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TEMPOROMANDİBULAR DİSFONKSİYONLU BİREYLERDE AĞRIYI FELAKETLEŞTİRME VE AĞRI YOĞUNLUĞUNUN ISIRMA KUVVETİ VE ÇENE KAS KUVVETİ İLE İLİŞKİSİ

Year 2021, Volume: 6 Issue: 3, 20 - 27, 24.12.2021
https://doi.org/10.52881/gsbdergi.972468

Abstract

Bu çalışma temporomandibular eklem rahatsızlığı (TMER) bulunan bireylerde ağrıyı felaketleştirme ve aktivite ağrısı ile ısırma kuvveti ve çene kas kuvveti arasındaki ilişkiyi göstermek amacıyla yapıldı. Çalışmaya TMER tanılı 43 birey (ortalama yaş 29.79±8.34 yıl) dâhil edildi. Bireylerin ağrıyı felaketleştirme düzeyleri Ağrı Felaketleştirme Skalası (AFS), aktivite ağrısı Görsel Analog Skala (GAS), ısırma kuvvetleri pinç metre ve çene kas kuvvetleri Lafayette manuel kas testi cihazı ile ölçüldü. Değişkenler arası ilişki Pearson Korelasyon testi ile incelendi. AFS ile ısırma kuvvetleri (merkezi: -0.519; sağ: -0.518; sol: -0.515) ve çene kas kuvvetleri (açma: -0.688; kapatma: -0.635; sağ ekskürsiyon: -0.609, sol ekskürsiyon: -0.645; protrüzyon: -0.621) arasında; aktivite ağrısı ile ısırma kuvvetleri (merkezi: -0.429; sağ: -0.453; sol: -0.451) ve çene kas kuvvetleri (açma: -0.511; kapatma: -0.420; sağ ekskürsiyon: -0.343, sol ekskürsiyon: -0.463; protrüzyon: -0.471) arasında negatif yönde anlamlı ilişki bulundu (p<0,05). TMER'li bireylerde ağrı ve ağrı algısı ısırma ve çene kas kuvvetini azaltmaktadır. Bu bireylerin aktivite ağrısı şiddetine kıyasla ağrı algıları ısırma ve çene kas kuvvetleri ile daha yüksek derecede ilişkilidir. Bu sonuçlara dayanarak TMER’li bireylerde daha iyi ısırma ve çene kas kuvveti için biyodavranışsal model ile ağrıya yaklaşımın daha yararlı olabileceğini söyleyebiliriz.

References

  • 1. De Leeuw R, Klasser G. American Academy of Orofacial Pain. Diagnosis and Management of TMDs. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 6th edition, 2018:127-86.
  • 2. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017;37(7):692-704.
  • 3. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8(3):291-305.
  • 4. Macfarlane TV, Kenealy P, Anne Kingdon H, Mohlin B, Pilley JR, Mwangi CW, et al. Orofacial pain in young adults and associated childhood and adulthood factors: results of the population study, Wales, United Kingdom. Community Dent Oral Epidemiol. 2009;37(5):438-50.
  • 5. De Leeuw R, Bertoli E, Schmidt JE, Carlson CR. Prevalence of traumatic stressors in patients with temporomandibular disorders. J Oral Maxillofac Surg. 2005;63(1):42-50.
  • 6. Carlson CR, Okeson JP, Falace DA, Nitz AJ, Curran SL, Anderson D. Comparison of psychologic and physiologic functioning between patients with masticatory muscle pain and matched controls. J Orofac Pain. 1993;7(1).
  • 7. Manfredini D, Landi N, Bandettini Di Poggio A, Dell Osso L, Bosco M. A critical review on the importance of psychological factors in temporomandibular disorders. Minerva Stomatol. 2003;52(6):321-30.
  • 8. Quartana PJ, Buenaver LF, Edwards RR, Klick B, Haythornthwaite JA, Smith MT. Pain catastrophizing and salivary cortisol responses to laboratory pain testing in temporomandibular disorder and healthy participants. J Pain. 2010;11(2):186-94.
  • 9. Visscher CM, Ohrbach R, van Wijk AJ, Wilkosz M, Naeije M. The tampa scale for kinesiophobia for temporomandibular disorders (TSK-TMD). Pain. 2010;150(3):492-500.
  • 10. Sullivan MJ, Lynch ME, Clark A. Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions. Pain. 2005;113(3):310-5.
  • 11. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52-64.
  • 12. Wertli MM, Burgstaller JM, Weiser S, Steurer J, Kofmehl R, Held U. Influence of catastrophizing on treatment outcome in patients with nonspecific low back pain: a systematic review. Spine. 2014;39(3):263-73.
  • 13. Spinhoven P, Ter Kuile M, Kole-Snijders AM, Mansfeld MH, Den Ouden D-J, Vlaeyen JW. Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain. Eur J Pain. 2004;8(3):211-9.
  • 14. Severeijns R, Vlaeyen JW, van den Hout MA, Picavet HSJ. Pain catastrophizing is associated with health indices in musculoskeletal pain: a cross-sectional study in the Dutch community. Health Psychol. 2004;23(1):49.
  • 15. Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17(2):165-72.
  • 16. Lund JP, Donga R, Widmer CG, Stohler CS. The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol. 1991;69(5):683-94.
  • 17. Sterling M, Jull G, Wright A. The effect of musculoskeletal pain on motor activity and control. J Pain. 2001;2(3):135-45.
  • 18. Côté JN, Bement MKH. Update on the relation between pain and movement: consequences for clinical practice. Clin J Pain. 2010;26(9):754-62.
  • 19. Le Pera D, Graven-Nielsen T, Valeriani M, Oliviero A, Di Lazzaro V, Tonali PA, et al. Inhibition of motor system excitability at cortical and spinal level by tonic muscle pain. Clin Neurophysiol. 2001;112(9):1633-41.
  • 20. Korotkov A, Ljubisavljevic M, Thunberg J, Kataeva G, Roudas M, Pakhomov S, et al. Changes in human regional cerebral blood flow following hypertonic saline induced experimental muscle pain: a positron emission tomography study. Neurosci Lett. 2002;335(2):119-23.
  • 21. Maihöfner C, Baron R, DeCol R, Binder A, Birklein F, Deuschl G, et al. The motor system shows adaptive changes in complex regional pain syndrome. Brain. 2007;130(10):2671-87.
  • 22. Vallence A-M, Smith A, Tabor A, Rolan PE, Ridding MC. Chronic tension-type headache is associated with impaired motor learning. Cephalalgia. 2013;33(12):1048-54.
  • 23. Gomes NC, Berni-Schwarzenbeck K, Packer AC, Rdrigues-Bigaton D. Effect of cathodal high-voltage electrical stimulation on pain in women with TMD. Braz J Phys Ther. 2012;16:10-5.
  • 24. Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524.
  • 25. Finch E. Physical rehabilitation outcome measures. A guide to enhanced clinical decision making. 2nd edition, 2002;64.
  • 26. Bonjardim L, Gavião M, Pereira L, Castelo P. Bite force determination in adolescents with and without temporomandibular dysfunction. J Oral Rehabil. 2005;32(8):577-83.
  • 27. Kogawa E, Calderon P, Lauris J, Araujo C, Conti P. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil. 2006;33(8):559-65.
  • 28. Pereira-Cenci T, Pereira LJ, Cenci MS, Bonachela WC, Del Bel Cury AA. Maximal bite force and its association with temporomandibular disorders. Braz Dent J. 2007;18(1):65-8.
  • 29. Mukaka MM. A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.
  • 30. Häggman-Henrikson B, Bechara C, Pishdari B, Visscher CM, Ekberg E. Impact of Catastrophizing in Patients with Temporomandibular Disorders--A Systematic Review. J Orofac Pain. 2020(4).
  • 31. Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J Pain Res. 2018;11:571.
  • 32. Carlson CR. Psychological considerations for chronic orofacial pain. Oral Maxillofac Surg Clin North Am. 2008;20(2):185-95.
  • 33. Keefe FJ, Block AR. Development of an observation method for assessing pain behavior in chronic low back pain patients. Behav Ther. 1982.
  • 34. Sullivan MJ. Toward a biopsychomotor conceptualization of pain: implications for research and intervention. Clin J Pain. 2008;24(4):281-90.
  • 35. Bahat HS, Weiss PLT, Sprecher E, Krasovsky A, Laufer Y. Do neck kinematics correlate with pain intensity, neck disability or with fear of motion? Man Ther. 2014;19(3):252-8.
  • 36. Geisser ME, Haig AJ, Wallbom AS, Wiggert EA. Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain. 2004;20(2):61-9.
  • 37. George SZ, Fritz JM, McNeil DW. Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain. Clin J Pain. 2006;22(2):197-203.
  • 38. Verbunt JA, Sieben JM, Seelen HA, Vlaeyen JW, Bousema EJ, van der Heijden GJ, et al. Decline in physical activity, disability and pain-related fear in sub-acute low back pain. Eur J Pain. 2005;9(4):417-25.
  • 39. Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30(1):77-94.
  • 40. Thomas JS, France CR. Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain. Spine. 2007;32(16):E460-E6.

THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION

Year 2021, Volume: 6 Issue: 3, 20 - 27, 24.12.2021
https://doi.org/10.52881/gsbdergi.972468

Abstract

This study was conducted to show the relationship between pain catastrophizing and activity pain severity with bite force and jaw muscle strength in individuals with temporomandibular disorders (TMD). Forty-three individuals (mean age 29.79±8.34 years) with a diagnosis of TMER were included in the study. Pain catastrophizing levels of individuals with the Pain Catastrophizing Scale (PCS), activity pain with the Visual Analog Scale (VAS), bite force with a pinch meter, and jaw muscle strength with Lafayette manual muscle testing device were measured. The relationship between the variables was examined with the Pearson Correlation test. Statistically significant negative correlations were found PCS between bite forces (central: -0.519; right: -0.518; left: -0.515) and jaw muscle strengths (opening: -0.688; closing: -0.635; right excursion: -0.609, left excursion: -0.645; protrusion: -0.621); activity pain intensity between bite forces (central: -0.429; right: -0.453; left: -0.451) and jaw muscle strengths (opening: -0.511; closing: -0.420; right excursion: -0.343, left excursion: -0.463; protrusion: -0.471) (p<0,05). Pain and pain perception decrease bite and jaw muscle strength in individuals with TMD. Pain perceptions of these individuals are more highly correlated with bite and jaw muscle strength compared to activity pain severity. Based on these results, we can say that a biobehavioral model and an approach to pain may be more beneficial for better bite and jaw muscle strength in individuals with TMD.

References

  • 1. De Leeuw R, Klasser G. American Academy of Orofacial Pain. Diagnosis and Management of TMDs. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. 6th edition, 2018:127-86.
  • 2. List T, Jensen RH. Temporomandibular disorders: Old ideas and new concepts. Cephalalgia. 2017;37(7):692-704.
  • 3. LeResche L. Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med. 1997;8(3):291-305.
  • 4. Macfarlane TV, Kenealy P, Anne Kingdon H, Mohlin B, Pilley JR, Mwangi CW, et al. Orofacial pain in young adults and associated childhood and adulthood factors: results of the population study, Wales, United Kingdom. Community Dent Oral Epidemiol. 2009;37(5):438-50.
  • 5. De Leeuw R, Bertoli E, Schmidt JE, Carlson CR. Prevalence of traumatic stressors in patients with temporomandibular disorders. J Oral Maxillofac Surg. 2005;63(1):42-50.
  • 6. Carlson CR, Okeson JP, Falace DA, Nitz AJ, Curran SL, Anderson D. Comparison of psychologic and physiologic functioning between patients with masticatory muscle pain and matched controls. J Orofac Pain. 1993;7(1).
  • 7. Manfredini D, Landi N, Bandettini Di Poggio A, Dell Osso L, Bosco M. A critical review on the importance of psychological factors in temporomandibular disorders. Minerva Stomatol. 2003;52(6):321-30.
  • 8. Quartana PJ, Buenaver LF, Edwards RR, Klick B, Haythornthwaite JA, Smith MT. Pain catastrophizing and salivary cortisol responses to laboratory pain testing in temporomandibular disorder and healthy participants. J Pain. 2010;11(2):186-94.
  • 9. Visscher CM, Ohrbach R, van Wijk AJ, Wilkosz M, Naeije M. The tampa scale for kinesiophobia for temporomandibular disorders (TSK-TMD). Pain. 2010;150(3):492-500.
  • 10. Sullivan MJ, Lynch ME, Clark A. Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions. Pain. 2005;113(3):310-5.
  • 11. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52-64.
  • 12. Wertli MM, Burgstaller JM, Weiser S, Steurer J, Kofmehl R, Held U. Influence of catastrophizing on treatment outcome in patients with nonspecific low back pain: a systematic review. Spine. 2014;39(3):263-73.
  • 13. Spinhoven P, Ter Kuile M, Kole-Snijders AM, Mansfeld MH, Den Ouden D-J, Vlaeyen JW. Catastrophizing and internal pain control as mediators of outcome in the multidisciplinary treatment of chronic low back pain. Eur J Pain. 2004;8(3):211-9.
  • 14. Severeijns R, Vlaeyen JW, van den Hout MA, Picavet HSJ. Pain catastrophizing is associated with health indices in musculoskeletal pain: a cross-sectional study in the Dutch community. Health Psychol. 2004;23(1):49.
  • 15. Severeijns R, Vlaeyen JW, van den Hout MA, Weber WE. Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clin J Pain. 2001;17(2):165-72.
  • 16. Lund JP, Donga R, Widmer CG, Stohler CS. The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol. 1991;69(5):683-94.
  • 17. Sterling M, Jull G, Wright A. The effect of musculoskeletal pain on motor activity and control. J Pain. 2001;2(3):135-45.
  • 18. Côté JN, Bement MKH. Update on the relation between pain and movement: consequences for clinical practice. Clin J Pain. 2010;26(9):754-62.
  • 19. Le Pera D, Graven-Nielsen T, Valeriani M, Oliviero A, Di Lazzaro V, Tonali PA, et al. Inhibition of motor system excitability at cortical and spinal level by tonic muscle pain. Clin Neurophysiol. 2001;112(9):1633-41.
  • 20. Korotkov A, Ljubisavljevic M, Thunberg J, Kataeva G, Roudas M, Pakhomov S, et al. Changes in human regional cerebral blood flow following hypertonic saline induced experimental muscle pain: a positron emission tomography study. Neurosci Lett. 2002;335(2):119-23.
  • 21. Maihöfner C, Baron R, DeCol R, Binder A, Birklein F, Deuschl G, et al. The motor system shows adaptive changes in complex regional pain syndrome. Brain. 2007;130(10):2671-87.
  • 22. Vallence A-M, Smith A, Tabor A, Rolan PE, Ridding MC. Chronic tension-type headache is associated with impaired motor learning. Cephalalgia. 2013;33(12):1048-54.
  • 23. Gomes NC, Berni-Schwarzenbeck K, Packer AC, Rdrigues-Bigaton D. Effect of cathodal high-voltage electrical stimulation on pain in women with TMD. Braz J Phys Ther. 2012;16:10-5.
  • 24. Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7(4):524.
  • 25. Finch E. Physical rehabilitation outcome measures. A guide to enhanced clinical decision making. 2nd edition, 2002;64.
  • 26. Bonjardim L, Gavião M, Pereira L, Castelo P. Bite force determination in adolescents with and without temporomandibular dysfunction. J Oral Rehabil. 2005;32(8):577-83.
  • 27. Kogawa E, Calderon P, Lauris J, Araujo C, Conti P. Evaluation of maximal bite force in temporomandibular disorders patients. J Oral Rehabil. 2006;33(8):559-65.
  • 28. Pereira-Cenci T, Pereira LJ, Cenci MS, Bonachela WC, Del Bel Cury AA. Maximal bite force and its association with temporomandibular disorders. Braz Dent J. 2007;18(1):65-8.
  • 29. Mukaka MM. A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24(3):69-71.
  • 30. Häggman-Henrikson B, Bechara C, Pishdari B, Visscher CM, Ekberg E. Impact of Catastrophizing in Patients with Temporomandibular Disorders--A Systematic Review. J Orofac Pain. 2020(4).
  • 31. Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. J Pain Res. 2018;11:571.
  • 32. Carlson CR. Psychological considerations for chronic orofacial pain. Oral Maxillofac Surg Clin North Am. 2008;20(2):185-95.
  • 33. Keefe FJ, Block AR. Development of an observation method for assessing pain behavior in chronic low back pain patients. Behav Ther. 1982.
  • 34. Sullivan MJ. Toward a biopsychomotor conceptualization of pain: implications for research and intervention. Clin J Pain. 2008;24(4):281-90.
  • 35. Bahat HS, Weiss PLT, Sprecher E, Krasovsky A, Laufer Y. Do neck kinematics correlate with pain intensity, neck disability or with fear of motion? Man Ther. 2014;19(3):252-8.
  • 36. Geisser ME, Haig AJ, Wallbom AS, Wiggert EA. Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain. 2004;20(2):61-9.
  • 37. George SZ, Fritz JM, McNeil DW. Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain. Clin J Pain. 2006;22(2):197-203.
  • 38. Verbunt JA, Sieben JM, Seelen HA, Vlaeyen JW, Bousema EJ, van der Heijden GJ, et al. Decline in physical activity, disability and pain-related fear in sub-acute low back pain. Eur J Pain. 2005;9(4):417-25.
  • 39. Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007;30(1):77-94.
  • 40. Thomas JS, France CR. Pain-related fear is associated with avoidance of spinal motion during recovery from low back pain. Spine. 2007;32(16):E460-E6.
There are 40 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Makaleler
Authors

Halime Arıkan 0000-0003-2381-9978

Seyit Çıtaker 0000-0002-4215-6797

Cahit Üçok This is me 0000-0003-3566-4731

Özlem Üçok 0000-0003-4904-0591

Publication Date December 24, 2021
Submission Date July 16, 2021
Acceptance Date July 23, 2021
Published in Issue Year 2021 Volume: 6 Issue: 3

Cite

APA Arıkan, H., Çıtaker, S., Üçok, C., Üçok, Ö. (2021). THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION. Gazi Sağlık Bilimleri Dergisi, 6(3), 20-27. https://doi.org/10.52881/gsbdergi.972468
AMA Arıkan H, Çıtaker S, Üçok C, Üçok Ö. THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION. Gazi Health Sci. December 2021;6(3):20-27. doi:10.52881/gsbdergi.972468
Chicago Arıkan, Halime, Seyit Çıtaker, Cahit Üçok, and Özlem Üçok. “THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION”. Gazi Sağlık Bilimleri Dergisi 6, no. 3 (December 2021): 20-27. https://doi.org/10.52881/gsbdergi.972468.
EndNote Arıkan H, Çıtaker S, Üçok C, Üçok Ö (December 1, 2021) THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION. Gazi Sağlık Bilimleri Dergisi 6 3 20–27.
IEEE H. Arıkan, S. Çıtaker, C. Üçok, and Ö. Üçok, “THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION”, Gazi Health Sci, vol. 6, no. 3, pp. 20–27, 2021, doi: 10.52881/gsbdergi.972468.
ISNAD Arıkan, Halime et al. “THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION”. Gazi Sağlık Bilimleri Dergisi 6/3 (December 2021), 20-27. https://doi.org/10.52881/gsbdergi.972468.
JAMA Arıkan H, Çıtaker S, Üçok C, Üçok Ö. THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION. Gazi Health Sci. 2021;6:20–27.
MLA Arıkan, Halime et al. “THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION”. Gazi Sağlık Bilimleri Dergisi, vol. 6, no. 3, 2021, pp. 20-27, doi:10.52881/gsbdergi.972468.
Vancouver Arıkan H, Çıtaker S, Üçok C, Üçok Ö. THE RELATIONSHIP OF PAIN CATASTROPHIZING AND ACTIVITY PAIN SEVERITY WITH BITING FORCE AND JAW MUSCLE STRENGTH IN INDIVIDUALS WITH TEMPOROMANDIBULAR DYSFUNCTION. Gazi Health Sci. 2021;6(3):20-7.