Nishiyama Akira, Kino Koji, Sugisaki Masashi, Tsukagoshi Kaori
Temporomandibular Joint and Oral Function, Comprehensive Oral Health Care, Comprehensive Patient Care, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Open Dent J. 2012;6:240-7. doi: 10.2174/1874210601206010240. Epub 2012 Dec 28.
The symptoms of temporomandibular disorders (TMD) are directly influenced by numerous factors, and it is thought that additional factors exert indirect influences. However, the relationships between TMD-related symptoms (TRS) and these contributing factors are largely unknown. Thus, the goal of the present study was to investigate influences on TRS in a working population by determining the prevalence of TRS, analyzing contributing factors, and determining their relative influences on TRS.
The study subjects were 2203 adults who worked for a single company. Subjects completed a questionnaire assessing TRS, psychosocial factors (stress, anxiety, depressed mood, and chronic fatigue), tooth-contacting habit, and sleep bruxism-related morning symptoms, using a 5-point numeric rating scale. Our analysis proceeded in 2 phases. First, all variables of the descriptor were divided into parts by using an exploratory factor analysis. Second, this factorial structure was verified by using a confirmatory factor analysis with structural equation modeling.
Of 2203 employees, 362 reported experiencing TRS (16.4%). Structural equation modeling generated a final model with a goodness of fit index of 0.991, an adjusted goodness of fit index of 0.984, and a root mean square error of approximately 0.021. These indices indicate a strong structural model. The standardized path coefficients for "habitual behavioral factors and TRS," "psychosocial factors and habitual behavioral factors," "psychosocial factors and TRS," and "gender and habitual behavior factors" were 0.48, 0.38, 0.14, and 0.18, respectively.
Habitual behavioral factors exert a stronger effect on TRS than do psychosocial factors.
颞下颌关节紊乱病（TMD）的症状受到多种因素的直接影响，并且认为还有其他因素发挥间接影响。然而，TMD相关症状（TRS）与这些促成因素之间的关系在很大程度上尚不清楚。因此，本研究的目的是通过确定TRS的患病率、分析促成因素并确定它们对TRS的相对影响，来调查工作人群中对TRS的影响。
研究对象为在同一家公司工作的2203名成年人。受试者使用5分数字评分量表完成了一份问卷，评估TRS、心理社会因素（压力、焦虑、抑郁情绪和慢性疲劳）、牙齿接触习惯以及与睡眠磨牙症相关的早晨症状。我们的分析分两个阶段进行。首先，使用探索性因素分析将描述符的所有变量分成几个部分。其次，使用带有结构方程模型的验证性因素分析来验证这个因子结构。
在2203名员工中，362人报告有TRS（16.4%）。结构方程模型生成了一个最终模型，其拟合优度指数为0.991，调整后拟合优度指数为0.984，均方根误差约为0.021。这些指标表明该结构模型很强。“习惯性行为因素与TRS”“心理社会因素与习惯性行为因素”“心理社会因素与TRS”以及“性别与习惯性行为因素”的标准化路径系数分别为0.48、0.38、0.14和0.18。
习惯性行为因素对TRS的影响比心理社会因素更强。
