碰撞相关损伤后下颌运动减少或疼痛：一项基于人群的研究。

Reduced or painful jaw movement after collision-related injuries: a population-based study.

作者信息

Carroll Linda J, Ferrari Robert, Cassidy J David

机构信息

Department of Public Health Sciences, Alberta Centre for Injury Prevention and Research, School of Public Health, University of Alberta, Edmonton, Alberta, Canada, T6G 2E1.

出版信息

J Am Dent Assoc. 2007 Jan;138(1):86-93. doi: 10.14219/jada.archive.2007.0026.

DOI:10.14219/jada.archive.2007.0026

PMID:17197407

Abstract

BACKGROUND

The authors report the incidence of and factors associated with reduced and/or painful jaw movement after motor vehicle collisions that resulted in whiplash-associated disorders (WADs).

METHODS

All adults filing collision-related personal injury claims during an 18-month period in Saskatchewan, Canada, were evaluated via questionnaire to determine demographic characteristics, precollision health (including jaw pain), collision parameters and collision-related symptoms, including reduced and/or painful jaw movement and injury-related neck pain. The authors excluded patients who were hospitalized for more than two days and those who sustained injuries as a pedestrian, bicyclist or motorcyclist. In determining incidence rates, the authors also excluded those who had had jaw pain before the collision.

RESULTS

The incidence of reduced and/or painful jaw movement was 14.9 percent (n = 1,158), and it was higher in subjects with WADs (15.8 percent) than in those without WADs (4.7 percent; relative risk = 3.36, 95 percent confidence interval, 2.36 to 4.78). Within the WAD injuries, multivariable logistic regression revealed that the onset of reduced and/or painful jaw movement was associated with female sex; age < 50 years; having hit one's head in the collision; and postinjury symptoms of difficulty swallowing, ringing in the ears, dizziness or unsteadiness, and more intense neck pain. Collision parameters, such as head position at the time of the crash and headrest use and type, were not associated with onset of jaw symptoms.

CONCLUSIONS

Reduced or painful jaw movement was more common in people with WADs than in those with other collision-related injuries. Among those with WADs, reduced or painful jaw movement was more common in women and younger people.

CLINICAL IMPLICATIONS

Reduced or painful jaw movement is an important aspect of WADs, and more studies are needed to determine how to best assess and treat this problem.

摘要

背景

作者报告了因机动车碰撞导致挥鞭样损伤相关疾病（WADs）后下颌运动减少和/或疼痛的发生率及相关因素。

方法

对在加拿大萨斯喀彻温省18个月期间提交与碰撞相关人身伤害索赔的所有成年人进行问卷调查，以确定人口统计学特征、碰撞前健康状况（包括下颌疼痛）、碰撞参数和与碰撞相关的症状，包括下颌运动减少和/或疼痛以及与损伤相关的颈部疼痛。作者排除了住院超过两天的患者以及行人、骑自行车者或骑摩托车者受伤的患者。在确定发病率时，作者还排除了碰撞前有下颌疼痛的患者。

结果

下颌运动减少和/或疼痛的发生率为14.9%（n = 1158），WADs患者中的发生率（15.8%）高于无WADs患者（4.7%；相对风险 = 3.36，95%置信区间，2.36至4.78）。在WAD损伤中，多变量逻辑回归显示下颌运动减少和/或疼痛的发作与女性性别、年龄<50岁、在碰撞中头部受伤以及伤后吞咽困难、耳鸣、头晕或不稳以及更剧烈的颈部疼痛症状有关。碰撞参数，如碰撞时头部位置以及头枕的使用和类型，与下颌症状的发作无关。