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Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking

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Abstract

Objective

To study and estimate the impact of clinical, somatosensory, and psychosocial variables associated with the concomitant presence of temporomandibular joint (TMJ) pain in patients with TMJ clicking.

Materials and methods

Ninety-three individuals composed the sample: patients with painful TMJ clicking (n = 47) and patients with painless TMJ clicking (n = 46). Four categories of data were evaluated: clinical features (gender, maximal interincisal distance (MID), side of complaint, age); bruxism (sleep bruxism (SB), awake bruxism (AB)); somatosensory (mechanical pain threshold (MPT), wind-up ratio (WUR), pressure pain threshold (PPT), conditioned pain modulation (CPM)); and psychosocial (Pittsburgh Sleep Quality Index (PSQI), pain vigilance and awareness questionnaire (PVAQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD), Oral Behaviors (OBs)).

Results

Female gender, AB, WUR, CPM, PSQI, PCS, and OBs significantly (p < 0.05) increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. On the other hand, MID, MPT, and PPT significantly (p < 0.05) decreased this chance. The other variables had no association.

Conclusion

It can be concluded that being a woman, having AB, hyperalgesia in WUR, less efficient CPM, poor sleep quality, pain catastrophizing, and harmful OBs significantly increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. In the opposite, high figures of MID, MPT, and PPT decreased the chance.

Clinical relevance

Most patients with TMJ clicking usually postpone seeking treatment until the clicking truly disturbs or there is a concomitant presence of TMJ pain. Understanding the variables associated with this concomitance can be important in clinical practice.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. We also acknowledge the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001 for the PhD. scholarship of Rodrigo Lorenzi Poluha (Process: 88887.195891/2018-00) and the Sao Paulo Research Foundation (FAPESP)—Brazil for the post-doctoral scholarship of Giancarlo De la Torre Canales (Process: 2017/21674-0).

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Authors and Affiliations

  1. Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil

    Rodrigo Lorenzi Poluha, Giancarlo De la Torre Canales & Paulo César Rodrigues Conti

  2. Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil

    Leonardo Rigoldi Bonjardim

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  1. Rodrigo Lorenzi Poluha
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  2. Giancarlo De la Torre Canales
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  3. Leonardo Rigoldi Bonjardim
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  4. Paulo César Rodrigues Conti
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Correspondence to Rodrigo Lorenzi Poluha.

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This research was approved by the Research Ethics Committee of the Bauru School of Dentistry, University of Sao Paulo, Bauru, São Paulo, Brazil (CAAE: 88592018.0.0000.5417/ N°: 2.725.838).

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Poluha, R.L., De la Torre Canales, G., Bonjardim, L.R. et al. Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking. Clin Oral Invest 25, 3633–3640 (2021). https://doi.org/10.1007/s00784-020-03685-8

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  • DOI: https://doi.org/10.1007/s00784-020-03685-8

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