Bevilaqua-Grossi Débora, Chaves Thaís Cristina, de Oliveira Anamaria S, Monteiro-Pedro Vanessa
Departamento de Biomecanica, Medicina e Reabilitação do, Aparelho Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brazil.
Cranio. 2006 Apr;24(2):112-8. doi: 10.1179/crn.2006.018.
The aim of this study was to determine the frequency and to characterize the symptoms and clinical signs of temporomandibular disorders (TMD) related to each severity category of Fonseca's anamnestic index in a sample of Brazilian young adults (mean age 21.61+/-1.91 years, 87% females and 13% males), by the application of an anamnestic index proposed by Fonseca (1992) and by clinical examination considering mandibular range of motion and tenderness to palpation of stomatognathic system structures. A significant number of participants were classified with mild TMD (43.2%) and moderate TMD (34.8%). Pain frequency during mastication, temporomandibular joint (TMJ) pain, and TMJ sounds were shown to be good predictors of TMD severity. Neck pain, headache, difficulty during mouth opening and lateral deviation, and tenderness to palpation of masticatory sites and during protrusion accompanied the TMD severity but failed to demonstrate differences between moderate and severe groups, showing a poor ability to determine TMD severity progression. This study suggests that not only the frequency of signs and symptoms of TMD should be determined, but also symptom severity and its relationship to the presence of clinical signs in order to discriminate patients with real treatment needs in nonpatient samples.
本研究的目的是通过应用丰塞卡（1992年）提出的问诊指数，并结合考虑下颌运动范围和口腔颌面部系统结构触诊压痛的临床检查，来确定巴西年轻成年人样本（平均年龄21.61±1.91岁，87%为女性，13%为男性）中与丰塞卡问诊指数各严重程度类别相关的颞下颌关节紊乱病（TMD）的频率，并对其症状和临床体征进行特征描述。大量参与者被归类为轻度TMD（43.2%）和中度TMD（34.8%）。咀嚼时的疼痛频率、颞下颌关节（TMJ）疼痛和TMJ弹响被证明是TMD严重程度的良好预测指标。颈部疼痛、头痛、张口和侧向偏斜困难以及咀嚼部位和前伸时的触诊压痛伴随TMD严重程度，但在中度和重度组之间未显示出差异，表明其确定TMD严重程度进展的能力较差。本研究表明，不仅应确定TMD体征和症状的频率，还应确定症状的严重程度及其与临床体征的关系，以便在非患者样本中区分有实际治疗需求的患者。
