Janal M N, Raphael K G, Nayak S, Klausner J
Department of Psychiatry, NJ Medical School, UMDNJ, NJ, USA.
J Oral Rehabil. 2008 Nov;35(11):801-9. doi: 10.1111/j.1365-2842.2008.01854.x. Epub 2008 Oct 7.
This study estimates the prevalence of the myofascial subtype of temporomandibular disorders (M-TMD) defined by Research Diagnostic Criteria (RDC), and relates that prevalence to the surveyed report of facial pain. From among 20 000 women selected at random in the NY metropolitan area who completed a telephone survey of facial pain, 2000 were invited for an RDC/TMD examination; 782 examinations were completed. Prevalence was estimated in analyses that were weighted to correct sampling biases. Differences among demographic strata were evaluated with logistic regression. The prevalence of M-TMD was estimated to be 10.5% (95% CL = 8.5-13.0%). Prevalence was significantly higher among younger women, among women of lower socio-economic status, among Black women, and among non-Hispanic women. The report of facial pain in the telephone survey (10.1%) had high specificity for M-TMD diagnosis (94.7%), but low sensitivity (42.7%). M-TMD is a fairly common disorder among American women. Among those reporting facial pain during the last month, half met RDC palpation criteria for M-TMD; thus, a formal physical examination is imperative to establish this diagnosis. Prevalence varies with age, socio-economic status, race and Hispanic ethnicity. A substantial number of RDC-diagnosed cases of M-TMD did not report facial pain in the survey; the reason for this requires further study.
本研究估算了依据研究诊断标准（RDC）定义的颞下颌关节紊乱病肌筋膜亚型（M-TMD）的患病率，并将该患病率与面部疼痛的调查报道相关联。在纽约大都市区随机选取的20000名完成面部疼痛电话调查的女性中，邀请了2000人进行RDC/TMD检查；完成了782例检查。在加权分析中估算患病率以校正抽样偏差。采用逻辑回归评估人口统计学分层之间的差异。M-TMD的患病率估计为10.5%（95%可信区间=8.5-13.0%）。在年轻女性、社会经济地位较低的女性、黑人女性以及非西班牙裔女性中，患病率显著更高。电话调查中面部疼痛的报道（10.1%）对M-TMD诊断具有较高的特异性（94.7%），但敏感性较低（42.7%）。M-TMD在美国女性中是一种相当常见的疾病。在过去一个月内报告面部疼痛的人群中，有一半符合M-TMD的RDC触诊标准；因此，必须进行正式的体格检查以确立该诊断。患病率随年龄、社会经济地位、种族和西班牙裔种族而变化。大量经RDC诊断的M-TMD病例在调查中未报告面部疼痛；其原因需要进一步研究。
