Percorrer por autor "Flores, Dyanne Medina"
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- Associations between temporomandibular disorders and tinnitus : a systematic reviewPublication . Canales, Giancarlo De La Torre; Christidis, Nikolaos; Grigoriadis, Anastasios; Strandberg, Tilde; Montan, Veronica; Flores, Dyanne Medina; Al-Moraissi, Essam Ahmed; Christidis, MariaObjectives: Temporomandibular disorders (TMD) and tinnitus are highly prevalent conditions, that affects about 10–30% of the adult population and seem to co-exist. The primary objective of this systematic review was to investigate any associations between TMD and tinnitus. The secondary objective was to investigate if the associations differ between painful and non-painful TMDs. Methods: An electronic literature search in five databases was performed, from the inception of the databases until 26th of October 2022. This was to identify clinical trials with prevalence numbers of patients with TMD, with and without tinnitus and vice versa. From 1240 studies, a total number of 32 studies were included in the meta-analysis. A risk of bias analysis was made using the Methodological Evaluation of Observational Research (MORE). Results: Seventeen studies showed low risk of bias, while fifteen studies showed some risk of bias. Among patients with TMD, 57.5% also displayed tinnitus. In contrast, among patients with tinnitus, 92.9% also suffered from TMD. There was a strong association between patients with TMD that also had tinnitus, and patients with tinnitus that also had TMD (p’s < 0.001). The odds ratio for TMD-patients also having tinnitus was 1.556 (p < .05), while it for tinnitus-patients also having TMD was 2.859 (p < .05). Six studies examined the psychological status, and there was a higher degree of psychosocial distress among patients with TMD and TMD/tinnitus. Conclusions: There is a strong significant association between TMD and tinnitus, but further research is needed to unravel the nature of this association and its clinical implication.
- Cognitive and orofacial intersections : prevalence of temporomandibular disorders and bruxism in individuals with symptoms of attention deficit hyperactivity disorderPublication . Caron, Arthur Alexis Valentin; Poluha, Rodrigo Lorenzi; Dias, Marlon Ferreira; Flores, Dyanne Medina; Sanchéz-Ayala, Alfonso; Durham, Justin; Canales, Giancarlo De la TorreObjective: Despite emerging evidence pointing to a comorbidity between temporomandibular disorders (TMD), bruxism, and neuropsychiatric conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD), limited studies have explored this relationship in adult populations. This study aimed to investigate the prevalence of painful TMD and self-reported bruxism in adults with highly consistent ADHD symptoms. Methodology: In total, 90 adult participants were divided into two groups based on the Adult ADHD Self-Report Scale Screener, G1: individuals with highly consistent ADHD symptomatology (n=60), and G2: controls (n=30). All participants completed validated instruments assessing TMD (TMD Pain Screener), self-reported bruxism (OBC), anxiety (GAD-7), somatization (PHQ-15), perceived stress (PSS), sleep quality (PSQI), pain hypervigilance (PVAQ), and jaw function (JFLS-8). The chi-square test, adjusted using Bonferroni criteria for multiple comparisons, and the Mann-Whitney U-test were used. Results: A higher prevalence of women (p=0.006), South Americans (p=0.008), and individuals with low/lower middle income (p=0.0001) was found in G1. G1 showed a significantly higher prevalence of painful TMD (p=0.001) and awake bruxism (p=0.013) compared to G2. Participants in G1 also exhibited significantly higher levels of anxiety, somatization, stress, poor sleep quality, pain hypervigilance, and jaw limitation (p<0.05). No significant differences in sleep bruxism were found between groups (p>0.05). Conclusion: These findings suggest a potential behavioral and emotional vulnerability to orofacial disorders in adults with highly consistent ADHD symptoms.
- Game over : unraveling the prevalence and associations between bruxism, TMD and psychosocial factors in the Esports arenaPublication . Cardoso, Flávia Paula Da Silva; Barjandi, Golnaz; Flores, Dyanne Medina; Poluha, Rodrigo Lorenzi; Christidis, Nikolaos; Canales, Giancarlo De la TorreBackground: The professionalization of electronic sports (Esports) and streaming has introduced new challenges to players' physical and mental health, including chronic stress, sleep disruption and pain-related dysfunction. These factors are linked to bruxism and temporomandibular disorders (TMD), yet their prevalence and psychosomatic correlations within this community remain unknown. This study aimed to investigate the occurrence of bruxism and TMD among Esports players and streamers as well as their associations with psychosomatic and gaming-related variables. Methods: This cross-sectional study included 97 Esports players and streamers that completed validated self-report instruments screening for TMD (TMD pain-screener), bruxism, sociodemographic data, oral behaviors, sleep quality, perceived stress, anxiety, somatic symptoms, pain vigilance, and gaming/streaming habits. In addition to standard statistical tests, orthogonal partial least squares-discriminant analysis (OPLS-DA) were applied to identify group differences and multivariate associations. Results: Nearly half of the participants screened positive for TMD (49.5 %) and 78.4 % reported self-reported bruxism. Increased daily gaming hours correlated significantly with higher perceived stress and oral parafunctions. Multivariate analyses further showed that anxiety, somatic symptoms, poor sleep and perceived stress were key factors distinguishing participants with TMD from those without, and those with combined sleep and awake bruxism from those with only awake bruxism. Conclusion: TMD and bruxism are highly prevalent among Esports players and streamers, with greater daily gaming exposure linked to psychosomatic stress and oral parafunctions. Digital athletes with combined sleep and awake bruxism and/or TMD, experience greater psychosocial distress, indicating a subgroup that needs closer attention through early screening and targeted preventive strategies.
- Hypervigilance and kinesiophobia characterize distinct exploratory data-driven profiles of temporomandibular disordersPublication . Archer, Adriana Battisti; Noel, Jonas Davi da Silva Mello; Salinas, Javier; Nordenflycht, Diego De; Cebola, Pedro Miguel Teixeira Carvas; Machado, Tassia Tillemont; Tesch, Ricardo de Souza; Calcia, Thayanne Brasil Barbosa; Souza, Beatriz Dulcineia Mendes de; Melo, Gilberto; Barhanko, Markus; Grigoriadis, Anastasios; Flores, Dyanne Medina; Canales, Giancarlo De la TorreHypervigilance and kinesiophobia have been associated with temporomandibular disorders (TMD), but their relationship with specific diagnostic profiles remains unclear. This study investigated the association between TMD diagnoses, hypervigilance, and kinesiophobia, and whether these variables could differentiate distinct clinical profiles across painful and non-painful conditions. In this multicenter cross-sectional observational study, 862 adults aged 18 to 50 years from Brazil, Chile, and Portugal were classified as controls, non-painful TMD, or painful TMD. Diagnoses were established using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Hypervigilance and kinesiophobia were assessed using the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Tampa Scale for Kinesiophobia for TMD (TSK/TMD). Statistical analyses included factor analysis of mixed data, hierarchical clustering on principal components, and partial least squares discriminant analysis, followed by multivariate and regression analyses to assess potential associations between psychosocial variables and TMD diagnoses. Among 862 participants (312 controls, 550 TMD), kinesiophobia and hypervigilance increased across groups, with the highest levels in painful TMD (p < 0.001). Unsupervised clustering identified three distinct profiles aligned with clinical presentation: controls with low psychological burden, non-painful TMD with intermediate levels, and painful TMD with elevated kinesiophobia and hypervigilance. Multivariate analyses showed associations of psychosocial variables with TMD diagnoses, with kinesiophobia consistently driving group differences, while age, gender, and pain vigilance had a moderate influence. Among TMD subgroups, joint pain was associated with higher pain vigilance and muscular TMD with higher kinesiophobia, suggesting greater clinical complexity. Higher levels of hypervigilance and kinesiophobia were associated with painful and clinical more complex TMD profiles.
- Impact of chewing muscle anesthesia on masticatory performance in healthy participantsPublication . Flores, Dyanne Medina; Karlsson, Tilda; Canales, Giancarlo De La Torre; Kaspo, Natalie; Malmström, Clara; Messerer, Sara; Kumar, Abhishek; Svedenlöf, Johanna; Conti, Paulo Cesar Rodrigues; Christidis, Nikolaos; Grigoriadis, AnastasiosThe impact of the muscle spindles in the masticatory performance remains elucidated. This study aimed to investigate the impact of local anesthesia in the jaw-closing muscles on masticatory performance in healthy participants. Thirty healthy pain-free volunteers underwent in two rounds of chewing tasks involving two types of viscoelastic candies and a two-coloured chewing gum. Lidocaine (3.0 mL) was injected into a total of six points in the masseter and temporalis muscles bilaterally for the second round. Pain intensity, fatigue, the number and area of particles, and the degree of mixing of the chewing gum were assessed at baseline and after each round of chewing. The number of candy particles after injection of lidocaine, was significantly lower (33%) for women compared to the results without anesthesia (p < 0.05). There was no significant difference in the variance of hue of the two-coloured chewing-gum when comparing values before and after anesthesia. None of the participants experienced any pain during the experiment. However, self-reported fatigue increased during the second round, i.e., after anesthesia, with significantly higher values observed at the final assessment point. (p = 0.029). Local anesthesia of the jaw-closing muscles appears to impair the masticatory function in women, leading to reduced efficiency in food comminution compared to normal mastication. The observed sex differences suggest that women may be more vulnerable to neuromuscular control alterations following sensory alterations.
- Influence of awake bruxism behaviors on fatigue of the masticatory muscles in healthy young adultsPublication . Barragán Nuñez, Maria Isabel; Flores, Dyanne Medina; Canales, Giancarlo De la Torre; Quevedo, Henrique Müller de; Conti, Paulo Rodrigues; Costa, Yuri Martins; Bonjardim, Leonardo RigoldiThe present cross-sectional study aimed to analyze the relationship between awake bruxism and fatigue of masticatory muscles in healthy young adults. For this purpose, 121 graduate students participated in this study. Frequency of awake bruxism was collected for 7 consecutive days by ecological momentary assessment (EMA) using an online survey (mentimeter). Muscle fatigue was tested one day after EMA assessment, which consisted of voluntarily and continuously clenching at 30% (kgf/cm2) of maximum bite force (MBF) until exhaustion. The percentage of change in MBF after the clenching task, as compared to the MBF before the clenching task was measured. The average frequency of awake bruxism was 45.5% during 7 days. Sustained clenching resulted in a significant reduction in MBF values in the total sample (p < 0.05). Nevertheless, no significant correlation was found between frequency of awake bruxism behaviors and percent of change in MBF and endurance time during the fatigue test. Therefore, it can be concluded that young healthy adults present a relatively high frequency of awake bruxism behaviors that do not seem to impact the degree of masticatory muscle fatigue.
- Psychological features associated with awake bruxism in painful TMD : the role of anxietyPublication . Flores, Dyanne Medina; Braga, Samilla Pontes; Canales, Giancarlo De La Torre; Stuginski-Barbosa, Juliana; Conti, Paulo César RodriguesBackground: Awake bruxism (AB) is closely linked to psychological factors and commonly co-occurs with painful temporomandibular disorders (TMD). Objective: To evaluate the role of anxiety comparing the frequency of AB behaviours, as well as levels of perceived stress, pain catastrophizing and depressive symptoms among patients with painful TMD, categorised by clinical anxiety levels. Methods: A total of 72 patients diagnosed with painful TMD were enrolled and classified into two groups based on T-scores derived from the Generalised Anxiety Disorder 7-item scale [GAD-7]: elevated symptoms of anxiety group (T ≥ 61): 30 and normative anxiety (T ≤ 60): 42. T-score calculations were based on a previously studied pain-free control group. AB behaviours were recorded through Ecological Momentary Assessment (EMA), and participants completed the Perceived Stress Scale [PSS], the Pain Catastrophizing Scale [PCS] and the Patient Health Questionnaire-9 [PHQ-9], alongside lifestyle assessment. Between-group comparisons and correlation analyses were conducted to evaluate associations between anxiety and clinical, behavioural and psychosocial outcomes. Results: Patients with elevated symptoms of anxiety exhibited higher total AB frequency (89%; 72.12%; p < 0.002), particularly increased tooth clenching (26.90%; 13.48%; p < 0.016). They also reported significantly higher clinical pain intensity (p < 0.005), as well as elevated perceived stress (p < 0.001), higher pain catastrophizing (p < 0.032), especially helplessness (p < 0.050) and rumination (p < 0.47) and more severe depressive symptoms (p < 0.002). No significant differences were seen between groups in physical activity, social engagement, alcohol drinking or smoking. Conclusion: These findings underscore that TMD patients with elevated clinical symptoms of anxiety exhibit significantly higher frequencies of AB, specifically tooth clenching, psychological distress and pain intensity.