John Mike T, Reissmann Daniel R, Schierz Oliver, Wassell Robert W
Department of Prosthodontics and Materials Science, University of Leipzig, Germany.
J Orofac Pain. 2007 Winter;21(1):46-54.
To characterize the level of impairment of oral health-related quality of life (OHRQoL) in a temporomandibular disorder (TMD) patient population.
OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G) in a consecutive sample of 416 patients seeking treatment for their complaints in the masticatory muscles and temporomandibular joints and with at least 1 diagnosis according to the German version of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The level of impairment of OHRQoL was characterized by the OHIP summary score mean and its 95% confidence interval. OHRQoL was described for each of the 8 RDC/TMD diagnoses (Axis I) and the RDC/TMD Axis II measures (Graded Chronic Pain Scale [GCPS], jaw disability list, depression, and somatization). These findings were compared with the level of impairment of OHRQoL in the adult general population derived from a national sample (n = 2,026).
Among the RDC/TMD Axis I measures, all diagnoses were correlated with much higher impacts compared to the normal population (means for all diagnoses were 32.8 to 53.7 versus 15.8 in the general population). All diagnoses had a similar level of impact except for disc displacement with reduction (which had a lower impact). There were larger differences in mean OHIP-G scores among subgroups of RDC/TMD Axis II measures than among subgroups of RDC/TMD Axis I characteristics. The strongest association was with GCPS, with mean OHIP scores of 33.3 for grade I, 48.1 for grade II, 71.7 for grade III, and 88.5 for grade IV.
OHRQoL was markedly impaired in TMD patients. The level of OHRQoL varied across diagnostic categories but more across Axis II, ie, the psychosocial axis; the variation was reflected especially in their level of graded chronic pain.
描述颞下颌关节紊乱病(TMD)患者群体中口腔健康相关生活质量(OHRQoL)的受损程度。
使用德文版口腔健康影响程度量表(OHIP-G)对连续的416例患者进行OHRQoL测量,这些患者因咀嚼肌和颞下颌关节问题前来就诊,并且根据德文版颞下颌关节紊乱病研究诊断标准(RDC/TMD)至少有1项诊断。OHRQoL的受损程度通过OHIP总分均值及其95%置信区间来描述。针对RDC/TMD的8种诊断(轴I)和RDC/TMD轴II测量指标(分级慢性疼痛量表[GCPS]、下颌功能障碍清单、抑郁和躯体化)分别描述OHRQoL。将这些结果与来自全国样本(n = 2,026)的成年普通人群的OHRQoL受损程度进行比较。
在RDC/TMD轴I测量指标中,与正常人群相比,所有诊断的影响都要高得多(所有诊断的均值为32.8至53.7,而普通人群为15.8)。除可复性盘移位(影响较小)外,所有诊断的影响水平相似。RDC/TMD轴II测量指标亚组之间的OHIP-G平均得分差异大于RDC/TMD轴I特征亚组之间的差异。最强的关联是与GCPS,I级的OHIP平均得分为33.3,II级为48.1,III级为71.7,IV级为88.5。
TMD患者的OHRQoL明显受损。OHRQoL水平在不同诊断类别中有所不同,但在轴II(即心理社会轴)上差异更大;这种差异尤其体现在其分级慢性疼痛水平上。