Araraquara School of Dentistry - Sao Paulo State University - Department of Dental Materials and Prosthetics Sao Paulo State University - Araraquara School of Dentistry
Subjective sleep complaints were associated with painful temporomandibular disorders in adolescents: The Epidor-Adolescere study Giovana Fernandes, Maurits K. A. van Selms, Frank Lobbezoo, Ghizlane Aarab, Guilherme Vinícius Vale do Braido, Leticia Bueno Campi, Paula Cristina Jordani, Daniela Aparecida Godoi de Gonçalves Journal of Oral Rehabilitation, 2022 BackgroundSleep disturbances in adolescents has received a lot of attention in the literature and it is recognised as a serious health concern. The association between pain and sleep disturbances in adolescents has been extensively studied. However, to the best of our knowledge, there is a lack of studies investigating the association between various subjective sleep variables and painful TMD in adolescents.Objectivesto investigate the association between painful TMD and subjective sleep variables in adolescents' non‐clinical sample. We conducted a cross‐sectional study. TMD was classified according to the RDC/TMD criteria. The Revised Face Scale evaluated TMD pain intensity, and pressure pain thresholds (PPTs) were assessed in trigeminal and extra‐trigeminal areas. The subjective sleep variables were assessed according to the Sleep Disturbance Scale for Children and Sleep Behaviour Questionnaire.ResultsThe final sample consisted of 690 adolescents (12.7 ± 0.76 years), with 16.2% of them presenting painful TMD. Adolescents who frequently reported waking up more than twice per night and feeling tired when awake were more likely to present painful TMD symptoms [OR = 1.7 (95% CI: 1.04–2.90); p = .034 and OR = 1.6 (95% CI: 1.01–2.48); p = .046, respectively]. The intensity of TMD pain was negatively associated with sleep quality (p = .015). Also, PPT values in the trigeminal and extra‐trigeminal areas were negatively associated with total sleep time (p = .048 and p = .042, respectively).ConclusionsThe present results point out the importance of considering sleep complaints associated with painful TMD in adolescents.
Morphological and molecular characterization of proliferative inflammatory atrophy in canine prostatic samples Giovana de Godoy Fernandes, Bruna Pedrina, Patrícia de Faria Lainetti, Priscila Emiko Kobayashi, Verônica Mollica Govoni, Chiara Palmieri, Veridiana Maria Brianezi Dignani de Moura, Renée Laufer-Amorim, Carlos Eduardo Fonseca-Alves Cancers, 2021 Proliferative inflammatory atrophy (PIA) is an atrophic lesion of the prostate gland that occurs in men and dogs and is associated with a chronic inflammatory infiltrate. In this study, we retrospectively reviewed canine prostatic samples from intact dogs, identifying 50 normal prostates, 140 cases of prostatic hyperplasia, 171 cases of PIA, 84 with prostate cancer (PC), 14 with prostatic intraepithelial neoplasia (PIN) and 10 with bacterial prostatitis. PIA samples were then selected and classified according to the human classification. The presence of PIA lesions surrounding neoplastic areas was then evaluated to establish a morphological transition from normal to preneoplastic and neoplastic tissue. In addition, the expression of PTEN, P53, MDM2 and nuclear androgen receptor (AR) were analyzed in 20 normal samples and 20 PIA lesions by immunohistochemistry and qPCR. All PIA lesions showed variable degrees of mononuclear cell infiltration around the glands and simple atrophy was the most common histopathological feature. PIA was identified between normal glands and PC in 51 (61%) out of the 84 PC samples. PIA lesions were diffusely positive for molecular weight cytokeratin (HMWC). Decreased PTEN and AR gene and protein expression was found in PIA compared to normal samples. Overall, our results strongly suggest that PIA is a frequent lesion associated with PC. Additionally, this finding corroborates the hypothesis that in dogs, as is the case in humans, PIA is a pre neoplastic lesion that has the potential to progress into PC, indicating an alternative mechanism of prostate cancer development in dogs.
Temporomandibular disorder, body pain and systemic diseases: Assessing their associations in adolescents Guilherme Vinícius do Vale BRAIDO, Leticia Bueno CAMPI, Paula Cristina JORDANI, Giovana FERNANDES, Daniela Aparecida de Godoi GONÇALVES Journal of Applied Oral Science, 2020 Painful temporomandibular disorders (TMD) in children and adolescents may impact negatively the individual´s life. The presence of comorbidities associated with TMD tends to increase the persistence of pain and to facilitate its chronification. Objective To investigate the presence of other painful conditions and systemic diseases and their association with painful TMD. Methodology In this cross-sectional study, 690 adolescents aged between 12-14 years old were evaluated through questionnaires and clinical examinations. Results Painful TMD was found in 16.2% of the sample, with a significant association with bronchitis (OR= 2.5; p=0.003) and asthma (OR=3.1; p=0.013), reported by the parents/legal guardians of the participants. Adolescents with regional and widespread pain were 2.7 (95% CI: 1.65-4.55) and 3.6 (95% CI: 1.29-10.14) more likely to also present painful TMD. Painful TMD was associated with a higher number of body pain sites in the last 12 months (4.26 vs. 2.90; p<0.001), as well as a higher number of systemic diseases (1.48 vs. 1.18; p=0.048), when compared to adolescents without painful TMD. Conclusion The findings of this study point out the importance of considering the presence of comorbid conditions in the diagnosis and management of painful TMD in adolescents. A multidisciplinary approach would contribute to better control of painful TMD and decrease its chronification risk.
Widespread Pain and Central Sensitization in Adolescents with Signs of Painful Temporomandibular Disorders Letícia Campi, Corine Visscher, Paula Ongaro, Guilherme Braido, Giovana Fernandes, Daniela Gonçalves Journal of Oral and Facial Pain and Headache, 2020 AIMS To investigate the associations between signs of painful temporomandibular disorders (TMD) and number of tender points (TPs) and fibromyalgia in adolescents, as well as the relationship between TPs and pressure-pain threshold (PPT) in individuals presenting with local, regional, or widespread pain as a way to investigate the presence of central sensitization (CS). METHODS The sample consisted of 690 Brazilian adolescents with and without signs of painful TMD, aged 12 to 14 years old. Painful TMD was classified according to the Research Diagnostic Criteria for TMD (RDC/TMD) Axis I. The criteria established by Yunus were applied to assess juvenile fibromyalgia and TPs. Mann-Whitney and chi-square tests were applied to test the associations between signs of painful TMD and demographic variables. Regression models were used to estimate the association between signs of painful TMD and number of TPs and to determine which additional predictive variables were associated with TPs. Regression analyses were performed to test the associations between PPT values and number of TPs. Fisher test was used to estimate the association between signs of painful TMD and FM. RESULTS Significant associations between signs of painful TMD and the number of TPs (P < .001), as well as between TPs and the PPT values for local, regional, and widespread pain (P < .001), were found. No association between signs of painful TMD and fibromyalgia was found (P = .158). CONCLUSION Individuals with signs of painful TMD presented with more TPs compared to pain-free adolescents. Moreover, the higher the number of TPs, the lower the PPT. This finding suggests that adolescents with signs of painful TMD are at increased risk of presenting with CS.
Obesity, sedentarism and TMD-pain in adolescents Paula C. Jordani, Letícia B. Campi, Guilherme V. V. Braido, Giovana Fernandes, Corine M. Visscher, Daniela A. G. Gonçalves Journal of Oral Rehabilitation, 2019 SummaryBackgroundObesity is a chronic and prevalent disorder, affecting individuals of all age. Previous evidence suggests that it is associated with some types of chronic pain, especially musculoskeletal pain. In addition, sedentarism is also associated with an increase of the inflammatory factors and chronic pain. So, we conducted a cross‐sectional study to evaluate the association between obesity, sedentarism and the presence of TMD‐pain in adolescents.MethodsTemporomandibular Disorders were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Obesity was assessed by the body mass index (BMI), bioimpedance (BIA), skinfold (triceps and subscapular) and circumferences (arm and abdominal). The level of physical activity was rated according to the instrument adopted by the Brazilian National School Health Survey. Descriptive statistics, univariate logistic regression and odds ratios (OR) with 95% confidence intervals (CI) were used to study the associations of interest.ResultsThe sample consisted of 690 individuals with a mean age of 12.7 (±0.76) years of whom 389 (56.4%) were girls. Of the total, 112 (16.2%) had TMD‐pain, 110 (15.9%) were obese according to BMI, 74 (10.8%) according to BIA, and 127 (18.4%) following the skinfolds and circumferences assessments. There was no significant association between TMD‐pain and obesity according to BMI (P = 0.95), BIA (P = 0.16), skinfold and circumference (P = 0.22), and neither with sedentarism (P = 0.94).ConclusionObesity and sedentarism were not associated with the presence of TMD‐pain in adolescents.
Musculoskeletal Disorders Giovana Fernandes, Daniela A.G. Gonçalves, Paulo Conti Dental Clinics of North America, 2018