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与疼痛相关的颞下颌关节紊乱症是心理因素与自我报告的磨牙症相互作用的产物吗?

Are Pain-Related Temporomandibular Disorders the Product of an Interaction Between Psychological Factors and Self-Reported Bruxism?

作者信息

van Selms Maurits Ka, Muzalev Konstantin, Visscher Corine M, Koutris Michail, Bulut Melike, Lobbezoo Frank

出版信息

J Oral Facial Pain Headache. 2017 Fall;31(4):331–338. doi: 10.11607/ofph.1909. Epub 2017 Oct 10.

Abstract

AIMS

To investigate whether pain-related temporomandibular disorders (TMD) are the product of an interaction between psychological factors and self-reported bruxism activities.

METHODS

Patients referred to a specialized clinic for complaints of orofacial pain and dysfunction completed a digital questionnaire prior to the first clinical visit. The patient sample was then split into a case group consisting of 268 patients diagnosed with TMD pain according to the Diagnostic Criteria for Temporomandibular Disorders (85.8% women; mean ± standard deviation [SD] age = 40.1 ± 14.5 years) and a control group consisting of 254 patients without any pain in the orofacial area (50.8% women; 46.9 ± 13.6 years). The possible moderating roles of six psychological factors (depression, somatic symptoms, anxiety, stress, optimism, and prior psychological treatment) on the relationship between self-reported bruxism and the clinical presence of TMD pain were examined.

RESULTS

Patients with TMD pain reported significantly more bruxism than patients without any report of orofacial pain. Furthermore, bruxism intensity was associated with a variety of psychological factors; however, there were no significant interactions between any of the psychological factors and bruxism with respect to the clinical presence of TMD pain.

CONCLUSION

These findings do not support the view that the effect of bruxism on TMD pain is stronger in patients who experience higher levels of psychological distress compared to those with lower levels of distress.

摘要

目的

研究与疼痛相关的颞下颌关节紊乱症(TMD)是否是心理因素与自我报告的磨牙活动之间相互作用的产物。

方法

因口面部疼痛和功能障碍而转诊至专科诊所的患者在首次临床就诊前完成了一份数字问卷。然后将患者样本分为病例组和对照组,病例组由268例根据颞下颌关节紊乱症诊断标准被诊断为TMD疼痛的患者组成(女性占85.8%;平均±标准差[SD]年龄=40.1±14.5岁),对照组由254例口面部无任何疼痛的患者组成(女性占50.8%;46.9±13.6岁)。研究了六种心理因素(抑郁、躯体症状、焦虑、压力、乐观和既往心理治疗)对自我报告的磨牙与TMD疼痛临床存在之间关系的可能调节作用。

结果

与无口面部疼痛报告的患者相比,TMD疼痛患者报告的磨牙情况明显更多。此外,磨牙强度与多种心理因素相关;然而,就TMD疼痛的临床存在而言,任何心理因素与磨牙之间均无显著相互作用。

结论

这些发现不支持以下观点,即与心理困扰程度较低的患者相比,心理困扰程度较高的患者中磨牙对TMD疼痛的影响更强。

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