José Stechman NetoTuiuti University of Paraná, Brazil
Title: Relationship between temporomandibular disorders painful and central sensibilization
Background and Aims
TMD affect 5-12% of the general population. They are classified as muscular, joint and headaches attributed to TMD (SCHIFFMAN et al, 2014). In TMD, pain is the main symptom, which can be in the orofacial region or referred to the head and neck region. It is also known that myofascial alterations are identified as the most prevalent among joint and mixed types (MANFREDINI, 2011).
These myofascial alterations are one of the most common causes of musculoskeletal pain, characterized by the presence of myofascial trigger points can initiate, activate and/or maintain the CS, which can be the cause or the result of this CS, leading to the permanence of pain or its chronicity (FERNÁNDEZ-DE-LAS-PEÑA, 2014).
SC is a disproportionate relationship between the provoked stimulus and the perception of pain caused by increased neuronal excitability, increased synaptic efficacy and/or 2009). CS is clinically characterized by allodynia, hyperalgesia, expansion of the receptive field, and prolonged pain after the stimulus has been removed (hyperpathia).
SC can be present in neuropathic pain, inflammatory pain, migraines/headaches, irritable bowel syndrome, fibromyalgia and other painful syndromes, including chronic muscular TMD (FERNANDEZ-DE-LAS-PEÑAS et al, 2010). These conditions are highly inter-correlated and share many symptoms in common, such as pain (KINDLER et al, 2011), in addition to fatigue, poor sleep, cognitive deficits, headaches, anxiety and depression, suggesting that they may share a common etiology (SCHUR, 2007).
Recent evidence has found that SC may be the link between these disorders (YUNUS, 2008), thus comprising central sensitization syndrome (CSS). In 2012, a multidisciplinary team specializing in patients with chronic pain developed a clinical screening instrument, called the Central Sensitization Inventory (CSI). Its objectives are (1) to identify the presence of SCs, (2) to quantify the degree of symptomatology associated with SC, (3) to assist health professionals in the syndrome categorization, sensitivity, identification of severity and treatment planning, in order to to minimize, or possibly avoid, unnecessary diagnoses and incorrect procedures (MAYER, 2012). Therefore, the dysfunction of the central nervous system in processing the input of a nociceptive stimulus is a precipitating and perpetuating factor of pain in patients with chronic TMD (LA TOUCHE et al, 2017). In addition, TMD is among the most prevalent conditions that cause CSS and most of these extremely severe patients (NEBLETT, 2017). The aim of this study is to investigate the relationship between these conditions.
Cross-sectional observational study where 116 patients were included (n = 116). Patients were examined according to the DC / TMD, followed by the application of the Central Sensitization Inventory (CSI). Data were analyzed using the SPSS 20.0 IBM Statistics. The frequency distribution of the variables was to calculate, and a bivariate analysis was performed. The chi-square test was used to assess associations between the categorical variable of DC/TMD diagnosis and the degree of CS (subclinical / mild or moderate to extreme severity). A nonparametric analysis was performed using the Mann-Whitney to test associations between mean age and pain and neuromodulation groups. The level of significance adopted was 5% (p < 0.05). This study was approved by the Ethics Committee for Research with Human Beings under No. 3.573.658
One hundred fifty patients were screened, and 116 patients (n=116) met the eligibility
To be updated