The associations of TMJ pain and bone characteristics on the activities of daily living

Oksana Jagur, Mart Kull, Edvitar Leibur, Riina Kallikorm, Margus Lember, Ülle Voog-Oras

Department of Internal Medicine, University of Tartu, Tartu, Estonia.
Department of Stomatology, Tartu University Hospital, University of Tartu, Tartu, Estonia.

DOI: 10.4236/ojst.2012.24042                

Abstract

The aim of this investigation was to analyze the associations of TMJ pain/discomfort and bone characteristics on the activities of daily living in a population based study. Methods: The study included 95 randomly selected participants. The impact of temporomandibular joint pain/discomfort on the daily activeties was assessed by using the daily living scale by List and Helkimo (1995). The levels of serum type I collagen telopeptide fragments (P1NP), C-telopeptide crosslaps of type I collagen (CTX-1), and vitamin D (25 (OH) D) were analysed. The Mann-Whitney U-test, Spearman rank correlation coefficent (rs) were used for statistical analyses. Results: Activities of daily living were influenced by temporomandibular joint pain/discomfort to varying degrees. The degree of pain/discomfort during eating was correlated with the level of C-telopeptide crosslaps of type I collagen (p = 0.02) and type 1 collagen telopeptide fragments (p = 0.04). The females in the study had significantly lower vitamin D levels compared to males (p = 0.04). Conclusions: This population based study indicates that TMJ pain/discomfort exerts a significant negative influence on activities of daily living and is related to the biochemical markers of bone turnover and 25 (OH) D level. Several functions of daily activities such as social life, exercising and eating are the most disturbed.

Keywords

Temporomandibular Joint; Activities of Daily Living; Bone Characteristics; Pain Assessment; Vitamin D

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Katz, W.A. and Barkin, R.L. (2010) Dilemmas in chronic/ persistent pain management. Disease-A-Month, 56, 233- 250. doi:10.1016/j.disamonth.2009.12.006
[2]	Magni, G., Caldieron, C., Rigatti-Luchini, S., et al. (1990) Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st national health and nutrition examination survey data. Pain, 43, 299-307. doi:10.1016/0304-3959(90)90027-B
[3]	Brattberg, G., Thorslund, M. and Wikman, A. (1989) The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain, 37, 215-222. doi:10.1016/0304-3959(89)90133-4
[4]	Dworkin, S.F., Huggins, K.H., LeResche, L., et al. (1990) Epidemiology of signs and symptoms in temporoman-dibular disorders: Clinical signs in cases and controls. Journal of the American Dental Association, 120, 273-281.
[5]	LeResche, L. (1997) Epidemiology of temporoman-dibular disorders: Implications for the investigation of etiologic factors. Critical Reviewers in Oral Biology & Medicine, 8, 291-305. doi:10.1177/10454411970080030401
[6]	John, M.T., Dworkin, S.F. and Mancl, L.A. (2005) Reliability of clinical temporomandibular disorder diagnoses. Pain, 118, 61-69. doi:10.1016/j.pain.2005.07.018
[7]	Svensson, P. (2007) What can human experimental pain models teach us about clinical TMD? Archives of Oral Biology, 52, 391-394. doi:10.1016/j.archoralbio.2006.11.015
[8]	Benoliel, R., Svensson, P., Heir, G.M., et al. (2011) Persistent orofacial muscle pain. Oral Disease, 7, 23-41. doi:10.1111/j.1601-0825.2011.01790.x
[9]	Voog, ü., Alstergren, P., Leibur, E., et al. (2003) Impact of temporomandibular joint pain on activities of daily living in patients with rheumatoid arthritis. Acta Odontologica Scandinavica, 61, 278-282. doi:10.1080/00016350310005989
[10]	Bucks, S.R. and Haworth, J. (2002) Bristol activities of daily living scale: A critical evaluation. Expert Review of Neurotherapeutics, 2, 669-676. doi:10.1586/14737175.2.5.669
[11]	Feinstein, A.R., Josephy, B.R. and Wells, C.K. (1986) Scientific and clinical problems in indexes of functional disability. Annals of Internal Medicine, 105, 413-420.
[12]	Katz, S., Ford, A.B., Moskowitz, R.W., et al. (1963) Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychological function. The Journal of the American Medical Association, 185, 914-919. doi:10.1001/jama.1963.03060120024016
[13]	List, T. and Helkimo, M. (1995) A scale for measuring the activities of daily living (ADL) of patients with craniomandibular disorders. Swedish Dental Journal, 19, 33-40.
[14]	Clark, G.T., Seligman, D.A., Solberg, W.K., et al. (1989) Guidelines for the examination and diagnosis of temporomandibular disorders. Journal of Craniomandibular Disorders, 3, 7-14.
[15]	Sokka, T. (2003) Assessment of pain in patients with rheumatic diseases. Best Practise & Research Clinical Rheumatology, 17, 427-449. doi:10.1016/S1521-6942(03)00020-2
[16]	Von Korff, M., Ormel, J., Keefe, F.J., et al. (1992) Grading the severity of chronic pain. Pain, 50, 133-149. doi:10.1016/0304-3959(92)90154-4
[17]	Wahlund, K., List, T. and Dworkin, S.F. (1998) Temporomandibular disorders in children and adolescents: Reliability of questionnaire, clinical examination, and diagnosis. Journal of Orofacial Pain, 12, 42-51.
[18]	Schiffman, E.L., Ohrbach, R., Truelove, E.L., et al. (2010) The Research Diagnostic Criteria for Temporomandibular Disorders. V: Methods used to establish and validate revised Axis I diagnostic algorithms. Journal of Orofacial Pain, 24, 63-78.
[19]	List, T. and Axelsson, S. (2010) Management of TMD: Evidence from systematic reviews and meta-analyses. Journal of Oral Rehabilitation, 37, 430-451. doi:10.1111/j.1365-2842.2010.02089.x
[20]	Garnero, P., Ferreras, M., Karsdal, M.A., et al. (2003) The type I collagen fragments ICTP and CTX reveal distinct enzymatic pathways of bone collagen degradation. Journal of Bone and Mineral Research, 18, 859-867. doi:10.1359/jbmr.2003.18.5.859
[21]	Kull, M.Jr., Kallikorm, R., Tamm, A., et al. (2009) Seasonal variance of 25-(OH) vitamin D in the general population of Estonia, a Nothern European country. BMC Public Health, 9, 22-33. doi:10.1186/1471-2458-9-22
[22]	Jagur, O., Kull, M., Leibur, E., et al. (2011) Relationship between radiographic changes in the temporomandibular joint and bone mineral density: A population based study. Stomatologija, Baltic Dental and Maxillofacial Journal, 13, 42-48.
[23]	Chopin, F., Garnero, P., le Henanff, A., et al. (2008) Longterm effects of infliximab on bone and cartilage turnover markers in patients with rheumatoid arthritis. Annals of the Rheumatic Diseases, 67, 353-357. doi:10.1136/ard.2007.076604
[24]	Reid, I.R., Davidson, J.S., Wattie, D., et al. (2004) Comparative responses of bone turnover markers to bisphosphonate therapy in Paget’s disease of bone. Bone, 35, 224-230. doi:10.1016/j.bone.2004.03.023
[25]	Dietrich, T., Joshipura, K.J., Dawson-Hughes, B., et al (2004). Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. The American Journal of Clinical Nutrition, 80, 108-113.
[26]	Houston, D.K., Tooze, J.A., Davis, C.C., et al. (2011) Serum 25-hydroxyvitamin D and physical function in older adults: The cardiovascular health study all stars. Journal of the American Geriatrics Society, 59, 1793-1801. doi:10.1111/j.1532-5415.2011.03601.x
[27]	Vlasiadis, K.Z., Damilakis, J., Velegrakis, G.A., et al. (2008) Relationship between BMD, dental panoramic radiographic findings and biochemical markers of bone turnover in diagnosis of osteoporosis. Maturitas, 59, 226-233. doi:10.1016/j.maturitas.2008.01.006
[28]	Undt, G., Murakami, K., Clark, G.T., et al. (2006) Crosscultural adaptation of the JPF-Questionnarie for German speaking patients with functional temporomandibular joint disorders. Journal of Cranio-Maxillofacial Surgery, 34, 226-233. doi:10.1016/j.jcms.2005.12.005
[29]	Tjakkes, G.H., Reinders, J.J., Tenvergert, E.M., et al. (2010) TMD pain: The effect on health related quality of life and the influence of pain duration. Health and Quality of Life Outcomes, 8, 46. doi:10.1186/1477-7525-8-46
[30]	Chong, D.K. (1995) Measurement of instrumental activities of daily living in stroke. Stroke, 26, 1119-1122. doi:10.1161/01.STR.26.6.1119
[31]	Dao, T.T. and LeResche, L. (2000) Gender differences in pain. Journal of Orofacial Pain, 14, 169-184.
[32]	Unell, L., Johansson, A., Carlsson, G.E., et al. (2006) Changes in reported orofacial symptoms over a ten-year period as reflected in two cohorts of fifty-year-old subjects. Acta Odontologica Scandinavica, 64, 202-208. doi:10.1080/00016350500520276
[33]	Lund, I. and Lundeberg, T. (2008) Is it all about sex? Acupuncture for the treatment of pain from a biological and gender perspective. Acupuncture in Medicine, 26, 33-45. doi:10.1136/aim.26.1.33
[34]	Dworkin, S.F., Huggins, K.H., Wilson, L., et al. (2002) A randomized clinical trial using research diagnostic criteria for temporomandibular disordersaxis II to target clinic cases for a tailored self-care TMD treatment program. Journal of Orofacial Pain, 16, 48-63.
[35]	?berg, T., Carlsson, G.E. and Fajers, C.M. (1971) The temporomandibular joint. A morphologic study on a human autopsy material. Acta Odontologica Scandinavica, 29, 349-384. doi:10.3109/00016357109026526
[36]	Nakamura, K. (2006) Vitamin D and prevention of osteoporosis: Japanese perspective. Environmental Health and Preventive Medicine, 11, 271-276. doi:10.1007/BF02898016
[37]	Von Korff, M., Dworkin, S.F. and Le Resche, L. (1990) Graded chronic pain status: An epidemiologic evaluation. Pain, 40, 279-291. doi:10.1016/0304-3959(90)91125-3
[38]	Pincus, T. (2010) Are patient questionnaire scores as “scientific” as laboratory tests for rheumatology clinical care? Bull NYU Hospital for Joint Diseases, 68, 130-139.
[39]	Hansson, T.L. (1992) Pathological aspects of arthritides and derangements. In: Sarnat, B.G. and Laskin, D.M, Eds., The Temporomandibular Joint: A Biological Basis for Clinical Practice, Saunders W.B. Company, Philadelpia, 165-182.
[40]	Abdel-Fattah, R.A. (1992) Evaluating TMJ injuries. Wiley Law Publications, New York.