Myogenic temporomandibular disorders: Clinical systemic comorbidities in a female population sample

M de-Pedro-Herráez, J Mesa-Jiménez, C Fernández-de-Las-Peñas, J-L de-la-Hoz-Aizpurua, M de-Pedro-Herráez, J Mesa-Jiménez, C Fernández-de-Las-Peñas, J-L de-la-Hoz-Aizpurua

Abstract

Background: Myogenic temporomandibular disorders (MTMD) frequently coexist with other clinical conditions in the same individual. In the last decades, several authors have analyzed these comorbidities looking for the origin of this overlapping. Objetives: The aim of this study was to perform a comparative anaylisis between a group of patients with MTMD and a control group of dental patients without dysfunctional pathology to assess whether there are significant differences in the presence of systemic medical comorbidities between the two groups.

Material and methods: Restrospective epidemiological analysis, based on medical questionnaires in a group of 31 patients, women, aged from 24 to 58 (average 39.96 years), diagnosed with MTMD (Masticatory Myofascial Pain), with a control group with the same number of individuals, gender and age range to evaluate if there is a significant statistical difference in the presence of medical comorbidities in this group of patients with MTMD and if they are in a higher risk of suffering different pathological conditions.

Results: It was found that the group affected by MTMD presented many more associated medical conditions than the control group: health changes during the last year, medical evaluations and treatments, presence of pain, sinus disease, tinnitus, headache, joint pain, ocular disorders, fatigue, dizziness, genitourinary disorders and xerostomia among others; and they were also in a higher risk to suffer other pathological entities as headaches and articular pain.

Conclusions: These results reinforce our hypothesis that MTMD belong to a group of medical conditions triggered by a loss of equilibrium of the individual's Psycho-Neuro-Endocrine-Immune (PNEI) Axis that produces alterations in the response against external stimuli in some genetically predisposed individuals. It is, therefore, necessary to change the way of diagnosing and managing these individual's medical conditions, being mandatory to look from a more multidisciplinary perspective than the one we are currently offering.

Conflict of interest statement

The authors have declared that no conflict of interest exist.

Figures

Figure 1
Figure 1
Sample.
Figure 2
Figure 2
Distribution of medical conditions with statistical differences.
Figure 3
Figure 3
Distribution of other medical conditions.

References

    1. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014;28:6–27.
    1. Bron C, Dommerholt JD. Etiology of myofascial trigger points. Curr Pain Headache Rep. 2012;16:439–44.
    1. Sanders AE, Slade GD, Bair E, Fillingim RB, Knott C, Dubner R. General health status and incidence of first-onset temporomandibular disorder: the OPPERA prospective cohort study. J Pain. 2013;14:51–62.
    1. Aaron LA, Buchwald D. A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med. 2001;134:868–81.
    1. Diatchenko L, Nackley AG, Slade GD, Fillingim RB, Maixner W. Idiopathic pain disorders--pathways of vulnerability. Pain. 2006;123:226–30.
    1. Yunus MB. The prevalence of fibromyalgia in other chronic pain conditions. Pain Res Treat. 2012;2012:584573.
    1. Kindler LL, Bennett RM, Jones KD. Central sensitivity syndromes: mounting pathophysiologic evidence to link fibromyalgia with other common chronic pain disorders. Pain Manag Nurs. 2011;12:15–24.
    1. Gerwin RD. Diagnosing fibromyalgia and myofascial pain syndrome: a guide. J Fam Pract. 2013;62:S19–25.
    1. Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160:221–7.
    1. Burris JL, Evans DR, Carlson CR. Psychological correlates of medical comorbidities in patients with temporomandibular disorders. J Am Dent Assoc. 2010;141:22–31.
    1. Hoffmann RG, Kotchen JM, Kotchen TA, Cowley T, Dasgupta M, Cowley AW. Temporomandibular disorders and associated clinical comorbidities. Clin J Pain. 2011;27:268–74.
    1. De Leeuw R, Klasser GD, Albuquerque RJ. Are female patients with orofacial pain medically compromised? J Am Dent Assoc. 2005;136:459–68.
    1. Headache Classification Committee of the International Headache Society IHS. The International Classification of Headache Disorders, 3rd edition (beta version) Cephalalgia. 2013;33:629–808.
    1. Charleston L, Strabbing R, Cooper W. Is sinus disease the cause of my headaches? An update on sinus disease and headache. Curr Pain Headache Rep. 2014;18:418.
    1. Calderon PdosS, Hilgenberg PB, Rossetti LM, Laurenti JV, Conti PC. Influence of tinnitus on pain severity and quality of life in patients with temporomandibular disorders. J Appl Oral Sci. 2012;20:170–3.
    1. Teachey WS, Wijtmans EH, Cardarelli F, Levine RA. Tinnitus of myofascial origin. Int Tinnitus J. 2012;17:70–3.
    1. Da Silva AA Jr, Brandao KV, Faleiros BE, Tavares RM, Lara RP, Januzzi E. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache. Arq Neuropsiquiatr. 2014;72:99–103.
    1. Inoue E, Maekawa K, Minakuchi H, Nagamatsu-Sakaguchi C, Ono T, Matsuka Y. The relationship between temporomandibular joint pathosis and muscle tenderness in the orofacial and neck/shoulder region. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:86–90.
    1. Sipila K, Suominen AL, Alanen P, Heliovaara M, Tiittanen P, Kononen M. Association of clinical findings of temporomandibular disorders (TMD) with self-reported musculoskeletal pains. Eur J Pain. 2011;15:1061–7.
    1. Monaco A, Streni O, Marci MC, Sabetti L, Giannoni M. Convergence defects in patients with temporomandibular disorders. Cranio. 2003;21:190–5.
    1. 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:e29–34.
    1. Fraga BP, Santos EB, Farias Neto JP, Macieira JC, Quintans LJ Jr, Onofre AS. Signs and symptoms of temporomandibular dysfunction in fibromyalgic patients. J Craniofac Surg. 2012;23:615–8.
    1. Hubbard JE. Myofascial trigger points. What physicians should know about these neurological imitators. Minn Med. 2010;93:42–5.
    1. Rodriguez MA, Afari N, Buchwald DS, National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Urological Chronic Pelvic Pain. Evidence for overlap between urological and nonurological unexplained clinical conditions. J Urol. 2009;182:2123–31.
    1. Da Silva LA, Teixeira MJ, de Siqueira JT, de Siqueira SR. Xerostomia and salivary flow in patients with orofacial pain compared with controls. Arch Oral Biol. 2011;56:1142–7.
    1. Burris JL, Perez C, Evans DR, Carlson CR. A preliminary study of cigarette smoking in female orofacial pain patients. Behav Med. 2013;39:73–9.
    1. Maintz L, Novak N. Histamine and histamine intolerance. Am J Clin Nutr. 2007;85:1185–96.
    1. Padilla F, Couble ML, Coste B, Maingret F, Clerc N, Crest M. Expression and localization of the Nav1.9 sodium channel in enteric neurons and in trigeminal sensory endings: implication for intestinal reflex function and orofacial pain. Mol Cell Neurosci. 2007;35:138–52.
    1. Kim SE, Chang L. Overlap between functional GI disorders and other functional syndromes: what are the underlying mechanisms? Neurogastroenterol Motil. 2012;24:895–913.
    1. Ablin K, Clauw DJ. From fibrositis to functional somatic syndromes to a bell-shaped curve of pain and sensory sensitivity: evolution of a clinical construct. Rheum Dis Clin North Am. 2009;35:233–51.

Source: PubMed

3
Sottoscrivi