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自述磨牙症和颞下颌关节紊乱:来自两个专业中心的发现。

Self-reported bruxism and temporomandibular disorders: findings from two specialised centres.

机构信息

Department of Maxillofacial Surgery, University of Padova, Padova, Italy.

出版信息

J Oral Rehabil. 2012 May;39(5):319-25. doi: 10.1111/j.1365-2842.2011.02281.x. Epub 2012 Jan 17.

Abstract

The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. Significant differences were shown between the two clinic samples as for the frequency of TMD diagnoses (chi-square, P<0·001) and the prevalence of at least one positive response to bruxism items (chi-square, P<0·001). The more widespread use of TMJ imaging techniques in one clinic sample led to a higher prevalence of multiple diagnoses, and the higher prevalence of self-reported bruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders.

摘要

本研究的目的是报告颞下颌关节紊乱(TMD)诊断的频率以及自述清醒和睡眠磨牙症的患病率,并描述两个专门中心的发现之间可能存在的差异,以此作为建议未来提高诊断一致性和准确性的基础。对意大利帕多瓦大学(n=219;74%为女性)和以色列特拉维夫大学的 TMD 诊所(n=397;79%为女性)的患者进行了标准化的研究诊断标准 TMD(RDC/TMD)评估,以分配 I 轴身体诊断,并记录关于自述清醒和睡眠磨牙症的数据。两个诊所样本之间在 TMD 诊断的频率(卡方,P<0·001)和至少一个磨牙症项目阳性反应的患病率(卡方,P<0·001)方面显示出显著差异。一个诊所样本中更广泛地使用 TMJ 成像技术导致了多种诊断的更高患病率,而在另一个诊所样本中描述的单独肌筋膜疼痛患者中自述磨牙症的更高患病率并未得到复制,这表明诊断 TMD 时采用不同的临床和影像学标准可能也会影响对其与磨牙症之间关联的报告。从这项研究中可以看出,研究样本的特征以及对相同诊断指南的不同解释可能对磨牙症和 TMD 患病率的流行病学报告以及两种疾病之间的关联产生强烈影响。

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