| 1. |
- Häggman Henrikson, Birgitta, et al.
(author)
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Temporomandibular Disorder Pain After Whiplash Trauma: A Systematic Review
- 2013
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In: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:3, s. 217-226
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Research review (peer-reviewed)abstract
- Aims: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. Methods: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Results: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). Conclusion: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.
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| 2. |
- Adèrn, Bengt, et al.
(author)
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Orsaker till remisser till bettfysiolog : en jämförelse mellan fyra specialistkliniker
- 2003
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In: Tandläkartidningen. - 0039-6982. ; 95:10, s. 50-55
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Journal article (other academic/artistic)abstract
- Specialistinstanser i bettfysiologi möter i huvudsak patienter som har en långvarig och svårt smärtproblematik. Under 1900-talet har dock även behandling av obstruktiv sömnapné tillkommit. Ofta är det en läkare som remitterat patienten till den bettfysiologiska kliniken. Denna studie visar att bettfysiologen är en viktig länk mellan tandvården och sjukvården vid utredning och behandling av orofacial smärta. Syf-tet med studien var att jämföra orsakerna till remisser till bettfysiologi. En jämförelse gjordes mellan fyra specialistkliniker i bettfysiologi un-der en 4-månadersperiod år 2001. De flesta remitterade patienter var kvinnor i åldern 20 år och uppåt. Bland de remitterade kvinnorna var smärta den dominerande orsaken medan männen lika ofta remittera-des för sömnstörning som för smärta. 86 procent av patienterna som remitterats för smärta värderade smärtans intensitet som måttlig till väldigt svår. Hos 80 procent av dessa patienter var smärtan långvarig.
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| 3. |
- Al-Harthy, Mohammad, et al.
(author)
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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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In: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
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Conference paper (other academic/artistic)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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| 4. |
- Al-Harthy, Mohammad, et al.
(author)
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Cross-cultural differences in types and beliefs about treatment in women with temporomandibular disorder pain
- 2018
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In: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 45:9, s. 659-668
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Journal article (peer-reviewed)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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| 5. |
- Al-Harthy, Mohammad, et al.
(author)
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Influence of culture on pain comorbidity in women with and without temporomandibular disorder-pain
- 2017
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In: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 44:6, s. 415-425
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Journal article (peer-reviewed)abstract
- Evidence on cultural differences in prevalence and impact of common chronic pain conditions, comparing individuals with temporomandibular disorders (TMD) versus individuals without TMD, is limited. The aim was to assess cross-cultural comorbid pain conditions in women with chronic TMD pain. Consecutive women patients (n = 122) with the index condition of chronic TMD pain diagnosed per the research diagnostic criteria for TMD and TMD-free controls (n = 121) matched for age were recruited in Saudi Arabia, Italy and Sweden. Self-report questionnaires assessed back, chest, stomach and head pain for prevalence, pain intensity and interference with daily activities. Logistic regression was used for binary variables, and ancova was used for parametric data analysis, adjusting for age and education. Back pain was the only comorbid condition with a different prevalence across cultures; Swedes reported a lower prevalence compared to Saudis (P < 001). Saudis reported higher prevalence of work reduced >50% due to back pain compared to Italians or Swedes (P < 001). Headache was the most common comorbid condition in all three cultures. The total number of comorbid conditions did not differ cross-culturally but were reported more by TMD-pain cases than TMD-free controls (P < 001). For both back and head pain, higher average pain intensities (P < 001) and interference with daily activities (P < 001) were reported by TMD-pain cases, compared to TMD-free controls. Among TMD-pain cases, Italians reported the highest pain-related disability (P < 001). Culture influences the associated comorbidity of common pain conditions. The cultural influence on pain expression is reflected in different patterns of physical representation.
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| 6. |
- Al-Harthy, Mohammad, et al.
(author)
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The effect of culture on pain sensitivity
- 2016
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In: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:2, s. 81-88
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Journal article (peer-reviewed)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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| 7. |
- Alkhateeb, Noor, et al.
(author)
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Patient-perceived features and clinical characteristics of tooth pain : A comparison between apical periodontitis and persistent dento-alveolar pain disorder (PDAP) – preliminary results
- 2017
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Conference paper (other academic/artistic)abstract
- Background: Differential diagnosis between tooth pain of inflammatory and neuropathic origin is crucial since treatment strategies differ. Aim: Evaluate and compare self-reported and clinically observed pain characteristics in patients with SAP (symptomatic apical periodontitis) and PDAP (persistent dento-alveolar pain disorder). Methodology: Patients diagnosed with SAP and PDAP were recruited from Malmö University and Folktandvården Östergötland. Data collection included clinical examination and questionnaire (tooth pain characteristics, verbal pain description [short-form McGill Pain Questionnaire; SF-MPQ], factors affecting the pain). Results: Data from 24 patients with SAP and 20 with PDAP (24 females, mean age 53 years) were analyzed. Average pain intensity was 4.4 (0–10 numeric rating scale) and average duration 1527 days. 64% reported continuous and 27% recurrent pain. 58% of teeth were tender to percussion and 66% to apical palpation. 27% reported concurrent pain from jaw muscles/joints. Significant differences were found for gender (% females; PDAP>SAP;p=0.013), pain duration (PDAP>SAP;p<0.0001), pain frequency (PDAP>SAP;p<0.001), percussion tenderness (SAP>PDAP;p=0.012), muscle/joint pain (PDAP>SAP;p=0.021). SF-MPQ and affecting factors did not differ (p=0.096–1.000). Conclusion: Preliminary results indicate that pain intensity, pain description and factors affecting the pain are similar for SAP and PDAP. Female gender, long pain duration, high pain frequency, and concurrent muscle/joint pain presented more frequently in PDAP.
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| 8. |
- Alsafi, Z, et al.
(author)
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Achieved competences in temporomandibular disorders/orofacial pain : a comparison between two dental schools in Europe
- 2015
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In: European journal of dental education. - : John Wiley & Sons. - 1396-5883 .- 1600-0579. ; 19:3, s. 161-168
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Journal article (peer-reviewed)abstract
- AIMS: The aim was to study achieved competences in temporomandibular disorders (TMD)/orofacial pain (OP) at two universities by comparing student's knowledge and understanding, satisfaction with their education and confidence in their clinical competences of TMD/OP. METHODS: The study was conducted in collaboration between Malmö University, Sweden-which uses problem-based learning-and the University of Naples Federico II, Italy-which uses traditional educational methods. Final-semester dental students responded to a self-report questionnaire regarding their knowledge and understanding, interpretation of cases histories, clinical experience, satisfaction and confidence in clinical examination, management and treatment evaluation. RESULTS: No significant difference was found between the students regarding knowledge and understanding. Eighty-seven per cent of the Malmö students and 96% of the Naples students met the criterion on achieved competence. Malmö students had a higher per cent of correct diagnoses than Naples students in the interpretation of case histories. Overall, Malmö students reported most clinical experience and higher confidence than Naple students. CONCLUSIONS: The main findings were that students from Malmö and Naples were, similar in knowledge and understanding of TMD/OP and in satisfaction with their clinical competences. However, Malmö students perceived more confidence in clinical management of patients with TMD/OP. This may reflect that, besides the theoretical part of the programme, a sufficient level of clinical exposure to patients with TMD/OP is essential to gain competences in TMD/OP
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| 9. |
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| 10. |
- Anderson, GC, et al.
(author)
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TMD Pain, Physical, and Emotional Functioning Related to Headache Frequency
- 2009
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Conference paper (other academic/artistic)abstract
- Temporormandibular disorders (TMD) and tension-type headaches (TTHA) share many signs and symptom and several studies have demonstrated an overlap between these conditions. Objectives: This study investigated the relationship of headache frequency with patient-reported TMD pain intensity, physical functioning, and emotional functioning in subjects with TTHA attributed to TMD. Methods: The RDC/TMD Validation Project, as a subset of 633 TMD cases, identified 153 subjects with concurrent TMD pain diagnoses (RDC/TMD myofascial pain or TMJ arthralgia) and TTHA (International Classification of Headache Disorders-II / ICHD-II) presenting in the temporal region. These subjects also demonstrated pain similar to their headache on provocation by palpation of the temporalis muscle. The headache diagnoses were sub-divided into infrequent episodic, frequent episodic, and chronic TTHA according to the ICHD-II. Outcomes of the study were self-report measures of jaw pain intensity (average pain intensity), physical functioning (Jaw Function Limitation Scale/JFLS, Ohrbach et al, 2008; Graded Chronic Pain Scale/GCPS, von Korff et al, 1992; Short Form -12/SF-12, Ware et al, 1996) and emotional functioning (depression, somatization, anxiety as measured by the Symptom Checklist-90/SCL-90). Differences in outcomes among the three headache subgroups were investigated using ANOVA. Results: Pain intensity in the temple and jaw regions was significantly associated with increased frequency of headache (p<0.01). Physical functioning as assessed with the JFLS (p<0.05) and the GCPS (p<0.01) were also significantly associated with headache frequency. Emotional functioning as assessed with the SCL-90 in terms of depression, somatization, and anxiety were all associated with frequency of headache (p<0.05). In general, the more frequent a subject's TTHA the more severe the levels of outcome. Conclusion: TMD pain intensity, physical functioning, and emotional functioning were associated with the frequency of TMD-related tension-type headache.
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