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      Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study

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          Abstract

          Objective

          The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs.

          Material and Methods

          130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05).

          Results

          Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810).

          Conclusions

          Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.

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          Most cited references35

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

          Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings.

            The aim of this study was to summarize and systematically review the literature on the prevalence of different research diagnostic criteria for temporomandibular disorders (RDC/TMD) version 1.0 axis I diagnoses in patient and in the general populations. For each of the relevant papers, the following data/information were recorded for meta-analysis and discussion: sample size and demographic features (mean age, female-to-male ratio); prevalence of the assigned diagnoses; prevalence of the diagnoses assigned to the left and right joints, if available; prevalence of the diagnoses assigned to the 2 genders, if available; prevalence of the different combinations of multiple diagnoses, if available; and prevalence of TMD (only for community studies). Twenty-one (n = 21) papers were included in the review (15 dealing with TMD patient populations and 6 with community samples). The studies on TMD patients accounted for a total of 3,463 subjects (mean age 30.2-39.4 years, female-to-male ratio 3.3), with overall prevalences of 45.3% for group I muscle disorder diagnoses, 41.1% for group II disc displacements, and 30.1% for group III joint disorders. Studies on general populations accounted for a total of 2,491 subjects, with an overall 9.7% prevalence for group I, 11.4% for group IIa, and 2.6% for group IIIa diagnoses. Prevalence reports were highly variable across studies. Myofascial pain with or without mouth opening limitation was the commonest diagnosis in TMD patient populations, and disc displacement with reduction was the commonest diagnosis in community samples. Copyright © 2011 Mosby, Inc. All rights reserved.
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              Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis.

              As part of the Multisite Research Diagnostic Criteria For Temporomandibular Disorders (RDC/TMD) Validation Project, comprehensive temporomandibular joint diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computerized tomography (CT). Interexaminer reliability was estimated using the kappa (kappa) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. Computerized tomography was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). For the radiologic diagnosis of OA, reliability of the 3 examiners was poor for panoramic radiography (kappa = 0.16), fair for MRI (kappa = 0.46), and close to the threshold for excellent for CT (kappa = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (kappa = 0.78) and for DD without reduction (kappa = 0.94) and good for effusion (kappa = 0.64). Overall percent agreement for pairwise ratings was >or=82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and of effusion was 81%. Negative percent agreement was >or=88% for all conditions. Compared with CT, panoramic radiography and MRI had poor and marginal sensitivity, respectively, but excellent specificity in detecting OA. Comprehensive image analysis criteria for the RDC/TMD Validation Project were developed, which can reliably be used for assessing OA using CT and for disc position and effusion using MRI.
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                Author and article information

                Journal
                J Appl Oral Sci
                J Appl Oral Sci
                jaos
                Journal of Applied Oral Science
                Faculdade De Odontologia De Bauru - USP
                1678-7757
                1678-7765
                2018
                29 May 2018
                : 26
                : e20170578
                Affiliations
                [1 ]Universidade Estadual de Maringá, Departamento de Odontologia, Maringá, Paraná, Brasil.
                [2 ]Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre, Rio Grande do Sul, Brasil.
                [3 ]Universidade Estadual de Maringá, Departamento de Estatística, Maringá, Paraná, Brasil.
                Author notes
                Corresponding address: Rodrigo Lorenzi Poluha. Departamento de Odontologia - Universidade Estadual de Maringá. Avenida Mandacaru, 1550 - 87080-000 - Maringá - PR - Brasil. Phone: + 55 42 999459674 / 44 30119051. e-mail: rodrigopoluha@ 123456gmail.com
                Article
                00476
                10.1590/1678-7757-2017-0578
                6010330
                29898186
                54281bd8-8542-483b-b237-d7cfe7bc94dc

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 November 2017
                : 13 March 2018
                : 14 March 2018
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 30, Pages: 1
                Categories
                Original Article

                trigger points,temporomandibular joint,tmj disorders,facial pain

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