title: Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients.
abstract: OBJECTIVE
  The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia.
  
  
  METHODS
  The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari.
  
  
  RESULTS
  24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients).
  
  
  CONCLUSIONS
  Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Corsalini
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Di Venere
authors.initials: DV
authors.lastname: Daniela
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Rapone
authors.initials: R
authors.lastname: Biagio
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Stefanachi
authors.initials: S
authors.lastname: Gianluca
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Laforgia
authors.initials: L
authors.lastname: Alessandra
authors.affiliation: Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy.
authors.forename: Pettini
authors.initials: P
authors.lastname: Francesco
keywords: Craniomandibular disorder; Fibromyalgia patient; Gnathologic examination; Hypothyroidism; Myofascial pain