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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(03): 195-200
DOI: 10.1590/0004-282X20160017
ARTICLE

Temporomandibular disorders in fibromyalgia patients: are there different pain onset?

Disfunção termomandibuar em doentes com fibromialgia: há diferença no início das dores?
Fábio J. C. Fujarra
1   Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Odontologia do Instituto Central, Dor Orofacial, Sao Paulo SP, Brazil;
,
Helena Hideko Seguchi Kaziyama
2   Universidade de São Paulo, Faculdade de Medicina, Instituto Central e Neurocirurgia Experimental do Instituto de Psquiatria, Departamento de Neurologia, Centro Multidisciplinas de Dor, Sao Paulo SP, Brazil;
,
Silvia Regina D. T. de Siqueira
1   Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Odontologia do Instituto Central, Dor Orofacial, Sao Paulo SP, Brazil;
2   Universidade de São Paulo, Faculdade de Medicina, Instituto Central e Neurocirurgia Experimental do Instituto de Psquiatria, Departamento de Neurologia, Centro Multidisciplinas de Dor, Sao Paulo SP, Brazil;
,
Lin Tchia Yeng
2   Universidade de São Paulo, Faculdade de Medicina, Instituto Central e Neurocirurgia Experimental do Instituto de Psquiatria, Departamento de Neurologia, Centro Multidisciplinas de Dor, Sao Paulo SP, Brazil;
,
Cinara M. Camparis
3   Universidade Estadual de São Paulo Paulo Júlio De Mesquita Filho, Faculdade de Odontologia, Sao Paulo SP, Brazil.
,
Manoel Jacobsen Teixeira
2   Universidade de São Paulo, Faculdade de Medicina, Instituto Central e Neurocirurgia Experimental do Instituto de Psquiatria, Departamento de Neurologia, Centro Multidisciplinas de Dor, Sao Paulo SP, Brazil;
,
José Tadeu Tesseroli de Siqueira
1   Universidade de São Paulo, Hospital das Clínicas, Faculdade de Medicina, Divisão de Odontologia do Instituto Central, Dor Orofacial, Sao Paulo SP, Brazil;
2   Universidade de São Paulo, Faculdade de Medicina, Instituto Central e Neurocirurgia Experimental do Instituto de Psquiatria, Departamento de Neurologia, Centro Multidisciplinas de Dor, Sao Paulo SP, Brazil;
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ABSTRACT

Objective To identify temporomandibular disorders (TMD) symptoms in two groups of fibromyalgia patients according to the temporal relation between the onset of facial pain (FP) and generalized body pain (GBP). Cross-sectional study design: Fifty-three consecutive women with fibromyalgia and FP were stratified according to the onset of orofacial pain: Group-A (mean age 47.30 ± 14.20 years old), onset of FP preceded GBP; Group-B (mean age 51.33 ± 11.03 years old), the FP started concomitant or after GBP. Clinical assessment Research Diagnostic Criteria for Temporomandibular Disorders and the Visual Analogue Scale.

Results Myofascial pain with mouth opening limitation (p = 0.038); right disc displacement with reduction (p = 0.012) and jaw stiffness (p = 0.004) were predominant in Group A. Myofascial pain without mouth opening limitation (p = 0.038) and numbness/burning were more common in Group B.

Conclusion All patients had temporomandibular joint symptoms, mainly muscle disorders. The prevalence of myofascial pain with limited mouth opening and right TMJ disc displacement with reduction were higher in Group A.

RESUMO

Objetivo Identificar sintomas de disfunção temporomandibular (DTM) em dois grupos de pacientes fibromiálgicas, segundo a relação temporal entre o início da dor facial (DF) e das dores generalizadas no corpo (DGC). Estudo transversal: 53 pacientes consecutivas com fibromialgia e DF foram divididas de acordo com o início da dor orofacial: Grupo A (média de idade 47,30 ± 14,20anos), o início da DF precedeu o da DGC; Grupo-B (idade média 51,33 ± 11,03anos), a DF iniciou concomitantemente ou após a DGC. Avaliação clínica: Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) e escala visual analógica (EVA).

Resultados Dor miofascial com limitação de abertura bucal (p = 0,038); deslocamento de disco à direita com redução (p = 0,012) e rigidez mandibular (p = 0,004) foram predominantes no Grupo A. Dor miofascial sem limitação de abertura bucal (p = 0,038) e dormência/queimação foram mais comuns no Grupo-B.

Conclusão Todos os pacientes tiveram sintomas de DTM, principalmente disfunção muscular. A prevalência de dor miofascial com limitação de abertura bucal e deslocamento de disco à direita com redução foi maior no Grupo A.

fibromyalgia - orofacial pain - facial pain - temporomandibular disorders
fibromialgia - dor orofacial - dor facial - desordens temporomandibulares


Publication History

Received: 03 September 2015

Accepted: 10 November 2015

Article published online:
06 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160(2):221-7. doi:10.1001/archinte.160.2.221
  • 2 Vierck CJ Jr. Mechanisms underlying development of spatially distributed chronic pain (fibromyalgia). Pain. 2006;124(3):242-63. doi:10.1016/j.pain.2006.06.001
  • 3 Staud R, Koo E, Robinson ME, Price DD. Spatial summation of mechanically evoked muscle pain and painful aftersensations in normal subjects and fibromyalgia patients. Pain. 2007;130(1-2):177-87. doi:10.1016/j.pain.2007.03.015
  • 4 Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72. doi:10.1002/art.1780330203
  • 5 Marbach JJ. Temporomandibular pain and dysfunction syndrome: history, physical examination and treatment. Rheumatic Dis Clin North Am. 1996;22(3):477-98. doi:10.1016/S0889-857X(05)70283-0
  • 6 Gui MS, Pimentel MJ, Rizzatti-Barbosa CM. Temporomandibular disorders in fibromyalgia syndrome: a short-communication. Rev Bras Reumatol. 2015; 55(2):189-94.
  • 7 Wolfe F, Katz RS, Michaud K. Jaw pain: its prevalence and meaning in patients with rheumatoid arthritis, osteoarthritis, and fibromyalgia. J Rheumatol. 2005;32(12):2421-8.
  • 8 Balasubramaniam R, Leeuw R, Zhu H, Nickerson RB, Okeson JP, Carlson CR. Prevalence of temporomandibular disorders in fibromyalgia and failed back syndrome patients: a blinded prospective comparison study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(2):204-16. doi:10.1016/j.tripleo.2007.01.012
  • 9 Leblebici B, Pektaş ZO, Ortancil O, Hürcan EC, Bagis S, Akman MN. Coexistence of fibromyalgia, temporomandibular disorder and masticatory myofascial pain syndromes. Rheumatol Int. 2007;27(6):541-4. doi:10.1007/s00296-006-0251-z
  • 10 De Leeuw R. Orofacial pain: guidelines for assessment, diagnosis and management. 4th ed. Chicago: Quintessence; 2008.
  • 11 Lobbezoo-Scholte AM, De Leeuw JR, Steenks MH, Bosman F, Buchner R, Olthoff LW. Diagnostic subgroups of craniomandibular disorders - Part I: Self-report data and clinical findings. J Orofac Pain. 1995;9(1):24-36.
  • 12 Lobbezoo-Scholte AM, Lobbezoo F, Steenks MH, De Leeuw JR, Bosman F. Diagnostic subgroups of craniomandibular disorders. Part II: symptom profiles. J Orofacial Pain. 1995;9(1):37-43.
  • 13 Fricton JR. The relationship of temporomandibular disorders and fibromyalgia: implications for diagnosis and treatment. Curr Pain Headache Rep. 2004;8(5):355-63. doi:10.1007/s11916-996-0008-0
  • 14 Fantoni F, Salvetti G, Manfredini D, Bosco M. Current concepts on the functional somatic syndromes and temporomandibular disorders. Stomatologija. 2007;9(1):3-9.
  • 15 Hedenberg-Magnusson B, Ernberg M, Kopp S. Presence of orofacial pain and temporomandibular disorder in fibromyalgia: a study by questionnaire. Swed Dent J. 1999;23(5-6):185-92.
  • 16 Siqueira JTT, Lin HC, Nasri C, Siqueira SR, Teixeira MJ, Heir G et al. Clinical study of patients with persistent orofacial pain. Arq Neuropsiquiatr. 2004;62(4):988-96. doi:10.1590/S0004-282X2004000600011
  • 17 Camparis CM, Siqueira JTT. Sleep bruxism: clinical aspects and characteristics in patients with and without chronic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(2):188-93. doi:10.1016/j.tripleo.2005.01.014
  • 18 Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders 2nd edition. Cephalalgia. 2004;24(1 Suppl):9-160.
  • 19 Pereira Junior FJ, Favilla EE, Dworkin S, Huggins K. Critérios de diagnóstico para pesquisa das disfunções temporomandibulares (RDC/TMD): Tradução oficial para a lingua portuguesa. J Bras Clin Odontol Integr. 2004;8(47):384-95.
  • 20 Kominsky M, Lucena LBS, Siqueira JTT, Pereira Júnior F, Góes PSA. Adaptação cultural do Questionário Research Diagnostic Criteria for Temporomandibular Disorders: Axis II para o Português. J Bras Clín Odontol Integr. 2004;8(43):51-61.
  • 21 Rosner B. Fundamentals of biostatistics. 2nd ed. Boston: PWS; 1986.
  • 22 Salvetti G, Manfredini D, Bazzichi L, Bosco M. Clinical features of the stomatognathic involvement in fibromyalgia syndrome: a comparison with temporomandibular disorders patients. Cranio. 2007;25(2):127-33. doi:10.1179/crn.2007.019
  • 23 Okifuji A, Turk DC. Fibromyalgia syndrome: prevalent and perplexing. Pain. 2003;11(3):1-4.
  • 24 Nasri C, Teixeira MJ, Okada M, Formigoni G, Heir G, Siqueira JTT. Burning mouth coumplaints: clinical characteristics of a Brazilian sample. Clinics (Sao Paulo). 2007;62(5):561-6. doi:10.1590/S1807-59322007000500005
  • 25 Xie YF, Zhang S, Chiang CY, Hu JW, Dostrovsky JO, Sessle BJ. Involvement of glia in central sensitization in trigeminal subnucleus caudalis (medullary dorsal horn). Brain Behav Immun. 2007;21(5):634-41. doi:10.1016/j.bbi.2006.07.008
  • 26 Siqueira SR, Nobrega JC, Teixeira MJ, Siqueira JT. Masticatory problems after balloon compression for trigeminal neuralgia: a longitudinal study. J Oral Rehabil. 2007;34(2):88-96. doi:10.1111/j.1365-2842.2006.01680.x
  • 27 Dao TT, Reynolds WJ, Tenenbaum HC. Comorbidity between myofascial pain of the masticatory muscles and fibromyalgia. J Orofac Pain. 1997;11(3):232-41.
  • 28 Mafredini D, Tognini F, Montagnani G, Bazzicchi L, Bombardieri S, Bosco M. Comparison of masticatory dysfunction in temporomandibular disorders and fibromyalgia. Minerv Stomatol. 2004;53(11-12):641-50.
  • 29 John MT, Miglioretti DL, LeResche L, Von Korff M, Critchlow CW. Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain. Pain. 2003;102(3):257-63. doi:10.1016/S0304-3959(02)00404-9
  • 30 Türp JC, Kowalski CJ, Stohler CS. Temporomandibular disorders-pain outside the head and face is rarely acknowledged in the chief complaint. Prosthet Dent. 1997;78(6):592-5. doi:10.1016/S0022-3913(97)70010-6
  • 31 da Silva LA, Kazyiama HH, de Siqueira JT, Teixeira MJ, de Siqueira SR. High prevalence of orofacial complaints in patients with fibromyalgia: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114(5): e29-34.