Craniomandibular pain, oral parafunctions, and psychological stress in a longitudinal case study

Journal of Oral Rehabilitation - Tập 31 Số 8 - Trang 738-745 - 2004
M.K.A. van Selms1, Frank Lobbezoo1, D.J. Wicks2, Hans Hamburger2, M. Naeije1
1Department of Oral Function, Section of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
2Department of Clinical Neurophysiology, Slotervaart General Hospital, Amsterdam, The Netherlands

Tóm tắt

summary In a single case study, the most frequently suggested contributing factors to craniomandibular pain, viz., oral parafunctions and psychological stress, were studied in more detail. During a 13‐week study period, questionnaires were completed, in which, among others, jaw muscle pain, bruxism behaviour, and experienced/anticipated stress were noted. During about 40% of the nights, nocturnal masticatory muscle activity (NMMA) was recorded, using single‐channel electromyography (EMG). The number of NMMA events per recorded hour was scored, using a detection threshold of 10% of the maximum voluntary contraction level. This threshold was established in a separate study, in which EMG was compared with polysomnography. Stepwise regression analyses indicated, that morning jaw muscle pain could be explained by evening jaw muscle pain for 64% and by alcohol intake for another 2%. In turn, evening jaw muscle pain was explained by daytime clenching for 56% and by vacuum sucking of the tongue for an additional 6%. Finally, daytime clenching was significantly explained by experienced stress for 30%. Data of the recorded nights showed, that variations in NMMA did not contribute to variations in morning jaw muscle pain. This case study corroborates the paradigm that experienced stress may be related to daytime clenching and, in turn, to evening and morning jaw muscle pain.

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Tài liệu tham khảo

10.1177/00220345790580090401

10.1038/sj.bdj.4805796

10.1016/0304-3959(89)90090-0

10.1016/1053-8127(96)00169-8

10.1053/smrv.1999.0070

Lobbezoo F, 1997, Do bruxism and temporomandibular disorders have a cause‐and‐effect relationship, J Orofacial Pain, 11, 15

10.1046/j.1365-2842.2001.00839.x

10.1080/08869634.1993.11677968

10.1177/00220345950740110401

10.1034/j.1600-0528.2002.00007.x

10.1177/00220345680470052001

Velly‐Miguel AM, 1992, Bruxism and other orofacial movements during sleep, J Craniomandibular Disord, 6, 71

10.1177/00220345960750010601

Rugh JD, 1975, Electromyographic studies of bruxist behaviour before and during treatment, J Calif Dent Assoc, 3, 56

Rugh JD, 1982, Behavioural aspects in dentistry, 179

Bowley JF, 1993, Reliability and validity of instrumentation used to record nocturnal clenching and/or grinding, J Orofacial Pain, 7, 378

10.1111/j.1365-2842.1995.tb00801.x

Pierce CJ, 1995, Stress, anticipatory stress, and psychologic measures related to sleep bruxism, J Orofacial Pain, 9, 51

Ikeda T, 1996, Criteria for the detection of sleep‐associated bruxism in humans, J Orofacial Pain, 10, 270

10.1177/00220345990780080901

10.1177/00220345010800020801

Okeson JP, 1996, Orofacial pain. Guidelines for assessment, diagnosis, and management, 113

Drangsholt M, 1999, Epidemiology of pain, 203

10.1046/j.1365-2869.2001.00261.x

SpilkerB.Guide to clinical trials. New York:Raven Press;1991:277.

10.1034/j.1600-0722.2000.00916.x

Dworkin SF, 1992, Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique, J Craniomandib Disord, 6, 301

10.1067/mpr.2001.118892

10.1111/j.1365-2869.1997.00259.x

Lavigne GJ, 2000, Principles and practice of sleep medicine, 773

10.1177/154411130301400104

10.1093/sleep/11.2.172

10.1111/j.1365-2842.1990.tb01412.x

Rugh JD, 1988, Nocturnal bruxism and temporomandibular disorders., Adv Neurol, 49, 329

Thorpy MJE, 1990, American sleep disorders association: parasomnia: international classification of sleep disorders: diagnostic and coding manual, 142

Rasmussen C, 1998, An automatic system for selective and standardized sleep deprivation, J Sleep Res, 7, 221

Rechtschaffen A, 1968, A manual of standardized terminology: techniques and scoring system for sleep stages of human subjects

Carskadon MA, 1994, Principles and practice of sleep medicine, 16

Gallo LM, 2002, Optimization of threshold values for automated analysis of EMG recordings, J Dent Res, 81, 316

Dao TTT, 1994, Comparison of pain and quality of life in bruxers and patients with myofascial pain of the masticatory muscles, J Orofacial Pain, 8, 350

10.1111/j.1600-0722.1997.tb00186.x

Arima T, 2001, Effect of jaw muscle pain and soreness evoked by capsaicin before sleep on orofacial motor activity during sleep, J Orofacial Pain, 15, 245

Watanabe T, 2003, Bruxism levels and daily behaviours: 3 weeks of measurement and correlation, J Orofacial Pain, 17, 65