Medical College of Wisconsin, Milwaukee, WI, USA.
Clin J Pain. 2011 Mar-Apr;27(3):268-74. doi: 10.1097/AJP.0b013e31820215f5.
Temporomandibular joint and muscle disorders (TMJD) are ill-defined, painful debilitating disorders. This study was undertaken to identify the spectrum of clinical manifestations based on self-report from affected patients.
A total of 1511 TMJD-affected individuals were recruited through the web-based registry of patients maintained by The TMJ Association, Ltd, a patient advocacy organization, and participated in the survey as well as 57 of their nonaffected friends. Results were also compared with US population for questions in common with the National Health and Nutrition Examination Survey.
The TMJD-affected individuals were on average 41 years of age and predominantly female (90%). Nearly 60% of both men and women reported recent pain of moderate-to-severe intensity with a quarter of them indicating interference or termination of work-related activities. In the case-control comparison, a higher frequency of headaches, allergies, depression, fatigue, degenerative arthritis, fibromyalgia, autoimmune disorders, sleep apnea, and gastrointestinal complaints were prevalent among those affected with TMJD. Many of the associated comorbid conditions were over 6 times more likely to occur after TMJD was diagnosed. Among a wide array of treatments used (46 listed), the most effective relief for most affected individuals (91%) was the use of thermal therapies--hot/cold packs to the jaw area or hot baths. Nearly 40% of individuals affected with TMJD patients reported one or more surgical procedures and nearly all were treated with one or many different medications. Results of these treatments were generally equivocal. Although potentially limited to the most severe TMJD affected individuals, the survey results provide a comprehensive dataset describing the clinical manifestations of TMJD.
The data provide evidence that TMJD represent a spectrum of disorders with varying pathophysiologies, clinical manifestations, and associated comorbid conditions. The findings underscore the complex nature of TMJD, the need for more extensive interdisciplinary basic and clinical research, and the development of outcome-based strategies to more effectively diagnose, prevent, and treat these chronic, debilitating conditions.
颞下颌关节和肌肉紊乱（TMJD）是一种定义不明确、疼痛、使人虚弱的疾病。本研究旨在根据受影响患者的自我报告，确定基于临床表现的范围。
通过 TMJ 协会（有限公司）维护的患者在线注册中心招募了 1511 名 TMJD 受影响的个体，并参与了这项调查。TMJ 协会是一个患者倡导组织，此外，还招募了 57 名他们未受影响的朋友作为对照。结果还与美国国家健康和营养检查调查中的常见问题进行了比较。
TMJD 受影响的个体平均年龄为 41 岁，主要为女性（90%）。近 60%的男性和女性报告近期有中度至重度疼痛，其中四分之一的人表示工作相关活动受到干扰或终止。在病例对照比较中，患有 TMJD 的个体更常出现头痛、过敏、抑郁、疲劳、退行性关节炎、纤维肌痛、自身免疫性疾病、睡眠呼吸暂停和胃肠道投诉等相关合并症。许多相关合并症在 TMJD 诊断后发生的可能性高出 6 倍以上。在使用的各种治疗方法（列出 46 种）中，大多数受影响个体（91%）最有效的缓解方法是使用热疗法——将热/冷包敷在颌部或热水浴。近 40%的 TMJD 患者报告进行了一次或多次手术，几乎所有人都接受了一种或多种不同的药物治疗。这些治疗的效果通常不确定。尽管可能仅限于最严重的 TMJD 受影响个体，但调查结果提供了一个全面的数据集，描述了 TMJD 的临床表现。
数据提供的证据表明，TMJD 代表了一系列具有不同病理生理学、临床表现和相关合并症的疾病。这些发现强调了 TMJD 的复杂性，需要更广泛的跨学科基础和临床研究，并制定基于结果的策略，以更有效地诊断、预防和治疗这些慢性、使人虚弱的疾病。
