| 1. |
- Al-Harthy, Mohammad, et al.
(författare)
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Cross-cultural Comparison of Pressure Pain Threshold and Pain Tolerance Levels in TMD Cases and Controls : A Preliminary Report
- 2010
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Ingår i: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to assess the influence of culture on pain expression, pressure pain thresholds (PPTs), and pain tolerance levels (PTLs) in temporomandibular disorders (TMD) pain cases and pain-free matched controls in three cultures. Methods: This was a case-controlled study on 150 (50 Saudi Arabians, 50 Italians and 50 Swedes) cases of chronic TMD pain compared with 148 age- and gender-matched pain-free controls (50 Saudi Arabians, 50 Italians, and 48 Swedes). The cases and controls completed pain questionnaires and underwent clinical examinations per the Research Diagnostic Criteria for TMD (RDC/TMD) for classification status. PPT and PTL were measured on all participants with a pressure algometer (Somedic®) at a pressure increase rate of 30 kPa/s using a 1.0-cm diameter probe. Three body sites on the right side were investigated: the temporalis, masseter, and thenar muscles. The average of three measurements made at 1-min intervals was calculated for PPT and PTL. A one-way ANOVA compared mean values. Results: Mean characteristic pain severity among TMD cases was 54±(25) for the Saudi Arabian; 56±(20) for the Swedish; and 62.5±(21) for the Italian cases. Between-culture differences were non-significant. PPTs at the temporalis and masseter muscles in the TMD cases were highest in the Saudi Arabians compared to the Swedes and Italians (P<0.001). No between-culture differences among the TMD cases were found in the thenar muscle. Among controls, higher PPTs in the masseter muscle were found in Swedes and Saudi Arabians compared with Italians (P<0.001), while Swedes reported the highest PPT for the thenar compared with Saudi Arabians and Italians (P<0.001). No between-culture differences were observed at the temporalis muscle. PTLs at the masseter muscle in the TMD cases were similar for the Saudi Arabians and Swedes but significantly lower for the Italians (P<0.001). Thenar PTLs were significantly higher in the Swedes compared to the Italians (P<0.001). No significant between-culture differences among the TMD cases were found in the temporalis muscle. Among controls, similar PTLs were observed in the Swedes and Saudi Arabians for the temporalis and masseter muscles, while the Italians had significantly lower PTLs than these groups at the masseter muscles (P<0.01) and lower than the Swedes at the temporalis (P<0.001). A significantly higher thenar PTL was found among Swedes compared to Saudi Arabians and Italians (P<0.001). Cross-modality PPT based on clinical pain for TMD cases revealed significant differences between Saudi Arabians and both Swedes and Italians in the temporalis and masseter muscles (P<0.001). No significant differences were found in the thenar muscle. Conclusions: Preliminary data suggest that Saudis and Swedes are more similar in PPT and PTL than Italians are to either group, indicating that cultural factors may influence pain perception.
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| 2. |
- Al-Harthy, Mohammad, et al.
(författare)
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Cross-cultural differences in types and beliefs about treatment in women with temporomandibular disorder pain
- 2018
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:9, s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesWomen with temporomandibular disorder (TMD) pain from three cultures were assessed for type of treatment received and core illness beliefs. MethodsIn a clinical setting, 122 women patients with chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) were evaluated for patient characteristics, type of practitioner, type of treatment received and beliefs about TMD prior to consultation in TMD specialist centres. Measures included a survey of treatments received and a belief scale regarding contributing, aggravating and treatment-relevant factors related to the pain. All questionnaires were translated from English and culturally adapted. Comparisons among cultural groups were performed using a linear regression model for continuous variables and logistic regression model for dichotomous variables. A P-value
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| 3. |
- Al-Harthy, Mohammad, et al.
(författare)
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The effect of culture on pain sensitivity
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:2, s. 81-88
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Tidskriftsartikel (refereegranskat)abstract
- Cross-cultural differences in pain sensitivity have been identified in pain-free subjects as well as in chronic pain patients. The aim was to assess the impact of culture on psychophysical measures using mechanical and electrical stimuli in patients with temporomandibular disorder (TMD) pain and pain-free matched controls in three cultures. This case-control study compared 122 female cases of chronic TMD pain (39 Saudis, 41 Swedes and 42 Italians) with equal numbers of age- and gender-matched TMD-free controls. Pressure pain threshold (PPT) and tolerance (PPTo) were measured over one hand and two masticatory muscles. Electrical perception threshold and electrical pain threshold (EPT) and tolerance (EPTo) were recorded between the thumb and index fingers. Italian females reported significantly lower PPT in the masseter muscle than other cultures (P < 0001) and in the temporalis muscle than Saudis (P = 0003). Swedes reported significantly higher PPT in the thenar muscle than other cultures (P = 0017). Italians reported significantly lower PPTo in all muscles than Swedes (P 0006) and in the masseter muscle than Saudis (P < 0001). Italians reported significantly lower EPTo than other cultures (P = 001). Temporomandibular disorder cases, compared to TMD-free controls, reported lower PPT and PPTo in all the three muscles (P < 0001). This study found cultural differences between groups in the PPT, PPTo and EPTo. Overall, Italian females reported the highest sensitivity to both mechanical and electrical stimulation, while Swedes reported the lowest sensitivity. Mechanical pain thresholds differed more across cultures than did electrical pain thresholds. Cultural factors may influence response to type of pain test.
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| 4. |
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| 5. |
- Cairns, Brian, et al.
(författare)
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JOR-CORE recommendations on rehabilitation of temporomandibular disorders
- 2010
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Ingår i: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 37:6, s. 481-489
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Tidskriftsartikel (refereegranskat)abstract
- In the long history of temporomandibular disorders (TMD), the term ”rehabilitation“ has been often associated with ”occlusal rehabilitation“ indicating a specific philosophy in which occlusion is the crucial factor for TMD and that intervention on the occlusion could ”cure“ the problem. In this paper, the term rehabilitation is used to denote any medical, physical, or psychological treatment which brings or restores an individual to a normal or optimal state of health, and this revised concept therefore significantly broadens the scope of rehabilitation of TMD. The purpose of the JOR-CORE in Siena, 2009 was to critically examine the current state-of-the-science in the field of TMDs. This lead to four extensive reviews and the present summaries and recommendations for future research into rehabilitation of TMDs.
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| 6. |
- Durham, Justin, et al.
(författare)
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Constructing the brief diagnostic criteria for temporomandibular disorders (bDC/TMD) for field testing
- 2024
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 51:5, s. 785-794
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings.Objective: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management.Methods: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium.Results: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment.Conclusion: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.
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| 7. |
- Durham, Justin, et al.
(författare)
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Self-management programmes in temporomandibular disorders : results from an international Delphi process
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:12, s. 929-936
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Forskningsöversikt (refereegranskat)abstract
- Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management. In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of self-management, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM.
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| 8. |
- Ekberg, EwaCarin, et al.
(författare)
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Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations : Comprehensive and short-form adaptations for adolescents.
- 2023
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 50:11, s. 1167-1180
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers, and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents, and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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| 9. |
- Häggman-Henrikson, Birgitta, et al.
(författare)
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Whiplash-Associated Disorders
- 2017
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Ingår i: Clinical Cases in Orofacial Pain. - : John Wiley & Sons. - 9781119194798 ; , s. 154-160
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Expand your knowledge and put it into practice with this unique, case-based guide Clinical Cases in Orofacial Pain is a valuable resource for undergraduate dental students as well as residents working towards board certification. Individual cases cover temporomandibular joint disorders, masticatory muscle disorders, headache, neuropathic pain, dental pain, tooth wear, and dystonia. Following the popular Clinical Cases series style, cases are presented with associated academic commentary, including background information, diagnostic criteria and fundamental points that might influence the diagnosis, treatment planning or management of the case. Well-illustrated throughout, each chapter features self-assessment study questions to help foster independent learning. Clinical Cases in Orofacial Pain is an excellent primer for undergraduate dental students and an invaluable study guide for postgraduate students and residents. Dental practitioners will also want to keep this unique, case-based guide as a ready reference in their working libraries.
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| 10. |
- Lindfors, Erik, et al.
(författare)
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Jaw Exercises in the Treatment of Temporomandibular Disorders : An International Modified Delphi Study
- 2019
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Ingår i: Journal of oral & facial pain and headache. - : Quintessence Publishing. - 2333-0376 .- 2333-0384. ; 33:4, s. 389-398
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether an international consensus exists among TMD experts regarding indications, performance, follow-up, and effectiveness of jaw exercises.Methods: A questionnaire with 31 statements regarding jaw exercises was constructed. Fourteen international experts with some geographic dispersion were asked to participate in this Delphi study, and all accepted. The experts were asked to respond to the statements according to a 5-item verbal Likert scale that ranged from “strongly agree” to “strongly disagree.” The experts could also leave free-text comments, which was encouraged. After the first round, the experts received a compilation of the other experts’ earlier responses. Some statements were then rephrased and divided to clarify the essence of the statement. Subsequently, the experts were then asked to answer the questionnaire (32 statements) again for the second round. Consensus was set to 80% agreement or disagreement.Results: There is consensus among TMD experts that jaw exercises are effective and can be recommended to patients with myalgia in the jaw muscles, restricted mouth opening capacity due to hyperactivity in the jaw closing muscles, and disc displacement without reduction. The patients should always be instructed in an individualized jaw exercise program and also receive both verbal advice and written information about the treatment modality.Conclusion: This Delphi study showed that there is an international consensus among TMD experts that jaw exercises are an effective treatment and can be recommended to patients with TMD pain and disturbed jaw function.
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