ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
FİZİKSEL TIP VE REHABİLİTASYON
BİLİMLERİ DERGİSİ
www.jpmrs.com
Kayıtlı İndexler


ORIJINAL ARAŞTIRMA

Fibromiyalji Sendromlu Kadınlarda Temporomandibular Eklem Disfonksiyonu Bruksizm Varlığı, Depresyon ve Anksiyete Düzeyinin Değerlendirilmesi
Assessment of Temporomandibular Joint Dysfunction, Presence of Bruxism, Depression and Anxiety Level in Women with Fibromyalgia Syndrome
Received Date : 02 Sep 2021
Accepted Date : 20 Nov 2021
Available Online : 02 Dec 2021
Doi: 10.31609/jpmrs.2021-86060 - Makale Dili: TR
J PMR Sci. 2022;25(2):181-88
ÖZET
Amaç: Bu çalışmanın amacı, fibromiyalji sendromlu (FMS) kadınlarda, temporomandibular eklem (TME) disfonksiyonu ve bruksizm sıklığını tespit etmek, anksiyete ve depresyon düzeyini belirlemek ve bu sonuçları sağlıklı kontrol grubu ile karşılaştırmaktır. Gereç ve Yöntemler: Bu çalışmaya, FMS tanısı konan 117 kadın hasta ve 48 sağlıklı kadın dâhil edildi. Katılımcıların maksimum ağız açıklığı ve klik sesinin varlığı veya yokluğu kaydedildi. Katılımcılara TME disfonksiyonu sınıflaması için Fonseca anketi, anksiyete ve depresyon riskini belirlemek için Hastane Anksiyete ve Depresyon (HAD) Ölçeği, bruksizm tanısı için bruksizm değerlendirme anketi ve FMS’li hastalarda fonksiyonel durum ve yaşam kalitesi durumunu değerlendirme amacıyla Fibromiyalji Etki Anketi dolduruldu. Bulgular: Hasta ve kontrol grubu, klik varlığı yönünden karşılaştırıldığında hasta grubunda hem ağzı açarken hem de kapatırken, kontrol grubuna göre istatistiksel olarak anlamlı derecede daha fazla klik olduğu tespit edildi (p=0,001, p=0,001). Fonseca anketi, puana göre sınıflandırıldığında hasta grubunda; hafif, orta ve şiddetli TME disfonksiyonu kontrol grubuna göre daha fazla olduğu görüldü (p=0,035). İki grup HAD-depresyon ve HAD-anksiyete skorlarına göre karşılaştırıldığında, hasta grubunda kontrol grubuna göre istatistiksel olarak anlamlı derece daha yüksek olduğu tespit edildi (p=0,003, p<0,001). Bruksizm değerlendirme anketi sonuçlarına göre hasta grubunda 65 (%55,5) kişide, kontrol grubunda ise 10 (%20,8) kişide bruksizm tespit edildi. Sonuç: FMS, TME disfonksiyonu ve bruksizmin aynı hasta grubunda bir arada görülme ihtimali olduğu açıktır. Hastaların artmış anksiyete ve depresyon seviyeleri, fizik muayenede klik varlığı bu birliktelik ihtimalini artırabilir.
ABSTRACT
Objective: The purpose of the study was to determine the frequency of temporomandibular joint (TMJ) and bruxism in women with fibromyalgia syndrome (FMS), to determine the level of anxiety and depression, and to compare these results with the healthy control group. Material and Methods: 117 female patients diagnosed with FMS and 48 healthy women were included in this study. Maximum mouth opening and presence or absence of click sound were recorded. The participants were completed the Fonseca questionnaire for TMJ dysfunction classification, the Hospital Anxiety Depression (HAD) Scale to determine the risk of anxiety and depression, the bruxism assessment questionnaire for the diagnosis of bruxism, and the Fibromyalgia Impact Questionnaire to evaluate the functional status and quality of life in patients with FMS. Results: When the patient and control groups were compared in terms of the presence of clicks, it was found that there were statistically significantly more clicks in the patient group compared to the control group both when opening and closing the mouth (p=0.001, p=0.001). When Fonseca questionnaire was classified according to score, it was seen that mild, moderate and severe TMJ dysfunction were more common in the patient group than in the control group (p=0.035). When the 2 groups were compared according to HAD-depression and HAD-anxiety scores, it was found that it was statistically significantly higher in the patient group than in the control group (p=0.003, p<0.001). According to the results of the bruxism assessment questionnaire, bruxism was detected in 65 (55.5%) people in the patient group and 10 (20.8%) in the control group. Conclusion: It is clear that FMS, TMJ dysfunction and bruxism can be seen together in the same patient group. Increased anxiety and depression levels of the patients and the presence of a click in the physical examination may increase the possibility of this association.
REFERENCES
  1. Kia S, Choy E. Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines. 2017;5:20. [Crossref]  [PubMed]  [PMC] 
  2. Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76:318-28. [Crossref]  [PubMed] 
  3. Chinn S, Caldwell W, Gritsenko K. Fibromyalgia pathogenesis and treatment options update. Curr Pain Headache Rep. 2016;20:25. [Crossref]  [PubMed] 
  4. Sommer C, Häuser W, Alten R, et al; Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Medikamen töse Therapie des Fibromyalgiesyndroms. Systematische Übersicht und Metaanalyse [Drug therapy of fibromyalgia syndrome. Systematic review, meta-analysis and guideline]. Schmerz. 2012;26:297-310. German. [Crossref]  [PubMed] 
  5. Goldenberg DL. Fibromyalgia and related syndromes. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weismann MH, eds. Rheumatology. 3rd ed. London: Mosby; 2003. p.701-12. [Link] 
  6. Ramoglu S, Ozan O, Aydın M. [Conservative treatment approaches in temporomandibular joint disorders: Occlusal splints]. ADO Klinik Bilimler Dergisi. 2011;5:913-23. [Link] 
  7. Nomura K, Vitti M, Oliveira AS, et al. Use of the Fonseca's questionnaire to assess the prevalence and severity of temporomandibular disorders in Brazilian dental undergraduates. Braz Dent J. 2007;18:163-7. [Crossref]  [PubMed] 
  8. Jokubauskas L, Baltrušaitytė A, Pileičikienė G. Oral appliances for managing sleep bruxism in adults: a systematic review from 2007 to 2017. J Oral Rehabil. 2018;45:81-95. [Crossref]  [PubMed] 
  9. Buescher JJ. Temporomandibular joint disorders. Am Fam Physician. 2007;76:1477-82. [PubMed] 
  10. Ahlberg J, Savolainen A, Rantala M, et al. Reported bruxism and biopsychosocial symptoms: a longitudinal study. Community Dent Oral Epidemiol. 2004;32:307-11. [Crossref]  [PubMed] 
  11. Bulut AC, Saadet A. [Contemporary approaches of bruxism diagnosis and treatment]. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2012;14:20-5. [Link] 
  12. Baldry PA. Acupuncture, Trigger Points and Musculoskeletal Pain. 2nd ed. Edinburg: Chur chill Livingstone; 1993. p.237-41. [Link] 
  13. Mikhail M, Rosen H. History and etiology of myofascial pain-dysfunction syndrome. J Prosthet Dent. 1980;44:438-44. [Crossref]  [PubMed] 
  14. Yap AU, Tan KB, Chua EK, et al. Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent. 2002; 88(5):479-84. [Crossref]  [PubMed] 
  15. Syrop SB. Non surgical management of temporomandibular disorders. In: Peterson LJ, ed. Principles of Oral and Maxillofacial Surgery. Philadelphia: J.B. Lippincott; 1992.Co; 1992: 1905-1931, Chapter 67
  16. Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum. 2007;36:339-56. [Crossref]  [PubMed] 
  17. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160-72. [PubMed] 
  18. Ezirganlı Ş, Kara Mİ, Küçük D, et al. Investigation amount of maximum mouth opening and association with temporomandibular joint disorders in Turkish adult population. Atatürk Üniv Diş Hek Fak Derg. 2013;21:57-62. [Link] 
  19. Aydemir Ö, Güvenir T, Küey L ve ark. [Reliability and Validity of the Turkish version of Hospital Anxiety and Depression Scale]. Türk Psikiyatri Dergisi. 1997;8:280-7. [Link] 
  20. Pintado MR, Anderson GC, DeLong R, et al. Variation in tooth wear in young adults over a two-year period. J Prosthet Dent. 1997;77: 313-20. [Crossref]  [PubMed] 
  21. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int. 2000;20:9-12. [Crossref]  [PubMed] 
  22. Güleç M, Taşsöker M, Özcan S. [Current concepts of diagnosis and treatment of bruxism]. Selcuk Dent J. 2019;6:221-8. [Link] 
  23. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 5th ed. USA: Mosby; 2003. [Link] 
  24. Madenci E, Herken H, Yağız E ve ark. [Depression levels and the ways of coping with pain in patients with chronic pain and fibromyalgia syndromes]. Turk J Phys Med Rehab. 2006;52:19-21. [Link] 
  25. Bilgici A, Akdeniz O, Güz H ve ark. [The role of depression and social adjustment in fibromyalgia syndrome]. Turk J Phys Med Rehab. 2005;51:98-102. [Link]