Franco Ana L, Fernandes Giovana, Gonçalves Daniela A G, Bonafé Fernanda S S, Camparis Cinara M
Department of Dental Materials and Prosthodontics, Faculdade de Odontologia de Araraquara, UNESP-Univ Estadual Paulista, Araraquara, SP, Brazil.
Clin J Pain. 2014 Apr;30(4):340-5. doi: 10.1097/AJP.0b013e31829ca62f.
To verify whether headaches (HAs) are associated with temporomandibular disorders (TMD) in young Brazilian adolescents.
From a population sample, 3117 public school children (12 to 14 y) were randomly invited to participate in this study. TMD was assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, in addition to questions #3, #4, and #14 of Axis II history questionnaire. HAs were investigated with question #18 of RDC/TMD Axis II. Chronic TMD pain was considered as pain that has persisted for 6 months or more, as proposed by the International Association for the Study of Pain. The statistical analysis consisted of χ tests, odds ratio (OR), and logistic regression models, adopting a significance level of 5%.
The sample included 1307 individuals (a response rate of 41.93%), and 56.8% (n=742) were girls. Overall, 330 adolescents (25.2%) were diagnosed with painful TMD and 595 (45.5%) presented with HAs. Individuals presenting with HAs were more likely to present painful TMD (OR=4.94; 95% confidence interval [CI], 3.73-6.54, P<0.001), especially combined muscle and joint painful TMD (OR=7.58; 95% CI, 4.77-12.05, P<0.001). HAs also increased the risk to a higher magnitude for chronic TMD pain (OR=6.12; 95% CI, 4.27-8.78, P<0.0001). All estimated ORs remained essentially unchanged after adjusting for sex.
HAs were a potential risk factor for TMD in adolescents, and the risk was particularly higher for painful and chronic TMD. When HAs are present in young adolescents, a complete examination is strongly recommended with regard to the presence of painful TMD, and vice versa.
验证巴西年轻青少年的头痛（HA）是否与颞下颌关节紊乱病（TMD）相关。
从一个人群样本中，随机邀请3117名公立学校儿童（12至14岁）参与本研究。除了颞下颌关节紊乱病研究诊断标准（RDC/TMD）轴II病史问卷的问题3、4和14外，根据RDC/TMD轴I评估TMD。通过RDC/TMD轴II的问题18调查HA。按照国际疼痛研究协会的提议，慢性TMD疼痛被定义为持续6个月或更长时间的疼痛。统计分析包括χ检验、比值比（OR）和逻辑回归模型，采用5%的显著性水平。
样本包括1307名个体（应答率为41.93%），其中56.8%（n = 742）为女孩。总体而言，330名青少年（25.2%）被诊断为疼痛性TMD，595名（45.5%）有HA。有HA的个体更有可能出现疼痛性TMD（OR = 4.94；95%置信区间[CI]，3.73 - 6.54，P < 0.001），尤其是肌肉和关节合并疼痛性TMD（OR = 7.58；95% CI，4.77 - 12.05，P < 0.001）。HA也使慢性TMD疼痛的风险增加到更高程度（OR = 6.12；95% CI，4.27 - 8.78，P < 0.0001）。在对性别进行调整后，所有估计的OR基本保持不变。
HA是青少年TMD的一个潜在危险因素，对于疼痛性和慢性TMD，这种风险尤其更高。当年轻青少年出现HA时，强烈建议对疼痛性TMD的存在进行全面检查，反之亦然。
