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| 2. |
- List, Thomas, et al.
(författare)
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Comparison of clinical signs in patients with episodic and chronic tension-type headache attributed to temporomandibular disorders. Preliminary results
- 2008
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Konferensbidrag (refereegranskat)abstract
- Aim: This study assessed (1) the sensitivity at trigeminal and non-trigeminal site in TMD patients with episodic (ETTH) and chronic tension type headache (CTTH) compared with healthy controls and (2) the relationship between familiar headache in the temples and provocation tests of the masticatory system in TMD patients with ETTH and CTTH. Materials and Methods: 153 TMD pain subjects and 84 healthy controls were enrolled in the study. Inclusion criterion for the TMD subjects was a RDC/TMD pain diagnosis (group I and III) and ETTH or CTTH diagnosed according to IHS criteria. Assessment variables were mandibular range of motion, masticatory muscle and TMJ tenderness, referred pain, pressure pain threshold (PPT), and provocation tests of the jaw. Results: PPT differed significantly between controls and TMD (ETTH and CTTH) patients at trigeminal and non-trigeminal sites (p < 0.001). Number of painful muscle sites increased significantly with headache frequency (p < 0.001). CTTH patients had significantly more sites with referred pain in the temples than ETTH patients (p < 0.03). Overall, 31% of ETTH and 57% of CTTH patients reported familiar headache in one or more of the provocation tests. Conclusion: TMD patients with ETTH and CTTH had increased sensitivity at trigeminal and non-trigeminal sites and more muscle tenderness compared with controls, which suggests involvement of peripheral and central sensitization. Overall, one-third of ETTH and over half of CTTH patients exhibited a causal temporal relationship with familiar headache in the temples following provocation tests.
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- Ohrbach, Richard, et al.
(författare)
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The jaw functional limitation scale : Development, reliability, and validity of 8-item and 20-item versions
- 2008
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 22:3, s. 219-230
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To develop the Jaw Functional Limitation Scale (JFLS), comprising 3 constructs and a global scale, based on a preliminary instrument, and to investigate content validity of the overall functional limitation construct, reliability, and generalizability. A temporomandibular disorders (TMD) patient group, compared to other diagnostic groups, was hypothesized to report further limitation in each of the 3 new proposed constructs. Methods: One hundred thirty-two consecutive patients from 5 diagnostic groups (TMD, primary Sjogren syndrome, burning mouth syndrome, skeletal malocclusion, and healthy controls) participated in a known-groups validity design. Fifty-two jaw functional limitation items were identified by an expert panel for content validity. Rasch methodology was used for item reduction and assessment of model fit. The instrument was retested 1 to 2 weeks later. Results: Three constructs (mastication, vertical jaw mobility, and emotional and verbal expression) comprising a total of 20 items were identified along with a global scale (the JFLS-20), and each exhibited excellent psychometric properties with respect to modeled variance, item fit, reliability, and internal consistency. The psychometric properties of each construct remained satisfactory when analyzed separately among the 5 diagnostic groups. Temporal stability was satisfactory. A shorter 8-item form (JFLS-8) also proved useful for assessing global functional jaw limitation. Conclusion: The JFLS-20 is an organ-specific instrument comprising 3 constructs for assessing functional status of the masticatory system, the 3 scales exhibit properties that are ideal for both research and patient evaluation in patient groups with a range of functional limitations of the jaw. The JFLS-8 emerged as a short form for measuring global functional limitation of the jaw.
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- Wahlund, Kerstin, et al.
(författare)
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The relationship between somatic and emotional stimuli: a comparison between adolescents with temporomandibular disorders (TMD) and a control group
- 2005
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Ingår i: European Journal of Pain. - : Elsevier Science B.V., Amsterdam. - 1090-3801 .- 1532-2149. ; 9:2, s. 219-227
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Tidskriftsartikel (refereegranskat)abstract
- The overall purpose of this study was to determine whether adolescents with chronic temporomandibular disorder (TMD) pain are more sensitive to all types of somatic and emotional stimuli compared with a matched healthy control group. Sixty adolescents, 8 boys and 52 girls ranging from 12 to 18 years, participated in the study. Thirty of the subjects exhibited TMD, reporting pain of at least 3 months duration. The age- and gender-matched control group consisted of 30 dental recall patients who reported TMD pain less than once a week. All participants completed a 40-item questionnaire comprising 10 items each of pleasant and aversive qualities crossed with somatic and emotional forms of stimuli The items, a selection of a broad range of familiar stimuli by a panel of experts, were rated based on intensity of experience (0-10, numerical rating scale). Well-fitting items that formed a valid construct within each of the four domains were selected using Rasch analysis The results showed that adolescents with TMD pain reported significantly greater sensitivity (p less than 0.05) to aversive somatic and pleasant somatic stimuli than the controls. The differences between groups for the aversive emotional and pleasant emotional stimuli were non-significant. These findings suggest that chronic TMD pain states in adolescents are accompanied by amplification of bodily, but not purely emotional stimuli and that cognitive systems are implicated, not only an alteration of the nociceptive systems.
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