咀嚼肌紊乱诊断标准:美国口腔颌面痛学会与研究性诊断标准/颞下颌关节紊乱(RDC/TMD)。
Masticatory muscle disorders diagnostic criteria: the American Academy of Orofacial Pain versus the research diagnostic criteria/temporomandibular disorders (RDC/TMD).
机构信息
Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
出版信息
J Oral Rehabil. 2012 Dec;39(12):941-7. doi: 10.1111/j.1365-2842.2012.02337.x. Epub 2012 Aug 9.
In this study, relevant cases were retrospectively reviewed to identify patients who were diagnosed as suffering from myofascial pain only according to the research diagnostic criteria/temporomandibular disorders (RDC/TMD) criteria, in order to examine whether or not they could fulfil the American Academy of Orofacial Pain (AAOP) diagnostic criteria for TMD-related masticatory muscle disorders. One hundred and twenty-seven patients, diagnosed according to the RDC/TMD criteria as having myofascial pain with or without limited jaw opening only, were allocated to two groups according to their answers to the RDC/TMD 'jaw disability checklist'. The two groups were compared for Axis I and II data taken from the RDC/TMD questionnaire. Thirty-eight of the patients (29·9%) did not associate their symptoms with jaw functions (e.g. chewing and yawning). This group was characterised by increased range of motion (ROM) and older average age. The AAOP diagnostic criteria for TMD require pain on function in all subtypes of TMD-related muscle disorders. An association between pain and jaw function is common and research is needed to determine whether this should be categorised differently to muscle pain unrelated to jaw function. There may well be different pathophysiological mechanisms and consequently different management strategies for these two pain conditions.
在这项研究中,回顾性地分析了相关病例,以确定仅根据研究诊断标准/颞下颌关节紊乱(RDC/TMD)标准诊断为肌筋膜疼痛的患者,以检查他们是否符合美国口腔颌面疼痛学院(AAOP)的 TMD 相关咀嚼肌疾病的诊断标准。根据 RDC/TMD 标准诊断为仅伴有或不伴有张口受限的肌筋膜疼痛的 127 例患者,根据 RDC/TMD“下颌功能障碍检查表”的回答将其分为两组。比较了这两组患者从 RDC/TMD 问卷中获得的轴 I 和轴 II 数据。38 例患者(29.9%)的症状与下颌功能无关(如咀嚼和打哈欠)。该组的特点是运动范围(ROM)增加和平均年龄较大。AAOP 诊断 TMD 的标准要求在所有 TMD 相关肌肉疾病亚型中都存在功能疼痛。疼痛与下颌功能之间的关联很常见,需要研究确定是否应该将其与与下颌功能无关的肌肉疼痛区分开来。这两种疼痛状况可能存在不同的病理生理机制,因此需要不同的管理策略。