple linear regression (statistical significance at 5% alpha). Results: Approximately 53% of the study sample showed decreased cognitive performance. High central sensitization, hypervigilance, and pain catastrophizing were observed. A significant negative correlation was observed between cognitive performance and hypervigilance (p=.003, r=−.49), cognitive performance and catastrophizing (p<.001, r=−.58), and cognitive performance and pain intensity (p<.001, r=−.58). Regarding the partial regression coefficients, only catastrophizing and pain intensity showed statistical significance (t=−2.12, p=.043; t=−2.64, p=.014, respectively), indicating a significant role in explaining cognitive performance at the sample. Conclusion: High pain intensity and the presence of catastrophic thoughts regarding pain can predict impaired cognitive performance in women with chronic pain-related TMD. Management strategies addressing psychosocial dimensions such as reducing catastrophizing and ensuring complete understanding of the condition are important

Bite force in temporomandibular dysfunction (TMD) and healthy complete denture wearers

The signs and symptoms of temporomandibular dysfunction (TMD) may contribute to reduce bite force and muscular activity. The aims of this study were to compare bite force in complete denture wearers with TMD (TMD group) and without TMD (healthy group).The TMD group consisted of 9 individuals, who had worn a maxillary and a mandibular complete removable denture for more than 10 years. The healthy group consisted of 9 participants who wore dentures and had satisfactory interocclusal and maxillomandibular relationship. Helkimo Index was used to analyze the dysfunction level. Maximum bite force was measured using a digital dynamometer with capacity of 100 kgf and adapted to oral conditions.The TMD group presented smaller mean bite force values than the healthy group, though without statistical significance (p>0.05). This outcome suggests that the TMD signs and symptoms and the structural conditions of the dentures did not affect the maximal bite force of complete denture wearers.Os sinais e sintomas de DTM podem contribuir na redução da força de mordida e da atividade muscular. O objetivo deste trabalho foi comparar a força de mordida em indivíduos com prótese total com DTM (Grupo CDTM) e sem DTM (Grupo SDTM). O Grupo CDTM (n=9) era composto por indivíduos que utilizavam as mesmas próteses totais há mais de 10 anos. O Grupo SDTM (n=9) por indivíduos com próteses totais satisfatórias quanto aos requisitos estruturais e funcionais, observados pelo profissional e relatados pelo paciente. O índice de Helkimo foi utilizado para análise do índice de disfunção. A força de mordida máxima foi medida na região de molares com gnatodinamômetro. Os resultados mostraram que o Grupo CDTM apresentou valor numérico médio de força de mordida menor que o Grupo SDTM, porém sem diferença estatisticamente significante entre os grupos avaliados (p<0,05) sugerindo que os sinais e sintomas da DTM e as condições estruturais das próteses não afetaram os resultados da força de mordida

Effect of acupuncture on the molar bite force in women with chronic neck pain

Objetive: To investigate the maximum molar bite force in women with chronic neck pain after treatment with acupuncture. Materials and Methods: Twenty-three women with chronic neck pain participated. Dynamometer was used to measure the right and left maximum molar bite force. Dong Bang acupuncture needles - 0.25 mm x 30 mm was inserted into the integumentary tissue. Treatment was 10 sessions, each 30 minutes long and twice a week. Results: The right (p = 0.01) and left (p = 0.004) molar bite force was assessed after treatment with acupuncture, and showed increased occlusal strength. Conclusions: This study suggests a functional improvement in the stomatognathic system in women with chronic cervical pain after treatment with acupuncture. However, it is important to note that further research is needed to fully elucidate the long-term effects and potential clinical implications of these findings in the field of pain management and rehabilitation

Reestablishment of occlusion through overlay removable partial dentures: a case report

Loss of posterior teeth may cause an imbalance in the stomatognathic system. Overlay removable partial dentures (ORPD) are a reversible and relatively inexpensive treatment for patients with severely worn teeth. This paper presents a treatment with ORPD in a 55-year-old male patient who had severe attrition in the maxillary and mandibular teeth, temporomandibular joint pain and reduced vertical dimension of occlusion (VDO). The treatment consisted in the reestablishment of the VDO using Lucia&#8217;s jig, fabricating removable partial denture with reconstruction of the worn teeth without preparation. This therapy can be used as an alternative treatment to provide esthetic, function and stable occlusion in patients with severely worn teeth

Immediate implants placed into infected sockets: a case report with 3-year follow-up

The esthetics and functional integrity of the periodontal tissue may be compromised by dental loss. Immediate implants became a viable option to maintain the periodontal architecture because of their anatomic compatibility with the dental socket and the possibility of eliminating local contamination. This article describes the procedure of immediate implant placement in the anterior maxilla replacing teeth with chronic periapical lesions, which were condemned due to endodontic lesions persisting after failed endodontic treatment and endodontic surgery, and discusses the relationship between the procedure and periapical lesions. Surgical removal of hopeless teeth 11, 12 and 21 was performed conservatively in such a way to preserve the anatomy and gingival esthetics. A second surgical access was gained at the apical level, allowing the debridement of the surgical chamber for elimination of the periapical lesion, visual orientation for setting of the implants and filling of the surgical chamber with xenogenous bovine bone graft. After this procedure, the bone chamber was covered with an absorbent membrane and the healing screws were positioned on the implants. Later, a provisional partial removable denture was installed and the implants were inserted after 6 months. After 3 years of rehabilitation, the implants present satisfactory functional and esthetic conditions, suggesting that immediate implant placement combined with guided bone regeneration may be indicated for replacing teeth lost due to chronic periapical lesions with endodontic failure history in the anterior maxilla.A integridade estética/funcional do tecido periodontal pode ser comprometida pela perda do elemento dental. Os implantes imediatos tornaram-se uma opção viável na manutenção da arquitetura periodontal, desde que haja a compatibilidade com o alvéolo e a possibilidade da contaminação local ser totalmente eliminada. O objetivo deste estudo foi descrever o procedimento de instalação de implantes imediatos na região anterior de maxila usados na reposição de dentes com lesões crônicas periapicais, discutindo a relação entre o procedimento e lesões periapicais. A remoção dos dentes condenados (11, 12 e 21) foi feita de forma conservadora a fim de preservar a estética e arquitetura periodontal. Um segundo acesso cirúrgico foi obtido a nível apical, permitindo: o debridamento da loja cirúrgica, orientação visual dos implantes e o preenchimento com enxerto ósseo bovino. A loja óssea foi coberta por uma membrana absorvível e uma prótese parcial removível provisória foi instalada e após 6 meses os implantes foram reabilitados. Após 3 anos de reabilitação, os implantes se apresentam em condições satisfatórias de estética/função, sugerindo que a instalação de implantes imediatos combinados com a regeneração tecidual guiada em lesões periapicais crônicas podem ser indicados para repor dentes perdidos devido a lesões periapicais crônicas com história de insucesso endodôntico na maxila anterior

Analysis of the sleep period and the amount of habitual snoring in individuals with sleep bruxism

The literature does not report any association between habitual snoring and sleep bruxism, but these situations can be a reason for frequent complaints of individuals, impairing the quality of life. This study was performed to investigate the sleep period and amount of habitual snoring in individuals with sleep bruxism observing expiratory, inspiratory, and mixed snoring. A total of 90 individuals were screened and divided into the following groups: with sleep bruxism (n=45) and those without sleep bruxism (n=45). Single night sleep polysomnography was performed to diagnose sleep bruxism, quantify habitual snoring and sleep period. The results were tabulated and submitted to a Multivariate analysis of variance (MANOVA) to compare the means of the two independent groups, considering the affected diagnosis of sleep bruxism, snoring (independent variables) and age as covariate. For the post hoc, was used correcting for multiple comparisons (Bonferroni test, P <.05). There was statistically significant difference among the groups ( p =.001) in the sleep period, in that individuals with sleep bruxism slept for a longer duration (with sleep bruxism group: 460 minutes and without sleep bruxism group: 401 minutes). There were no statistically significant differences among the groups for the number of inspiratory, expiratory and mixed snores, but was observed greater amount of snoring in the with sleep bruxism group. The main finding of this study is that individuals with sleep bruxism slept longer than the control group. It may also be suggested that individuals with sleep bruxism tended to increase the amount of habitual snoring during sleep

Mindfulness-based intervention reduces sensitivity parameters in women with chronic painful TMD

Objective: to analyze clinical parameters suggestive of central sensitization in women with chronic painful temporomandibular disorder before and after an intervention based on mindfulness. Method: Eleven women aged 27 to 44 years (36.36 ± 5.61), diagnosed with chronic painful TMD (Diagnostic Criteria for Temporomandibular Disorders), participated in the study. Hyperalgesia, allodynia and LDP pressure pain threshold were assessed at trigeminal and extra-trigeminal points before and after the mindfulness-based intervention, as well as the application of the MAAS questionnaire (Mindful Attention Awareness Scale ”- MAAS). The 8-week mindfulness program was offered to study participants, based on the Mindfulness Trainings International - MTI protocol, in weekly 2-hour sessions and a 4-hour session. Results: There was a significant reduction in allodynia, hyperalgesia and an increase in the pressure pain threshold, in addition to a significant increase in the level of mindfulness (p &lt;0.05) as a marker of effectiveness of the offered mindfulness-based intervention. Conclusion: Healthier indexes in clinical parameters suggestive of central sensitization investigated after the intervention, represent a significant improvement in the relationship of the person with a chronic illness that generates continuous unpleasant experiences such as TMDObjetivo: analizar parámetros clínicos sugestivos de sensibilización central en mujeres con trastorno temporomandibular doloroso crónico antes y después de una intervención basada en la atención plena. Método: Participaron once mujeres de 27 a 44 años (36.36 ± 5.61), diagnosticadas con TMD dolorosa crónica. La hiperalgesia, la alodinia y el umbral de dolor de presión de LDP se evaluaron en los puntos trigémino y extra-trigémino antes y después de la intervención basada en la atención plena, así como la aplicación del cuestionario MAAS (Escala de conciencia de atención consciente "- MAAS). El programa de atención plena de 8 semanas se ofreció a los participantes basado en el protocolo Mindfulness Trainings International - MTI, en sesiones semanales de 2 horas y una sesión de 4 horas. Resultados: Reducción en la alodinia, hiperalgesia y un aumento en el umbral de dolor por presión, además de un aumento en el nivel de atención plena (p &lt;0.05) como un marcador de efectividad de la intervención ofrecida. Conclusión: los índices más saludables en los parámetros clínicos sugestivos de sensibilización central investigados después de la intervención, representan una mejora significativa en la relación de la persona con una enfermedad crónica que genera experiencias continuas desagradables como TMD.Objetivo: analisar parâmetros clínicos sugestivos de sensibilização central em mulheres com disfunção temporomandibular dolorosa crônica antes e após uma intervenção baseada em mindfulness. Método: onze mulheres com idade entre 27 e 44 anos (36,36 ± 5,61), com diagnóstico de disfunções temporomandibulares dolorosa crônica (Diagnostic Criteria for Temporomandibular Disorders),participaram do estudo. A hiperalgesia, a alodinia e o limiar de dor à pressão foram avaliados em pontos trigeminais e extra-trigeminais antes e após a intervenção baseada em mindfulness, bem como a aplicação do questionário Mindful Attention Awareness Scale. O programa de mindfulness de 8 semanas foi oferecido às participantes do estudo, com base no protocolo Mindfulness Trainings International, em sessões semanais de 2 horas e uma sessão de 4 horas. Resultados: houve redução significativa da alodinia, da hiperalgesia e aumento do limiar de dor à pressão, além de aumento significativo do nível de atenção plena (p &lt; 0,05) enquanto marcador de efetividade da intervenção baseada em mindfulness oferecida. Conclusão: índices mais saudáveis nos parâmetros clínicos sugestivos de sensibilização central investigados após a intervenção, representam melhora significativa na relação da pessoa com quadro de enfermidade crônica geradora de experiências desagradáveis contínuas como a disfunções emporomandibulares

Electromyographic analysis of the masseter and temporalis muscles and bite force in a patient treated by functional maxillary orthopedics: a case report

This case report evaluated electromyographic activity of the masseter and temporalis muscles and molar bite force, before and after with functional orthopedic. A 65 years woman presenting with orofacial pain symptoms, cervical tension, condyle subluxation and osteoarthrosis. The patient was diagnosed with temporomandibular dysfunction and treated with use of a Simões Network 9 modified type functional maxillary orthopedics appliance. The Myosystem BR1 apparatus was used to analyze the electromyographic activity of the masseter and temporalis muscles. The maximum molar bite force was measured with the digital dynamometer (Kratus). This study showed increased EMG activity of the masseter and temporalis muscles in postural conditions of mandible and molar bite force after 12 months of treatment. After twelve months of treatment, the patient had lack of pain symptoms as well as an improvement in the balance of the mastication muscles, as demonstrated by EMG activity and maximum molar bite force