Department of Dentistry, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Bakirkoy, Istanbul, Turkey.
J Oral Rehabil. 2009 Dec;36(12):864-71. doi: 10.1111/j.1365-2842.2009.02008.x.
The aim of this study was to determine the prevalence of temporomandibular disorder (TMD) signs in a group of institutionalized patients with schizophrenia. Three hundred thirty-nine patients with schizophrenia were examined and compared with 107 age-matched and gender-matched control subjects. TMD signs were evaluated according to the Research Diagnostic Criteria to assess temporomandibular joint pain to palpation, limitation of maximum mouth opening, alteration of mouth opening pathway (deviation/deflection) and temporomandibular joint noises. In addition, tooth wear was recorded for the assessment of bruxism. The prevalence of any TMD signs was observed higher (P = 0.001) in the patients with schizophrenia (284/339, 83.7%) than in the controls (72/107, 67.3%). The prevalence of more than one TMD sign was also significantly higher (P = 0.03) in the patients with schizophrenia (131/339, 38.6%) than in the controls (29/107, 27.1%). Significant differences between the two groups were apparent for joint pain on palpation (P = 0.006), deflection (P = 0.006) and joint sounds (P = 0.002). Severe tooth wear was evident in 39.2% of the patients with schizophrenia compared with 21.2% in the control group (P = 0.001). The finding of the present study showed that, compared to control population, chronically hospitalized patients with schizophrenia seem to be more prone to the development of TMD signs and severe tooth wear and bruxism.
本研究旨在确定一组机构化精神分裂症患者颞下颌关节紊乱(TMD)的患病率。共检查了 339 名精神分裂症患者,并与 107 名年龄和性别匹配的对照组进行比较。根据研究诊断标准评估 TMD 体征,以评估颞下颌关节触诊疼痛、最大张口度受限、张口路径改变(偏斜/偏移)和颞下颌关节噪音。此外,还记录了牙齿磨损情况以评估磨牙症。精神分裂症患者的任何 TMD 体征的患病率均明显更高(P=0.001)(284/339,83.7%),对照组为 72/107(67.3%)。精神分裂症患者中出现一种以上 TMD 体征的患病率也明显更高(P=0.03)(131/339,38.6%),对照组为 29/107(27.1%)。两组之间在触诊关节疼痛(P=0.006)、偏斜(P=0.006)和关节噪音(P=0.002)方面存在显著差异。精神分裂症患者中有 39.2%出现严重的牙齿磨损,而对照组为 21.2%(P=0.001)。本研究的结果表明,与对照组相比,慢性住院精神分裂症患者似乎更容易出现 TMD 体征和严重的牙齿磨损和磨牙症。