Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Differences in Symptoms According to the Concordance Value Between Self-Reported Pain Sites and Standardized Palpation Pain Sites in Temporomandibular Disorder Patients: Pilot Study

  • Jee-Won Jang (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Seo-Young Choi (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Yong-Woo Ahn (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Sung-Hee Jeong (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Soo-Min Ok (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital) ;
  • Hye-Mi Jeon (Dental Clinic Center, Pusan National University Hospital) ;
  • Hye-Min Ju (Department of Oral Medicine, Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2024.06.10
  • Accepted : 2024.07.14
  • Published : 2024.09.30
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Abstract

Purpose: The aims were to investigate potential differences in clinical assessments among acute pain-related temporomandibular disorder (TMD) with different concordance value (CV) between number of self-reported painful site (NSP) and number of painful sites on palpation (NPP), and if it makes sense to treat them differently. Methods: A total of 61 patients were divided into three groups according to CV: 10 patients (concordance poor [CP]), 19 patients (concordance moderate [CM]), and 32 patients (concordance high [CH]). Clinical assessments were conducted using a standardized method in diagnostic criteria for temporomandibular disorders (DC/TMD). We compared collected information including sex, diagnosis, numerical rating scale (NRS), NPP, NSP, sleep duration, DC/TMD Axis II questionnaire, and perceived stress scale among three groups. Results: Among the clinical assessment, NRS, sleep duration, NPP, NSP, total scores of Oral Behaviors Checklist, Patient Health Questionnaire (PHQ)-15, PHQ-9 showed significant differences among 3 groups. NRS, NPP, NSP, PHQ-15, and PHQ-9 were higher in the CP group than in the CM and CH groups. Sleep duration was positively and NPP, NRS were negatively correlated with CV. Conclusions: While previous studies suggested differences between chronic and acute TMD in DC/TMD items, our findings propose the CV might be a key factor that could predict the severity and susceptibility of acute-TMD patients. However, Additional studies are required to determine whether their long-term prognosis was similar to that of chronic pain patients and what the response to treatment was among the three groups.

Keywords

Acknowledgement

This work was supported by a 2-year Research Grant of Pusan National University.

References

  1. Facial pain [Internet]. National Institute of Dental and Craniofacial Research; c2013 [cited 2024 Apr 20]. Available from: https://www.nidcr.nih.gov/research/data-statistics/facial-pain. 
  2. Okeson JP. Occlusion and functional disorders of the masticatory system. Dent Clin North Am 1995;39:285-300.  https://doi.org/10.1016/S0011-8532(22)01779-7
  3. Schiffman E, Ohrbach R, Truelove E, et al.; International RDC/TMD Consortium Network, International association for Dental Research; Orofacial Pain Special Interest Group, International Association for the Study of Pain. 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 Group†. J Oral Facial Pain Headache 2014;28:6-27.  https://doi.org/10.11607/jop.1151
  4. Felin GC, Tagliari CVDC, Agostini BA, Collares K. Prevalence of psychological disorders in patients with temporomandibular disorders: a systematic review and meta-analysis. J Prosthet Dent 2022. doi: 10.1016/j.prosdent.2022.08.002. [Epub ahead of print] 
  5. Barjandi G, Kosek E, Hedenberg-Magnusson B, Velly AM, Ernberg M. Comorbid conditions in temporomandibular disorders myalgia and myofascial pain compared to fibromyalgia. J Clin Med 2021;10:3138. 
  6. Bird R, Beecroft EV. TMD diagnosis-what should general dentists and orthodontists know? Semin Orthod 2024;30:243-249.  https://doi.org/10.1053/j.sodo.2024.01.002
  7. Paranhos R, Silvestre L, Fernandes R, et al. Analysis of sleep, pain and anxiety correlation in individuals with TMD: an analytic transversal study. Headache Med 2022;13(Suppl):42. 
  8. Botros J, Gornitsky M, Samim F, der Khatchadourian Z, Velly AM. Back and neck pain: a comparison between acute and chronic pain-related temporomandibular disorders. Can J Pain 2022;6:112-120.  https://doi.org/10.1080/24740527.2022.2067032
  9. Dreweck FDS, Soares S, Duarte J, Conti PCR, De Luca Canto G, Luis Porporatti A. Association between painful temporomandibular disorders and sleep quality: a systematic review. J Oral Rehabil 2020;47:1041-1051.  https://doi.org/10.1111/joor.12993
  10. Elsaraj SM, Gornitsky M, Hovey R, Samim F, Der Khatchadourian Z, Velly A. The contribution of insomnia and obstructive sleep apnea on the transition from acute to chronic painful temporomandibular disorders and their persistence: a prospective 3-month cohort study. Can J Pain 2023;7:2266738. 
  11. Garofalo JP, Gatchel RJ, Wesley AL, Ellis E 3rd. Predicting chronicity in acute temporomandibular joint disorders using the research diagnostic criteria. J Am Dent Assoc 1998;129:438-447.  https://doi.org/10.14219/jada.archive.1998.0242
  12. Gatchel RJ, Garofalo JP, Ellis E, Holt C. Major psychological disorders in acute and chronic TMD: an initial examination. J Am Dent Assoc 1996;127:1365-1370, 1372, 1374.  https://doi.org/10.14219/jada.archive.1996.0450
  13. Hedenberg-Magnusson B, Ernberg M, Kopp S. Symptoms and signs of temporomandibular disorders in patients with fibromyalgia and local myalgia of the temporomandibular system. A comparative study. Acta Odontol Scand 1997;55:344-349.  https://doi.org/10.3109/00016359709059198
  14. Hietaharju M, Kivimaki I, Heikkila H, et al. Comparison of Axis II psychosocial assessment methods of RDC/TMD and DC/TMD as part of DC/TMD-FIN phase II validation studies in tertiary care Finnish TMD pain patients. J Oral Rehabil 2021;48:1295-1306.  https://doi.org/10.1111/joor.13260
  15. Lee YH, Auh QS. Sleep analysis results of portable polysomnography in patients with acute and chronic temporomandibular disorder. Dent Res Oral Health 2022;5:83-93. 
  16. Lovgren A, Visscher CM, Lobbezoo F, et al. The association between myofascial orofacial pain with and without referral and widespread pain. Acta Odontol Scand 2022;80:481-486.  https://doi.org/10.1080/00016357.2022.2036363
  17. Sabsoob O, Elsaraj SM, Gornitsky M, et al. Acute and chronic temporomandibular disorder pain: a critical review of differentiating factors and predictors of acute to chronic pain transition. J Oral Rehabil 2022;49:362-372.  https://doi.org/10.1111/joor.13283
  18. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain 2015;156:1003-1007.  https://doi.org/10.1097/j.pain.0000000000000160
  19. Marchevsky AM, Walts AE, Lissenberg-Witte BI, Thunnissen E. Pathologists should probably forget about kappa. Percent agreement, diagnostic specificity and related metrics provide more clinically applicable measures of interobserver variability. Ann Diagn Pathol 2020;47:151561. 
  20. McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb) 2012;22:276-282.  https://doi.org/10.11613/BM.2012.031
  21. Ohrbach R, Slade GD, Bair E, et al. Premorbid and concurrent predictors of TMD onset and persistence. Eur J Pain 2020;24:145-158.  https://doi.org/10.1002/ejp.1472
  22. Meloto CB, Slade GD, Lichtenwalter RN, et al. Clinical predictors of persistent temporomandibular disorder in people with first-onset temporomandibular disorder: a prospective case-control study. J Am Dent Assoc 2019;150:572-581.e10.  https://doi.org/10.1016/j.adaj.2019.03.023
  23. Velly AM, Look JO, Carlson C, et al. The effect of catastrophizing and depression on chronic pain: a prospective cohort study of temporomandibular muscle and joint pain disorders. Pain 2011;152:2377-2383.  https://doi.org/10.1016/j.pain.2011.07.004
  24. John MT, Miglioretti DL, LeResche L, Von Korff M, Critchlow CW. Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain. Pain 2003;102:257-263.  https://doi.org/10.1016/S0304-3959(02)00404-9
  25. Epker J, Gatchel RJ. Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorder. Psychosom Med 2000;62:69-75.  https://doi.org/10.1097/00006842-200001000-00010
  26. Nguyen TT, Vanichanon P, Bhalang K, Vongthongsri S. Pain duration and intensity are related to coexisting pain and comorbidities present in temporomandibular disorder pain patients. J Oral Facial Pain Headache 2019;33:205-212.  https://doi.org/10.11607/ofph.2088
  27. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606-613.  https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  28. Kroenke K, Spitzer RL, Williams JB. The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 2002;64:258-266.  https://doi.org/10.1097/00006842-200203000-00008
  29. Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R. Has the prevalence of migraine and tension-type headache changed over a 12-year period? A Danish population survey. Eur J Epidemiol 2005;20:243-249.  https://doi.org/10.1007/s10654-004-6519-2
  30. van der Meulen MJ, Lobbezoo F, Aartman IH, Naeije M. Validity of the oral behaviours checklist: correlations between OBC scores and intensity of facial pain. J Oral Rehabil 2014;41:115-121.  https://doi.org/10.1111/joor.12114
  31. Reiter S, Emodi-Perlman A, Goldsmith C, Friedman-Rubin P, Winocur E. Comorbidity between depression and anxiety in patients with temporomandibular disorders according to the research diagnostic criteria for temporomandibular disorders. J Oral Facial Pain Headache 2015;29:135-143.  https://doi.org/10.11607/ofph.1297
  32. Wright AR, Gatchel RJ, Wildenstein L, Riggs R, Buschang P, Ellis E 3rd. Biopsychosocial differences between high-risk and lowrisk patients with acute TMD-related pain. J Am Dent Assoc 2004;135:474-483.  https://doi.org/10.14219/jada.archive.2004.0213
  33. Anker EA, Sande T, Arefjord K, Hystad SW, Rosen A. The association between pain-related factors and psychological distress in patients with temporomandibular disorder. Psychol Health Med 2023;28:1049-1056. https://doi.org/10.1080/13548506.2022.2121969