Browsing by Author "Sanz, David"
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- Association of malocclusion with temporomandibular disorders:a cross-sectional studyPublication . Ângelo, David Faustino; Teixeira, Maria Cristina Faria; Maffia, Francesco; Sanz, David; Sarkis, Marcella; Marques, Rute; Mota, Beatriz; São João, Ricardo; Cardoso, Henrique JoséBackground/Objectives: Temporomandibular disorders (TMD) encompass a range of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and associated structures. This cross-sectional study, conducted in a Portuguese TMD department, aimed to assess the relationship between malocclusion and TMD severity. Methods: Data on demographic variables, TMD clinical symptoms, and malocclusion classes were collected using the EUROTMJ database. The Chi-square test (χ2) identified associations, with their intensity measured by Cramér’s V (φc). Results: The study included 1170 patients (932 females and 238 males), with a mean age of 41.73 ± 16.80 years. Most patients exhibited Angle Class I malocclusion (85.5%), followed by Angle Class II (13.5%) and Angle Class III (1.1%). Class II malocclusion was associated with increased TMD severity (p < 0.001), higher myalgia levels (p = 0.002), more frequent disc displacement without reduction (p = 0.002) and lower maximum mouth opening values (Class II: 38.13 ± 7.78 mm, Class I: 39.93 ± 8.67 mm). Significant associations were also found between malocclusion type and arthralgia (p = 0.021), mouth-opening limitation (p = 0.016), and TMJ crepitus (p = 0.017). In cases of malocclusion, the presence of oral signs of bruxism explained the degree of myalgia, disc displacement, and severity (p = 0.003; p = 0.048; p = 0.045). Conclusions: This study highlights that (1) the most common type of dental malocclusion in TMD patients was Class I; (2) Class II malocclusion was associated with increased TMD severity and oral signs of bruxism; and (3) Class III was rarely observed in TMD consultation. The findings suggest that bruxism behavior in cases of malocclusion may be significant in TMD.
- Fonseca anamnestic index for screening temporomandibular disorders - reliability to discriminate muscular from intra-articular disordersPublication . São João, Ricardo; Cardoso, Henrique José; Sanz, David; Ângelo, David FaustinoBackground/ Objective: Fonseca anamnestic index (FAI) is a simple and quick survey used for screening the presence and severity of Temporomandibular Disorders (TMD). The presented study aimed to screen the FAI accuracy to discriminate different types of TMD: intra-articular (AD), Masticatory Muscular Disorder (MMD), or the presence of both typologies. Methods: The existence of a pattern in the FAI based on the frequency of answers was evaluated and supported by other variables: sex, age, medical diagnosis and Visual Analog Scale of health-related quality of Life (VASLife). The non-parametric Chi-square test () or Fisher's exact test were used to assess the existence of associations between these variables. In the pairs of variables where such association was identified, its intensity was measured by Cramér's V Coefficient. The prediction if FAI could be a good decision tool for distinguish the type of TMD was assessed through logistic regression models (ordinal and multinomial). Results: The higher FAI score was associated with questions related with temporomandibular joint (TMJ) pain, TMJ clicks and person anxiety. Severe cases classified by FAI are correlated with typology of Both (AD+MMD). Moreover, the female patients presented more moderate and severe cases in FAI and also correlated with the presence of AD+MMD. The logistic model showed low accuracy to distinguish the TMD typology (~70%). Conclusion: FAI is a good initial methodology in TMD diagnosis, however integrated in a logistic regression model for distinguish the typology of TMD has proved to be insufficient. It is expected that the combination of this survey with other outcomes will make the model more accurate.
- Fonseca anamnestic index for screening temporomandibular disorders:reliability to discriminate muscular from intra-articular disordersPublication . São João, Ricardo; Cardoso, Henrique J.; Sanz, David; Ângelo, David F.Introduction - Temporomandibular disorders (TMD) are a set of musculoskeletal and/or articular conditions that affect respectively the masticatory musculature and/or the temporomandibular joint (TMJ) complex. TMD is the most common nondental cause of orofacial pain and have a negative impact on the patient's daily life. The two main origins of pain in this region are considered to be due to intra-articular or masticatory muscle changes. Actually, the diagnosis of TMD is largely based on the patient's symptoms, as pain in TMJ and surrounding muscles, difficulty in opening the mouth, and other complaints such aspresence of clicking in the joint, malocclusion and headaches.The Fonseca Anamnestic Index (FAI) is a TMD patient-reported questionnaire, quick and easy to administer, based in signs and symptoms with 10 questions, used in recent years to classify the severity of TMD. Objectives - The presented study aimed to screen the FAI accuracy to discriminate different types of TMD: intra-articular (AD), Masticatory Muscular Disorders (MMD), or the presence of both typologies
- Prevalence of clinical signs and symptoms of temporomandibular joint disorders registered in the EUROTMJ database:a prospective study in a portuguese centerPublication . Ângelo, David Faustino; Mota, Beatriz; São João, Ricardo; Sanz, David; Cardoso, Henrique JoséTemporomandibular joint disorders (TMDs) are characterized by their multifactorial etiology and pathogenesis. A 3-year prospective study was conducted in a Portuguese TMDs department to study the prevalence of different TMDs signs and symptoms and their association with risk factors and comorbidities. Five hundred ninety-five patients were included using an online database: EUROTMJ. Most patients were female (80.50%), with a mean age of 38.20 ± 15.73 years. The main complaints were: (1) temporomandibular joint (TMJ) clicking (13.26%); (2) TMJ pain (12.49%); (3) masticatory muscle tension (12.15%). The main clinical findings were myalgia (74%), TMJ clicking (60–62%), and TMJ arthralgia (31–36%). Risk factors such as clenching (60%) and bruxism (30%) were positively associated with TMJ pain and myalgia. Orthodontic treatment (20%) and wisdom tooth removal (19%) were positively associated with TMJ clicking, while jaw trauma (6%), tracheal intubation (4%) and orthognathic surgery (1%) were positively associated with TMJ crepitus, limited mandibular range of motion, and TMJ pain, respectively. In total, 42.88% of TMDs patients had other associated chronic diseases, most of them were mental behavioral or neurodevelopmental disorders (33.76%), namely, anxiety (20%) and depression (13%). The authors also observed a positive association of mental disorders with the degree of TMJ pain and myalgia. The online database seems to be a relevant scientific instrument for healthcare providers who treat TMDs. The authors expect that the EUROTMJ database can serve as a milestone for other TMDs departments.