SUMMARY OBJECTIVE: This study aimed to assess the prevalence of temporomandibular dysfunction in ankylosing spondylitis patients and healthy controls, examining the relationship between temporomandibular dysfunction and disease activity in ankylosing spondylitis patients, as well as associations with psychosocial factors. METHODS: The study included 113 ankylosing spondylitis patients and 110 healthy individuals aged 18–75. Temporomandibular dysfunction presence was evaluated using Diagnostic Criteria for Temporomandibular Disorders Axis I. Disease activity was assessed with the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, and Bath Ankylosing Spondylitis Functional Index. RESULTS: Among healthy individuals, 60.9% did not receive a temporomandibular dysfunction diagnosis, while 39.1% received at least one diagnosis. In contrast, 69.9% of the 113 ankylosing spondylitis patients received at least one temporomandibular dysfunction diagnosis, and only 30.1% were not included in any diagnosis group (p<0.001). Joint (p=0.001) and pain disorders (p=0.008) were significantly more common in the ankylosing spondylitis group than in the healthy controls. Significant associations emerged between Bath Ankylosing Spondylitis Disease Activity Index (p<0.001) and Bath Ankylosing Spondylitis Functional Index (p=0.005) scores and pain disorders. CONCLUSION: Temporomandibular dysfunction is more prevalent in ankylosing spondylitis patients than in healthy individuals, linked to increased joint issues and pain associated with disease activity. ClinicalTrials.gov ID: NCT05839925. OBJECTIVE controls factors METHODS 11 1875 18 75 18–75 I RESULTS 609 60 9 60.9 391 39 1 39.1 contrast 699 69 69.9 301 30 30.1 p<0.001. p0001 p p<0.001 . 0 001 p=0.001 (p=0.001 p=0.008 p0008 008 (p=0.008 (p<0.001 p=0.005 p0005 005 (p=0.005 CONCLUSION ClinicalTrialsgov ClinicalTrials gov ID NCT05839925 NCT 187 7 18–7 6 60. 3 39. 69. 30. p000 p<0.00 00 p=0.00 (p=0.00 (p<0.00 NCT0583992 18– p00 p<0.0 p=0.0 (p=0.0 (p<0.0 NCT058399 p0 p<0. p=0. (p=0. (p<0. NCT05839 p<0 p=0 (p=0 (p<0 NCT0583 p< p= (p= (p< NCT058 (p NCT05 NCT0

Abstract Aim The bifid mandibular condyle is a morphological alteration of the temporomandibular joint in which the condyle has a groove on its upper surface that generates two condylar heads. This alteration can be unilateral or bilateral. Most bifid mandibular condyles are detected by panoramic radiographs, however, Cone Beam computed tomography of the temporomandibular joint is considered the test of choice for the diagnosis of this alteration. The purpose of this work is to present a case of bilateral bifid mandibular condyle, incidentally detected by Cone Beam computed tomography requested for a presumptive diagnosis of osteoarthritis. Clinical case A 22-year old female patient with no history of craniofacial trauma requests a Cone Beam computed tomography of the temporomandibular joints due to a presumptive diagnosis of osteoarthritis. In the volume exploration, bifid mandibular condyles were found with two condylar heads, medial and lateral bilaterally, being more accentuated in the right condyle.

Resumen Objetivo El cóndilo mandibular bífido es una alteración morfológica de la articulación temporomandibular en la que el cóndilo presenta un surco en la superficie superior que genera dos cabezas condilares. Esta alteración puede ser unilateral o bilateral. La mayoría de los cóndilos mandibulares bífidos se detectan mediante radiografías panorámicas, sin embargo, la tomografía computarizada Cone Beam de articulación temporomandibular es considerado el examen de elección para el diagnóstico de esta alteración. El propósito de este trabajo es presentar un caso de cóndilo mandibular bífido bilateral detectado incidentalmente mediante una tomografía computarizada Cone Beam solicitada por un diagnóstico presuntivo de osteoartritis. Caso clínico Una paciente de 22 años sin antecedentes de traumatismos cráneo faciales solicita una tomografía computarizada Cone Beam de articulaciones temporomandibulares por diagnóstico presuntivo de osteoartritis. En la exploración del volumen se encontraron cóndilos mandibulares bífidos con dos cabezas condilares, medial y lateral de forma bilateral, siendo más acentuado en el cóndilo derecho.

JUSTIFICATIVA E OBJETIVOS: A disestesia oclusal, também chamada de síndrome da mordida fantasma, é caracterizada por discrepâncias oclusais persistentes e não verificáveis clinicamente. Em 1976 a literatura relatou os dois primeiros casos, porém a abordagem do tratamento tem sido baseada apenas no conhecimento incompleto da etiologia, em que nenhuma das teorias propostas é totalmente explicada em todos os casos disponíveis. O objetivo desta revisão é mostrar as hipóteses sobre a etiologia, diagnóstico e tratamento da disestesia oclusal. MÉTODOS: A revisão da literatura pesquisou as seguintes bases de dados: NCBI/PubMed (National Center for Biotechnology Information) e Scielo (Scientific Electronic Library Online). Na estratégia de busca foram utilizados os seguintes descritores: Disestesia oclusal OR mordida fantasma AND Distúrbios da articulação temporomandibular em português e inglês. Foram encontrados um total de 166 artigos, destes 18 atenderam os critérios de elegibilidade. RESULTADOS: Etiologicamente a disestesia oclusal pode relacionar-se com desordens psiquiátricas, fenômeno do membro fantasma e alterações do input proprioceptivo.  O critério diagnóstico propõe avaliar as queixas de mordida desconfortável por mais de 6 meses, sensação de desconforto ao morder, ausência de discrepância oclusal, sofrimento emocional associado, falhas em vários procedimentos odontológicos. Dentre diversas modalidades de tratamentos, a terapia mais aceita é a medicamentosa com uso de antidepressivos como o milnaciprano. CONCLUSÃO: Em pacientes com queixas oclusais persistentes, o diagnóstico deve considerar a disestesia oclusal. A abordagem terapêutica deve ser realizada por uma equipe interdisciplinar, que inclui além do cirurgião dentista, psiquiatras e psicólogos ​​com experiência nesta área.

BACKGROUND AND OBJECTIVES: Occlusal dysesthesia, also called phantom bite syndrome, is characterized by persistent and clinically unverifiable occlusal discrepancies. In 1976, the literature reported the first two cases, but the treatment approach has been based only on incomplete knowledge of the etiology, in which none of the proposed theories is fully explained in all available cases. The objective of this review is to show hypotheses about the etiology, diagnosis and treatment of occlusal dysesthesia. METHODS: A literature search was performed in the following databases: NCBI/PubMed (National Center for Biotechnology Information) and Scielo (Scientific Electronic Library Online). The following descriptors were used in the search strategy: occlusal dysesthesia OR phantom bite AND temporomandibular joint disorders in Portuguese and English. A total of 166 articles were found, of which 18 met the eligibility criteria. RESULTS: Etiologically, occlusal dysesthesia may be related to psychiatric disorders, phantom limb phenomenon and changes in proprioceptive input. The diagnostic criteria propose to evaluate the complaints of uncomfortable bite for more than 6 months, feeling of discomfort when biting, absence of occlusal discrepancy, associated emotional suffering, and failures in several dental procedures. Among several treatment modalities, the most accepted therapy is medication with the use of antidepressants such as milnacipran. CONCLUSION: In patients with persistent occlusal complaints, the diagnosis should consider occlusal dysesthesia. The therapeutic approach must be carried out by an interdisciplinary team, which includes, in addition to the dental surgeon, psychiatrists and psychologists with experience in this area.

Abstract The temporomandibular joint (TMJ) is a mobile synovial joint that articulates the temporal bone, particularly the articular tubercle and the glenoid fossa, with the condyle of the mandibular bone. Inside it, there is an articular disc that divides the cavity into two compartments, which act as a functional unit. To correctly evaluate the status of the TMJ, it is necessary to know its normal anatomy and function. In addition, one must be familiar with the imaging findings present in magnetic resonance imaging (MRI), which must be correlated with the physical examination and clinical symptoms, to reach an accurate diagnosis. Temporomandibular disorders (TMD) are a heterogeneous set of pathologies that involve the TMJ complex and adjacent bone and muscular structures. MRI is considered the gold-standard imaging technique to evaluate TMD. This technique provides information on the anatomical and functional characteristics, in addition to adequately characterizing the different pathological processes and the response to treatment.

Resumen La articulación temporomandibular (ATM) es una articulación sinovial móvil que articula el hueso temporal, particularmente el tubérculo articular y la fosa glenoidea, con el cóndilo del hueso mandibular. En su interior existe un disco articular que divide la cavidad en dos compartimentos, los cuales actúan como una unidad funcional. Para evaluar correctamente el estado de la ATM es necesario conocer su anatomía normal y funcionamiento. Además, se debe estar familiarizado con los hallazgos imagenológicos presentes en la resonancia magnética (RM), los cuales deben ser correlacionados con el examen físico y la clínica, para así llegar a un diagnóstico certero. Los trastornos temporomandibulares (TTM) son un conjunto heterogéneo de patologías que involucran al complejo de la ATM y las estructuras óseas y musculares adyacentes. La RM se considera la técnica imagenológica de preferencia para evaluar los TTM. Esta proporciona información sobre las características anatómicas y funcionales, además de caracterizar adecuadamente los diferentes procesos patológicos y la respuesta al tratamiento.

INTRODUCTION: Myofascial Pain Syndrome (MFPS) of the head and neck is a frequently misdiagnosed cause of Temporomandibular Disorders (TMDs). In South Africa, literature regarding general dental practitioners' (GDPs) knowledge/management of TMDs associated with MFPS is limited AIM: To determine perceived knowledge and treatment practices of GDPs on TMDs associated with MFPS DESIGN/METHODS: A researcher-developed questionnaire consisting of sections on demographics, education/training, perceived knowledge and treatment/management, including referral practices, was conducted on GDPs registered with the Health Professions Council of South Africa, sampled through this database RESULTS: More than three-quarters (n=40; 76.9%) of GDPs received MFPS training at the undergraduate level with 78.8% (n=41) dissatisfied with their knowledge and 57.7% (n=30) having attended postgraduate training. More than two-thirds (69.2%; n=36) referred patients to other healthcare professionals - mostly dental specialists (83.3%; n=30). Adjusted logistic regression revealed that those with adequate knowledge of MFPS were 6.52 times more likely to refer patients to other health practitioners than those with inadequate knowledge (OR=6.5, p=0.28, B=1.88); 73.1% (n=38) would consider such co-management strategies CONCLUSION: This study highlights the gap in GDPs' perceived knowledge in MFPS and TMDs. Supplementary training and mutual referral between allopathic and alternative medical professions is recommended for a more integrated treatment approach

ABSTRACT Introduction: Anterior teeth have a predominant function in the stomatognatic system, essential for the aesthetics, phonation and mastication. Objective: To characterize adults with anterior guide of dysfunctional dental occlusion according to clinical and epidemiological variables. Methods: A descriptive and cross-sectional study, was carried out from October, 2021 to April, 2022, in the 3 de Octubre Teaching Stomatological Clinic from Las Tunas. The universe was formed by 825 medical records that contained the diagnosis of patients with bruxism, traumatic occlusion and temporomandibular disorders who presented anterior guide of the dysfunctional dental occlusion. By means of the intentional non probabilistic sampling, a sample of 615 with entire dental formula or class III partial toothlessness of Kennedy and concluded stomatologic care or inactivation of the cavity and acute inflammatory processes was selected. Results: There was a prevalence of the female sex (54.8%) and the 40-49 age group (33.5%). Bruxism prevailed as clinical diagnosis (41.9%) with prevalence of the corresponding to sleep (39.1%), secondary (51.2%), probable (59.7%) and moderate (69.4%); among the most outstanding classifications was the dysfunctional stomatognatic system (84.4%). The predominant dental clinical manifestations were the wear facets (87.5%). Conclusions: The characterization of patients with anterior guide of the dysfunctional dental occlusion allows to establish an up-to-date panoramic of this health problem, for a better follow-up and treatment to these patients.

RESUMEN Introducción: Los dientes anteriores tienen una función predominante en el sistema estomatognático, esencial para la estética, la fonación y la masticación. Objetivo: Caracterizar a los adultos con guía anterior de la oclusión dentaria disfuncional según variables clínicas y epidemiológicas. Métodos: Se realizó un estudio descriptivo y transversal, desde octubre de 2021 hasta abril de 2022, en la Clínica Estomatológica Docente 3 de Octubre de Las Tunas. El universo estuvo conformado por 825 historias clínicas que contenían el diagnóstico de pacientes con bruxismo, oclusión traumática y trastornos temporomandibulares, quienes presentaban disfunción de la guía anterior de la oclusión dentaria. Mediante el muestreo no probabilístico intencional, fue seleccionada una muestra de 615 con fórmula dentaria íntegra o desdentamiento parcial de clase III de Kennedy y atención estomatológica concluida o inactivación de los procesos de caries e inflamatorios agudos. Resultados: Primaron el sexo femenino (54,8 %) y las edades de 40-49 años (33,5 %). El bruxismo prevaleció como diagnóstico clínico (41,9 %) con predominio del correspondiente al sueño (39,1 %), el secundario (51,2 %), el probable (59,7 %) y el moderado (69,4 %); entre sus clasificaciones más relevantes se destacó el sistema estomatognático disfuncional (84,4 %). Las manifestaciones clínicas dentarias predominantes fueron las facetas de desgaste (87,5 %). Conclusiones: La caracterización de los pacientes con guía anterior de la oclusión dentaria disfuncional permite establecer una panorámica actualizada de esta problemática de salud para un mejor seguimiento y tratamiento a dichos pacientes.

ABSTRACT: Nowadays it is very common to receive patients in the dental clinic reporting unilateral or bilateral pain in the lateral area of the face, more specifically in the mandibular rami area. The origin of this pain can often be dental, muscular, from the temporomandibular joint or even tonsillar. Because the named pathologies are more frequent, many times the clinician does not consider that the cause of this pain could be associated with Eagle syndrome. This research was based on the need to use panoramic radiographs as a tool to associate pain that does not refer to conventional treatments with calcifications of the stylohyoid complex, many times radiographic findings that are not commonly considered by the clinician. This correlational cross analytical study was carried out at San Sebastián University Health Center. A random sample of 815 radiographs and associated clinical records was taken, in which the presence, type and location of calcifications of the stylohyoid complex were analyzed, as well as whether the patients reported painful symptoms associated with Eagle syndrome. Subsequently, a descriptive, exploratory, and inferential analysis of association between variables was conducted. The percentage of patients who presented calcifications of the stylohyoid complex reached 85.4%, being the majority the elongated type (70.98%), followed by the segmented type (26.72%) and far below the pseudoarticulated type (2.3%). Regarding the prevalence of symptoms, the vast majority of patients did not present (96.32%), without seeing differences according to gender or age. Finally, when performing the association analysis, the calculated X2 value was 3.171, lower than the critical tabulated X2 value of 3.841. Obtaining a calculated X2 lower than a critical tabulated X2 showed that there is no association between the presence of calcifications of the stylohyoid complex and associated clinical symptoms. In addition, the prevalence of calcifications and their types did not vary according to age or gender, which did not allow us to establish a causal relationship between the variables.

RESUMEN: Hoy en día es común recibir pacientes en la clínica odontológica relatando dolor uni o bilateral en la zona lateral de la cara, más específicamente en la zona de las ramas mandibulares. Este dolor puede ser muchas veces de origen dental, muscular masticatorio, de las articulaciones temporomandibulares, o incluso tonsilar. Debido a que las anteriores son patologías más frecuentes, muchas veces el clínico no considera que la causa de estos dolores podría estar asociada al síndrome de Eagle. Esta investigación se fundamentó en la necesidad de utilizar las radiografías panorámicas como herramienta para asociar dolores que no remiten a tratamientos convencionales a calcificaciones del complejo estilohioideo, muchas veces hallazgos radiográficos que no son comúnmente tomados en consideración por el clínico. El objetivo del estudio fue eterminar la asociación entre calcificaciones del complejo estilohioideo en radiografías panorámicas y sintomatología clínica dolorosa en pacientes del centro de salud de la Universidad San Sebastián, sede Santiago, Chile. Se realizó un estudio correlacional, analítico y retrospectivo en el Centro de Salud de la Universidad San Sebastián. Se tomó una muestra aleatoria de 815 radiografías y fichas clínicas asociadas, en las cuáles se analizó la presencia, tipo y ubicación de calcificaciones del complejo estilohioideo, así como, si los pacientes relataron sintomatología dolorosa asociable al Síndrome de Eagle. Posteriormente se realizó un análisis descriptivo, exploratorio e inferencial de asociación entre variables. El porcentaje de pacientes que presentó calcificaciones del complejo estilohioideo alcanzó un 85,4%, siendo la mayoría de tipo elongado (70,98%), seguida del tipo segmentado (26,72%) y muy por debajo el tipo pseudoarticulado (2,3%). Con respecto a la prevalencia de sintomatología la gran mayoría de los pacientes no presentó (96,32%), sin verse diferencias según sexo o edad. Por último, al realizar el análisis de asociación el valor de X 2 calculado fue de 3,171, menor al valor de X2 crítico tabulado de 3,841. Al obtener un X2 calculado menor a un X2 crítico tabulado se demostró que no existe una asociación entre la presencia de calcificaciones del complejo estilohioideo y sintomatología clínica asociada. Además, las prevalencias de calcificaciones y sus tipos no variaron según la edad o género, lo que no nos permitió establecer una relación causal entre las variables.

Abstract During oral surgery and temporomandibular joint repositioning, pain hypersensitivity often occurs due to irritation or inflammation of the nerve endings in the orofacial region. Objective: This study aimed to investigate the effects of ECa 233, a Centella asiatica–standardized extract, on the development of mechanical hyperalgesia and allodynia induced by chronic constriction injury of the infraorbital nerve in mice. Methodology: The right infraorbital nerves of the mice were ligated. Oral carbamazepine (20 mg/kg) or ECa 233 (30, 100, or 300 mg/kg) was administered daily for 21 days. Von Frey and air-puff tests were performed on both sides of the whisker pad on days 0, 7, 14, and 21. Thereafter, the expression of purinergic receptor subtype 3 (P2X3) and voltage-gated sodium channel 1.7 (NaV1.7), a transmembrane protein, in the trigeminal ganglion and c-fos immunoreactivity-positive neurons in the trigeminal nucleus caudalis was assessed. Results: After 21 days of infraorbital nerve ligation, the mice showed allodynia- and hyperalgesia-like behavior, P2X3 and NaV1.7 were upregulated in the trigeminal ganglion, and nociceptive activity increased in the trigeminal nucleus caudalis. However, the oral administration of carbamazepine (20 mg/kg), ECa 233 (100 mg/kg), or ECa 233 (300 mg/kg) mitigated these effects. Nevertheless, ECa 233 failed to affect NaV1.7 protein expression. Conclusion: Carbamazepine and ECa 233 can prevent pain hypersensitivity in mice. Considering the side effects of the long-term use of carbamazepine, ECa 233 monotherapy or combined ECa 233 and carbamazepine therapy can be used as an alternative for regulating the development of hypersensitivity in trigeminal pain. However, further detailed clinical studies should be conducted to provide comprehensive information on the use of ECa 233. repositioning region Objective asiaticastandardized asiatica standardized extract Methodology ligated 20 (2 mg/kg mgkg mg kg 23 30, 30 (30 100 2 airpuff air puff 0 7 14 Thereafter PX P X (P2X3 voltagegated voltage gated 17 1 1. NaV1.7, NaV17 NaV , NaV1 (NaV1.7) cfos c fos immunoreactivitypositive immunoreactivity positive assessed Results ligation hyperalgesialike like behavior P2X NaV1. However mg/kg, (10 Nevertheless Conclusion longterm long term ( (3 10 (P2X (NaV1.7 (1 (NaV1. (NaV1 (NaV

Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student’s t-test, Mann–Whitney U test, non-parametric Friedman’s analysis of variance for paired samples and pairwise multiple comparisons, Pearson’s chi-square test, two-proportion z-test, non-parametric McNemar’s and Cochran’s Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism. lowcost, lowcost low cost, cost low-cost (MOS 4 conditions (ROS n 23 20 groups (TMJ visual scale, scale , scale) WHOQOLBREF, WHOQOLBREF WHOQOL BREF (WHOQOL-BREF) mucosa anxiety HADS, HADS (HADS) T0, T0 T (T0) (T6) 1 T12 (T12 Students Student s ttest, ttest t test t-test MannWhitney Mann Whitney nonparametric non parametric Friedmans Friedman comparisons Pearsons Pearson chisquare chi square twoproportion two proportion ztest, ztest z z-test McNemars McNemar Cochrans Cochran Q p 0.05. 005 0.05 . 0 05 0.05) scores 0.023. 0023 0.023 023 0.023) Therefore 2 (WHOQOL-BREF (HADS (T0 (T6 T1 (T1 00 0.0 002 0.02 02 (T 0.

ABSTRACT Purpose: to verify if there is an electromyographic difference during maximal (maximum) voluntary contraction of the masseter and temporalis muscles in patients with temporomandibular disorders, before and after speech therapy intervention with and without the use of therapeutic elastic bandages. Methods: an analysis of secondary data from a clinical intervention study, carried out with 17 adult volunteers, diagnosed with temporomandibular muscle dysfunction with or without disc displacement with reduction. The Bandage Group received manual therapy associated with elastic bandages and the No Bandage Group received only manual therapy. Surface electromyography was performed to record the Maximum Voluntary Contraction before and after four weeks of speech therapy intervention. For exploratory analysis, the Mann Whitney and Wilcoxon paired tests were used, with P<0.05. Results: in the Bandage Group, there was a statistically significant decrease in electrical activity during Maximum Voluntary Contraction in the masseter and temporalis muscles on the left side at the post-therapeutic moment. Comparing the pre- and post-intervention between Bandage Group and No Bandage Group, a statistical difference was found in the electrical activity values of the Maximum Voluntary Contraction in the left temporal muscle. Conclusion: manual myofunctional speech therapy, associated or not with the use of therapeutic elastic bandages, impacts the muscle activity of the masseter and temporal muscles during Maximum Voluntary Contraction, whether the values demonstrate relaxation and/or equivalence of the electromyographic values of the masticatory muscles. Purpose maximum (maximum disorders Methods study 1 volunteers reduction used P005 P 0 05 P<0.05 Results posttherapeutic post moment pre postintervention Conclusion andor P00 P<0.0 P0 P<0. P<0 P<

RESUMO Objetivo: verificar se há diferença eletromiográfica durante contração voluntária máxima dos músculos masseter e temporal de pacientes com disfunção temporomandibular, antes e após intervenção fonoaudiológica com e sem uso de bandagem elástica terapêutica. Métodos: foi realizada a análise de dados secundários de estudo do tipo intervenção clínica, com 17 voluntárias, adultas, com diagnóstico de disfunção temporomandibular muscular com ou sem deslocamento de disco com redução. O Grupo Bandagem recebeu terapia manual associada à bandagem elástica e o Grupo Sem Bandagem recebeu apenas terapia manual. Foi realizada eletromiografia de superfície para registro da contração voluntária máxima antes e após quatro semanas de intervenção fonoaudiológica. Para análise exploratória foram utilizados os testes: Mann Whitney e Wilcoxon Pareado, com p<0,05. Resultados: no Grupo Bandagem, houve diminuição estatisticamente significante da atividade elétrica durante a Contração Voluntária Máxima nos músculos masseter e temporal do lado esquerdo no momento pós-terapêutico. Na comparação do pré e pós-intervenção entre Grupo Bandagem e Grupo Sem Bandagem, constatou-se diferença estatística nos valores da atividade elétrica de Contração Voluntária Máxima no músculo temporal esquerdo. Conclusão: a terapia fonoaudiológica miofuncional manual, associada ou não ao uso da bandagem elástica terapêutica, impacta a atividade muscular dos músculos masseter e temporal durante a Contração Voluntária Máxima, sejam os valores demonstrando relaxamento e/ou equivalência dos valores eletromiográficos da musculatura mastigatória. Objetivo terapêutica Métodos clínica 1 voluntárias adultas redução testes Pareado p005 p 0 05 p<0,05 Resultados pósterapêutico. pósterapêutico pós terapêutico. terapêutico pós-terapêutico pósintervenção constatouse constatou Conclusão eou mastigatória p00 p<0,0 p0 p<0, p<0 p<

ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder (TMD) has complex symptoms that involve the orofacial region, such as otalgia. Considering the difficult differential diagnoses for associating otological symptoms with TMD. The aim of this study was to verify the diagnosis of TMD in patients with otalgia. METHODS: This is a cross-sectional and descriptive study, where 75 patients diagnosed with otalgia were evaluated. The European Academy of Craniomandibular Disorders’s (EACD) screening questionnaire was initially applied, and those who answered affirmatively to at least one question were evaluated by the Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), with a final sample of 50 patients. Data were tabulated and ANOVA verified whether there was a statistical difference between TMD subtypes classified by DC/TMD, considering confidence intervals with 95% significance. RESULTS: The mean age of the participants was 39.9±14.1 years, with a predominance of females (76%) (p<0.0001). Among those diagnosed with TMD, females also predominated, with a higher percentage in all evaluated subtypes, with emphasis on arthralgia (82%) and myofascial pain with limited opening (81.8%), followed by myofascial pain (74%) and disc displacement with reduction (72.7%). When observing the distribution of TMD subtypes between genders, there was a predominance of myofascial pain in males (75%) and females (68%), but no statistical significance was observed in this variable and in the others studied. CONCLUSION: Patients with otalgia had one or more TMD subtypes, and the myofascial subtype TMD was the most prevalent among study participants. OBJECTIVES (TMD region METHODS crosssectional cross sectional 7 Disorderss s EACD (EACD applied DCTMD DC/TMD , DC (DC/TMD) 5 95 RESULTS 399141 39 9 14 1 39.9±14. years 76% 76 (76% p<0.0001. p00001 p p<0.0001 . 0 0001 (p<0.0001) predominated 82% 82 (82% 81.8%, 818 81.8% 81 8 (81.8%) 74% 74 (74% 72.7%. 727 72.7% 72 (72.7%) genders 75% (75% 68%, 68 68% (68%) studied CONCLUSION (DC/TMD 39914 3 39.9±14 (76 p0000 p<0.000 000 (p<0.0001 (82 81.8 (81.8% (74 72.7 (72.7% (75 6 (68% 3991 39.9±1 (7 p000 p<0.00 00 (p<0.000 (8 81. (81.8 72. (72.7 (68 399 39.9± ( p00 p<0.0 (p<0.00 (81. (72. (6 39.9 p0 p<0. (p<0.0 (81 (72 39. p<0 (p<0. p< (p<0 (p< (p

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular (DTM) possui sintomas complexos que envolvem a região orofacial, como a otalgia. Considerando os difíceis diagnósticos diferenciais para associar sintomas otológicos com DTM. O objetivo deste estudo foi verificar o diagnóstico de DTM em pacientes com otalgia. MÉTODOS: Este é um estudo transversal e descritivo, com uma avaliação de 75 pacientes diagnosticados com otalgia. O questionário de triagem da Academia Europeia de Disfunções Craniomandibulares (EACD) foi aplicado inicialmente, e aqueles que responderam afirmativamente a pelo menos uma questão foram avaliados pelo Critério Diagnóstico de Pesquisa para Disfunções Temporomandibulares (DC/TMD), com amostra final de 50 pacientes. Os dados foram tabulados e por meio da ANOVA foi verificado se havia diferença estatística entre os subtipos de DTM classificados pelo DC/TMD, considerando intervalos de confiança com 95% de significância. RESULTADOS: A idade média dos participantes foi de 39,9±14,1 anos. Além disso, predominou-se o sexo feminino (76%) (p<0,0001), com maior percentual em todos os subtipos avaliados, destacando-se a artralgia (82%) e a dor miofascial com limitação de abertura (81,8%), seguida da dor miofascial (74%) e deslocamento de disco com redução (72,7%). Quando observada a distribuição dos subtipos de DTM entre os sexos, notou-se predominância de dor miofascial no sexo masculino (75%) e feminino (68%), mas não foi observada significância estatística nessa variável e nas demais estudadas. CONCLUSÃO: Os pacientes com otalgia manifestaram mais de um dos subtipos de DTM, sendo o subtipo de dor miofascial o mais prevalente entre os participantes do estudo. OBJETIVOS (DTM orofacial MÉTODOS descritivo 7 EACD (EACD inicialmente DCTMD DC/TMD , DC TMD (DC/TMD) 5 95 RESULTADOS 399141 39 9 14 1 39,9±14, anos disso predominouse predominou 76% 76 (76% p<0,0001, p00001 p p<0,0001 0 0001 (p<0,0001) destacandose destacando 82% 82 (82% 81,8%, 818 81,8% 81 8 (81,8%) 74% 74 (74% 72,7%. 727 72,7% . 72 (72,7%) sexos notouse notou 75% (75% 68%, 68 68% (68%) estudadas CONCLUSÃO (DC/TMD 39914 3 39,9±14 (76 p0000 p<0,000 000 (p<0,0001 (82 81,8 (81,8% (74 72,7 (72,7% (75 6 (68% 3991 39,9±1 (7 p000 p<0,00 00 (p<0,000 (8 81, (81,8 72, (72,7 (68 399 39,9± ( p00 p<0,0 (p<0,00 (81, (72, (6 39,9 p0 p<0, (p<0,0 (81 (72 39, p<0 (p<0, p< (p<0 (p< (p

ABSTRACT Paroxysmal Hemicrania is a trigeminal autonomic cephalalgia described as a severe and strictly unilateral pain, which occurs in paroxysms at orbital, supraorbital and/ or temporal region. A 45-year-old woman presented to an orofacial pain specialist reporting severe, burning, throbbing, strictly right-sided headache associated to ipsilateral autonomic symptoms and orofacial pain. The pain was perceived on the maxillary region followed by pain spread to the head. Interdisciplinary evaluation, along with absolute responsiveness to indomethacin and normal Brain Magnetic Resonance imaging, led to the diagnosis of primary Episodic paroxysmal hemicrania with facial representation and myofascial pain of masticatory muscles. Dentists should be aware of paroxysmal hemicrania with facial representation and the possibility of temporomandibular disorder coexistence, in order to avoid misdiagnosis and inadequate management. Paroxysmal hemicrania may be first perceived on the face and may be associated with interparoxysmal pain. In these cases, efficient anamnesis and clinical evaluation followed by interdisciplinary approach is needed. orbital 45yearold yearold 45 year old burning throbbing rightsided right sided head imaging muscles coexistence management cases needed 4

RESUMO A Hemicrania Paroxística é uma cefalalgia autonômica trigeminal descrita como uma dor severa e estritamente unilateral, que ocorre em paroxismos na região orbital, supraorbital e/ou temporal. Uma mulher de 45 anos de idade apresentou-se a um especialista em dor orofacial, referindo uma cefaleia intensa, ardente, latejante, estritamente do lado direito, associada a sintomas autonómicos ipsilaterais e dor orofacial. A dor era sentida na região maxilar, seguida de dor que se estendia à cabeça. A avaliação interdisciplinar, aliada à resposta absoluta à indometacina e à normalidade em ressonância magnética cerebral, levou ao diagnóstico de hemicrania paroxística episódica primária com representação facial e dor miofascial dos músculos mastigatórios. Os médicos dentistas devem estar atentos à hemicrania paroxística com representação facial e à possibilidade de coexistência de Disfunção Temporomandibular, de modo a evitar diagnósticos incorretos e um tratamento inadequado. A hemicrania paroxística pode ser percebida inicialmente na face e pode estar associada à dor interparoxística. Nesses casos, é necessária uma anamnese e avaliação clínica eficientes, seguidas de abordagem interdisciplinar. unilateral orbital eou ou temporal 4 apresentouse apresentou orofacial intensa ardente latejante direito maxilar cabeça interdisciplinar cerebral mastigatórios Temporomandibular inadequado interparoxística casos eficientes

ABSTRACT Purpose To analyze the sensation of pain and the range of mandibular movements of adult individuals with temporomandibular disorder, before and after the application of the athletic tape. Method This is a double-blind randomized clinical trial, in which 22 adults with temporomandibular disorder participated, randomly allocated into two groups, with group A comprising 10 women and one man (mean age 28.2±8.3 years) and group B comprising nine women and two men (mean age 26.2±3.9 years). Group A was submitted to the application of the athletic tape on the masseter with 40% stretch and the group B to the application of the athletic tape on the masseter without stretching. All participants underwent the application of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Pain threshold assessment was performed using an algometer to apply pressure to measurement points. The measurement of mandibular movements was performed using a caliper. The athletic tape was glued using the I technique, with a fixed point over the insertion and a movable point over the origin of the masseter muscle. Participants remained with the athletic tape for 24 hours and were re-evaluated. Results There was pain relief in the group A in the temporomandibular joint on the right and at the origin of the masseter on the left. The group B showed a reduction in pain in the left anterior temporal region. No differences were found in mandibular movements after intervention, as well as no difference was found in the comparison by groups. Conclusion The use of the athletic tape over the masseter muscle, with stretching, for 24 hours produced relief from the sensation of pain, on the origin of the right masseter and in the right temporomandibular joint, and, without stretching, in the left anterior temporal muscle. There was no difference in the range of mandibular movements. doubleblind double blind trial 2 participated groups 1 mean 28283 28 8 3 28.2±8. years 26239 26 9 26.2±3. years. . 40 stretching DC/TMD. DCTMD DC/TMD DC TMD (DC/TMD) points caliper technique muscle reevaluated. reevaluated re evaluated. evaluated re-evaluated region intervention 2828 28.2±8 2623 26.2±3 4 (DC/TMD 282 28.2± 262 26.2± 28.2 26.2 28. 26.

RESUMO Objetivo Analisar a sensação de dor e amplitude dos movimentos mandibulares de indivíduos adultos com disfunção temporomandibular, antes e após aplicação da bandagem elástica por 24 horas. Método Trata-se de um ensaio clínico randomizado duplo-cego, do qual participaram 22 sujeitos adultos com disfunção temporomandibular, alocados aleatoriamente em dois grupos, sendo grupo A composto por 10 mulheres e um homem (média de idade de 28,2±8,3 anos) e grupo B por nove mulheres e dois homens (média de idade de 26,2±3,9 anos). Todos os participantes foram submetidos à aplicação do Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Foi realizada a avaliação do limiar da dor, com uso de um algômetro, para aplicação da pressão no masseter e temporal e medição dos movimentos mandibulares, com paquímetro. O grupo A foi submetido à aplicação da bandagem sobre o músculo masseter com estiramento de 40% e o grupo B sem estiramento. A colagem da bandagem foi realizada, com corte em “I”, com ponto fixo sobre a inserção e ponto móvel sobre a origem do músculo masseter. Os participantes permaneceram com a bandagem por 24 horas e foram reavaliados. Resultados Houve alívio da dor no grupo A na articulação temporomandibular à direita e na origem do masseter à esquerda. O grupo B apresentou redução da dor em região de temporal anterior à esquerda. Não foram encontradas diferenças nos movimentos mandibulares após intervenção, bem como não houve diferença na comparação entre os grupos. Conclusão O uso da bandagem sobre o masseter, por 24 horas, com estiramento, produziu alívio da dor na origem do masseter direito e na região da articulação temporomandibular direita e, sem estiramento, no temporal anterior esquerdo. Não houve diferença na amplitude de movimentos mandibulares. 2 Tratase Trata se duplocego, duplocego duplo cego, cego duplo-cego grupos 1 média 28283 28 8 3 28,2±8, anos 26239 26 9 26,2±3, anos. . DC/TMD. DCTMD DC/TMD DC TMD (DC/TMD) algômetro paquímetro 40 I, I , “I” reavaliados esquerda intervenção esquerdo 2828 28,2±8 2623 26,2±3 (DC/TMD 4 “I 282 28,2± 262 26,2± 28,2 26,2 28, 26,

Abstract Aim To identify the phenotypic characteristics of individuals with temporomandibular disorders (TMD) who may benefit from adding duloxetine to self-management (SM) strategies. Methodology This was a post hoc exploratory analysis of a randomized, placebo-controlled clinical trial with SM-duloxetine (duloxetine 60 mg/day plus SM strategies for 12 weeks) in adult participants with painful TMD. The primary outcome was the proportion of responders to treatment (individuals with ≥ 30% reduction in pain intensity) in SM-duloxetine and SM-placebo group at week 12. For responder analysis, five phenotyping domains recommended by Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials were assessed: pain, psychological, sleep, quantitative sensory testing, and conditioned pain modulation. Relative risk (RR), 95% confidence intervals (CI), and absolute risk reduction were calculated. Results Among participants treated with SM-duloxetine, severe pain intensity (RR 1.33, 95% CI: 0.56, 3.17), pain disability (RR 1.30, 95% CI: 0.63, 2.67), ≥ 1 painful comorbidity (RR 1.48, 95% CI: 0.57, 3.79), and anxiety symptoms (RR 1.80, 95% CI: 0.75, 4.34) were associated with greater likelihood of response to treatment. Among individuals treated with SM-placebo, only temporal summation of pain was associated with greater likelihood of response to treatment. Conclusion Personalized medicine may be implemented in painful TMD management, and phenotype characteristics related to pain and psychological domains may predict which individuals with painful TMD are more likely to respond to the addition of serotonin and norepinephrine reuptake inhibitors to SM strategies to clinically and significantly reduce pain intensity. (TMD selfmanagement self management (SM randomized placebocontrolled placebo controlled SMduloxetine 6 mgday mg day weeks 30 SMplacebo Methods Measurement assessed sleep testing modulation RR, RR , (RR) 95 CI, CI (CI) calculated SMduloxetine, duloxetine, 133 33 1.33 056 0 56 0.56 3.17, 317 3.17 3 17 3.17) 130 1.30 063 63 0.63 2.67, 267 2.67 2 67 2.67) 148 48 1.48 057 57 0.57 3.79, 379 3.79 79 3.79) 180 80 1.80 075 75 0.75 4.34 434 4 34 SMplacebo, placebo, 9 (CI 13 1.3 05 5 0.5 31 3.1 06 0.6 26 2.6 14 1.4 37 3.7 7 18 8 1.8 07 0.7 4.3 43 1. 0. 3. 2. 4.

RESUMO JUSTIFICATIVA E OBJETIVOS: Embora as mulheres pareçam ser mais suscetíveis à dor, há poucos estudos comparando os diagnósticos obtidos por meio do Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) entre mulheres e homens. Assim, este estudo teve como objetivo verificar a influência do sexo nas disfunções temporomandibulares (DTM) e suas comorbidades em uma amostra brasileira. MÉTODOS: Os pacientes foram avaliados por meio do RDC/ TMD. Os diagnósticos foram obtidos para o Eixo I (dor miofascial, deslocamento de disco e outras condições articulares) e Eixo II (sintomas de depressão, dor crônica, somatização e limitação da função mandibular). Modelos de regressão logística foram utilizados para verificar se existe diferença na prevalência e nas chances de desenvolver DTM entre mulheres e homens. RESULTADOS: A amostra incluiu 310 pacientes. As mulheres apresentaram mais dor miofascial e foram mais propensas a desenvolvê-la (73,04%; OR: 1,91; IC 95%: 1,08 - 3,39), bem como mais distúrbios articulares (54,78%; OR: 2,07; IC 95%: 1,08 - 3,99), em comparação aos homens. Ademais, as mulheres compuseram a maioria da amostra, procuraram tratamento com maior frequência e apresentaram níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial. CONCLUSÃO: As mulheres apresentam mais DTM e são mais propensas a desenvolvê-la, bem como apresentam níveis mais graves de sintomas de depressão, somatização da dor, limitação da função mandibular e dor miofascial. OBJETIVOS RDC/TMD RDCTMD RDC TMD (RDC/TMD homens Assim (DTM brasileira MÉTODOS depressão crônica mandibular. . mandibular) RESULTADOS 31 desenvolvêla desenvolvê la 73,04% 7304 73 04 (73,04% OR 1,91 191 1 91 95% 95 108 08 1,0 3,39, 339 3,39 , 3 39 3,39) 54,78% 5478 54 78 (54,78% 2,07 207 2 07 3,99, 399 3,99 99 3,99) Ademais CONCLUSÃO desenvolvêla, la, 73,04 730 7 0 (73,04 1,9 19 9 10 1, 33 3,3 54,78 547 5 (54,78 2,0 20 3,9 73,0 (73,0 3, 54,7 (54,7 2, 73, (73, 54, (54, (73 (54 (7 (5 (

ABSTRACT BACKGROUND AND OBJECTIVES: Although women seem to be more susceptible to pain, there are few studies comparing the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) diagnoses between women and men. Thus, this study aimed to verify the influence of gender on Temporomandibular Disorders (TMD) and their comorbidities in a Brazilian sample. METHODS: Patients were assessed using the RDC/TMD. Diagnoses were obtained for Axis I (myofascial pain, disc displacement, and other joint conditions) and Axis II (depressive symptoms, chronic pain, somatization, and limitation of mandibular function). Logistic regression models were used to verify whether there is a difference in the prevalence and odds of developing TMD between women and men. RESULTS: The sample included 310 patients. Women had more myofascial pain and were more likely to develop it (73.04%; OR: 1.91; IC 95%: 1.08 - 3.39), as well as more joint disorders (54.78%; OR: 2.07; IC 95%: 1.08 - 3.99), in comparison to men. Furthermore, women composed the majority of the sample, more often sought treatment, and had more severe levels of depressive symptoms, somatization of pain, limitation of mandibular function, and myofascial pain. CONCLUSION: Women have more TMD and are more likely to develop it, and also show more severe levels of depressive symptoms, pain somatization, limited mandibular function, and myofascial pain. OBJECTIVES RDC/TMD RDCTMD RDC (RDC/TMD men Thus (TMD METHODS displacement conditions symptoms function. function . function) RESULTS 31 patients 73.04% 7304 73 04 (73.04% OR 1.91 191 1 91 95% 95 108 08 1.0 3.39, 339 3.39 , 3 39 3.39) 54.78% 5478 54 78 (54.78% 2.07 207 2 07 3.99, 399 3.99 99 3.99) Furthermore treatment CONCLUSION 73.04 730 7 0 (73.04 1.9 19 9 10 1. 33 3.3 54.78 547 5 (54.78 2.0 20 3.9 73.0 (73.0 3. 54.7 (54.7 2. 73. (73. 54. (54. (73 (54 (7 (5 (