Diagnosis of temporomandibular dysfunction subtypes in a population seeking specialized care
Diagnóstico dos subtipos de disfunção temporomandibular em uma população que busca atendimento especializado
Ludmila Maria Alves e Silva; Luciana e Silva Nobre; Luciane Lacerda Franco Rocha Rodrigues; Lidia Audrey Rocha Valadas; Thiago Bezerra Leite; António Sérgio Guimarães
Abstract
BACKGROUND AND OBJECTIVES: The goal of the present study was to assess the frequency of temporomandibular disorders (TMD) subtypes in individuals that search for specialized care, identifying the subtypes of TMD, muscular and/or articular, in addition to relating each subtype with variables such as gender and age.
METHODS: In this context, after a screening, 270 individuals, aged between 18 and 70 years, were selected. All data were acquired using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) instrument.
RESULTS: Among the 267 patients, 88.7% (n = 237) were female and 11.3% (n = 30) were male, with a mean age of 42±11.8 years. In this study, the predominance of joint/muscle TMD was evidenced (51.7%; n = 138), followed by only muscle TMD (47.5%; n = 127) and lastly, joint TMD (0.8%; n = 2). Important correlations (p> 0.05) were not identified when comparing TMD subtypes with the variables gender and age, according to chi-square test. By relating the diagnosis to the TMD subtype, it was evidenced that bilateral myalgia was the most prevalent in muscle TMD (n = 100; 37.4%) and articular/muscular (n = 112; 41.9%). The other variables did not show significant statistics, neither moderate nor strong correlation.
CONCLUSION: In this research, all TMD subtypes were found, with a clear predominance of joint/muscle type of TMD, followed by muscle only, especially in females aged between 39 and 48 years.
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Resumo
JUSTIFICATIVA E OBJETIVOS: O objetivo do presente estudo foi avaliar a frequência dos subtipos de disfunção temporomandibular (DTM) em indivíduos que buscaram atendimento especializado, identificando os subtipos da DTM, se muscular e/ou articular, além de relacionar cada subtipo com variáveis como sexo e faixa etária.
MÉTODOS: Neste contexto, após uma triagem, foram selecionados 270 indivíduos na cidade de Fortaleza/CE, com faixa etária entre 18 anos e 70 anos de idade. Todos os indivíduos foram avaliados por meio do instrumento Diagnostic Criteria for Temporomandibular Disorders (DC/TMD).
RESULTADOS: Entre os 267 pacientes, 88,7% (n = 237) foram do sexo feminino e 11,3% (n = 30) do masculino, com média de idade de 42 ± 11,8 anos. Neste estudo evidenciou-se a predominância de DTM articular/muscular (51,7%; n = 138), seguida de indivíduos com DTM somente muscular (47,5%; n = 127) e por último a articular (0,8%; n = 2). Não foram identificadas correlações importantes (p > 0,05), segundo o teste qui-quadrado, quando comparados os subtipos de DTM com as variáveis gênero e idade. Ao relacionar o diagnóstico com o subtipo de DTM, evidenciou-se que a mialgia bilateral foi a mais prevalente na DTM muscular (n = 100; 37,4%) e articular/muscular (n = 112; 41,9%). As demais variáveis não apontaram significância estatística nem correlação moderada ou forte.
CONCLUSÃO: Nesta pesquisa, foram encontrados todos os tipos de DTM, havendo um claro predomínio da DTM do tipo articular/muscular, seguida da somente muscular, especialmente em indivíduos do gênero feminino e de idade entre 39 e 48 anos.
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Referências
1 Barreto DDC, Barbosa ARC, Frizzo ACF. Relação entre disfunção temporomandibular e alterações auditivas. Rev CEFAC. 2010;12:1067-76.
2 Alajbeg IZ, Gikic M, Valentic-Peruzovic M. Changes in pain intensity and oral health-related quality of life in patients with temporomandibular disorders during stabilization splint therapy--a pilot study. Acta Clin Croat. 2014;53(1):7-16.
3 Chisnoiu AM, Picos AM, Popa S, Chisnoiu PD, Lascu L, Picos A, Chisnoiu R. Factors involved in the etiology of temporomandibular disorders-a literature review. Clujul Med. 2015; 88(4):473-8.
4 Jang JY, Kwon JS, Lee DH, Bae JH, Kim ST. Clinical signs and subjective symptoms of temporomandibular disorders in instrumentalists. Yonsei Med J. 2016;57(6):1500-7.
5 Cidrão ALM, Guimarães AS. Prevalence of temporomandibular dysfunction symptoms in dental surgeons. J Young Pharm. 2019;11(4):424-8.
6 Ohrbach R, Dworkin SF. The evolution of TMD diagnosis: past, present, future. J Dent Res. 2016;95(10):1093-101.
7 List T, Jensen RH. Temporomandibular disorders: old ideas and new concepts. Cephalalgia. 2017;37(7):692-704.
8 Ohrbach R, Slade GD, Bair E, Rathnayaka N, Diatchenko L, Greenspan JD, Maixner W, Fillingim RB. Premorbid and concurrent predictors of TMD onset and persistence. Eur J Pain. 2020;24(1):145-58.
9 De Leeuw R, Klasser GD (Eds). Orofacial pain. Guidelines for assessment, diagnosis, and management, 5th. Hanover Park: Quintessence Publishing Co; 2013. 129-30, 150, 151-154p.
10 Klasser DG, Leeuw De R. Orofacial Pain: Guidelines for Assessment, Diagnosis, and management. 6ª Ed. Chicago. Quintessence Publishing; 2018.
11 Leeuw R. Dor orofacial: guia de avaliação, diagnóstico e tratamento. 4ª ed. São Paulo: Quintessence; 2010.
12 Dantas AMX, Santos EJL, Vilela RM, Lucena LBS. Perfil epidemiológico de pacientes atendidos em um serviço de controle da dor orofacial. Rev Odontol UNESP. 2015;44(6):313-9.
13 Góes KRB, Grangeiro MTV, Figueiredo VMG. Epidemiologia da disfunção temporomandibular: uma revisão de literatura. J Dent Pub H. 2018;9(2):12-7.
14 Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91(6):378-86.
15 Fehrenbach J, da Silva BSG, Brondani LP. A associação da disfunção temporomandibular à dor orofacial e cefaleia. J Oral Investig. 2018;7(2):69-78.
16 Krasińska-Mazur M, Homel P, Gala A, Stradomska J, Pihut M. Differential diagnosis of temporomandibular disorders - a review of the literature. Folia Med Cracov. 2022;62(2):121-37.
17 Chan NHY, Ip CK, Li DTS, Leung YY. Diagnosis and treatment of myogenous temporomandibular disorders: a clinical update. Diagnostics (Basel). 2022;12(12):2914.
18 Carrara SV, Conti PCR, Barbosa JS. Termo do 1º Consenso em Disfunção Temporomandibular e Dor Orofacial. Dental Press J Orthod. 2010;15(3):114-20.
19 Ismail F, Eisenburger M, Lange K, Schneller T, Schwabe L, Strempel J, Stiesch M. Identification of psychological comorbidity in TMD-patients. Cranio. 2016;34(3):182-7.
20 Chen H, Slade G, Lim PF, Miller V, Maixner W, Diatchenko L. Relationship between temporomandibular disorders, widespread palpation tenderness, and multiple pain conditions: a case-control study. J Pain. 2012;13(10):1016-27.
21 Gonçalves DAG, Camparis CM, Speciali JG, Franco AL, Castanharo SM, Bigal ME. Temporomandibular disorders are differentially associated with headache diagnoses a controlled study. Clin J Pain. 2011;27(7):611-5.
22 Silva SRC, Leite CMC, Ferraz MAAL, Silva MFB, Souza TCS. Dor orofacial e qualidade de vida de adultos. Rev Odontol. Biol Central. 2013;21(56):421-5.
23 Donnarumma V, Ohrbach R, Simeon V, Lobbezoo F, Piscicelli N, Michelotti A. Association between waking-state oral behaviours, according to the oral behaviors checklist, and TMD subgroups. J Oral Rehabil. 2021;48(9):996-1003.
24 Pihut M, Kulesa-Mrowiecka M. The emergencies in the group of patients with temporomandibular disorders. J Clin Med. 2022;12(1):298.
25 Caruso S, Storti E, Nota A, Ehsani S, Gatto R. Temporomandibular joint anatomy assessed by CBCT images. Biomed Res Int. 2017;1(1)1-10.
26 Takahara N, Nakagawa S, Sumikura K, Kabasawa Y, Sakamoto I, Harada H. Association of temporomandibular joint pain according to magnetic resonance imaging findings in temporomandibular disorder patients. J Oral Maxillofac Surg. 2017;75(9):1848-55.
27 Valesan LF, Da-Cas CD, Réus JC, Denardin ACS, Garanhani RR, Bonotto D, Januzzi E, de Souza BDM. Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis. Clin Oral Investig. 2021;25(2):441-53.
28 Tjakkes GH, Reinders JJ, Tenvergert EM, Stegenga B. TMD pain: the effect on health related quality of life and the influence of pain duration. Health Qual Life Outcomes. 2010;8:46.
29 Naeije M, Te Veldhuis AH, Te Veldhuis EC, Visscher CM, Lobbezoo F. Disc displacement within the human temporomandibular joint: a systematic review of a ‘noisy annoyance’. J Oral Rehabil. 2013;40(2):139-58.
Submetido em:
20/11/2022
Aceito em:
10/02/2023