Signs and Symptoms of Temporomandibular Dysfunction in Fibromyalgic Patients

Fraga, Byanka Porto; Santos, Emanuella Barros dos; Neto, Jader P. Farias; Macieira, José Caetano; Quintans‐Júnior, Lucindo José; Onofre, Alexandre Sherlley Casimiro; DeSantana, Josimari Melo; Martins-Filho, Paulo Ricardo; Bonjardim, Leonardo Rigoldi

doi:10.1097/scs.0b013e31824cd81a

Cited by 39 publications

(45 citation statements)

References 18 publications

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“…A study on patients with fibromyalgia [19] showed that the most common signs are pain in masticatory muscles, in the TMJ, articular click in jaw opening; the aforementioned study defined cephalea and facial pain as symptoms; moreover, the prevalence of; myofascial pain was found.…”

Section: Discussionmentioning

confidence: 99%

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients

Corsalini¹,

Venere²,

Rapone³

et al. 2017

TODENTJ

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Objective:The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia.Materials and Method:The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari.Results:24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients).Conclusion:Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients

Corsalini¹,

Venere²,

Rapone³

et al. 2017

TODENTJ

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“…The conclusion was that the comorbidity between TMD and fibromyalgia is due to central sensitization, with high levels of substance P and growth factor causing a compromise in thalamic function (21). That same year, Fraga et al concluded that MTMD should be included as diagnostic criteria in fibromyalgia (22). 29% of MTMD patients refer the presence of Dizziness/Vertigo vs 19.4% in the control group.…”

Section: Discussionmentioning

confidence: 99%

Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample

Pedro

Mesa-Jiménez²,

Fernández‐de‐las‐Peñas³

et al. 2016

Med Oral

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BackgroundMyogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping.ObjetivesThe aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups.Material and MethodsRestrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions.ResultsIt was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain.ConclusionsThese results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual’s Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual’s medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering. Key words:Temporomandibular joint disorders, myofascial pain syndromes, comorbidity, chronic pain, health status, health questionnaire, self report.

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“…Using this classification, almost all patients with FM are women because they have more tender points than do men [4]. Overall, FM symptoms lead to significant reduction in functional capacity and quality of life [2, 5, 6]. Developing treatment teams is useful, including clinicians with expertise in patient education, exercise training interventions, and cognitive behavioral therapy [7–9].…”

Section: Introductionmentioning

confidence: 99%

“…A key issue is the association of FM with other musculoskeletal comorbidities, such as temporomandibular dysfunction (TMD) [5]. It has been shown that TMD can develop as a result of mandibular compression during daily living activities and sleep in the patients with FM [5–7], in which the coexistence of these pathologies generates a clinical outcome of high complexity [8].…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown that TMD can develop as a result of mandibular compression during daily living activities and sleep in the patients with FM [5–7], in which the coexistence of these pathologies generates a clinical outcome of high complexity [8]. Unfortunately, no published studies of patients with FM and TMD have evaluated an effective pharmacologic and/or nonpharmacologic therapeutic intervention.…”

Section: Introductionmentioning

confidence: 99%

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Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial

Silva

Albertini

Leal-Junior

et al. 2015

Trials

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BackgroundFibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin.Methods/DesignA randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay.DiscussionThis is the first randomized controlled trial in which the role of phototherapy, exercise training, and a combination of these interventions will be evaluated for chronic pain in patients with FM and TMD. The results will offer valuable clinical evidence for objective assessment of the potential benefits and risks of procedures.Trial registrationClinicalTrials.gov Identifier: NCT02279225. Registered 27 October 2014.

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Signs and Symptoms of Temporomandibular Dysfunction in Fibromyalgic Patients

Abstract: Thus, there is a high prevalence of signs and symptoms of TMD in FM patients, indicating the need for an integrated diagnosis and treatment of these patients, which suggest that the FM could be a medium- or long-term risk factor for the development of TMD.

Cited by 39 publications

References 18 publications

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients

Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients

Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample

Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial

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