Jussila Päivi, Knuutila Jarno, Salmela Sampo, Näpänkangas Ritva, Päkkilä Jari, Pirttiniemi Pertti, Raustia Aune
a Research Unit of Oral Health Sciences, Faculty of Medicine , University of Oulu , Oulu , Finland.
b Medical Research Center, Oulu University Hospital and University of Oulu , Oulu , Finland.
Acta Odontol Scand. 2018 Oct;76(7):525-529. doi: 10.1080/00016357.2018.1479769. Epub 2018 Jun 19.
To investigate the association between risk factors and pain-related symptoms and clinical signs of temporomandibular disorders (TMD) in Northern Finland Birth Cohort (NFBC) 1966.
A total of 1962 subjects (1050 women, 912 men) attended the follow-up study. The questionnaires included the subjects' background information concerning living conditions and general health, socioeconomic factors, and dental health. The clinical examination was performed using the modified protocol of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) presented at the International Association for Dental Research (IADR) Conference in 2010. Cross-tabulation, a chi-square test and Fisher's exact test were used to analyze differences between groups.
Female gender showed statistically significant association with symptoms and signs of TMD, while marital status, living conditions, and socioeconomic group showed no association. A strong association was found between self-reported health condition as well as general health problems [i.e. depression, migraine, fibromyalgia (FM), gastrointestinal diseases] and TMD pain-related symptoms and pain on palpation in the masticatory muscles and TMJs.
In conclusion, general health problems and female gender had a strong association with pain-related symptoms and clinical signs of TMD. These findings are important to take into account when diagnosing and treating TMD patients. Conversely to earlier presented results, no statistically significant association was shown here between marital status, living conditions or socioeconomic group and pain-related symptoms and clinical signs of TMD.
探讨1966年芬兰北部出生队列（NFBC）中颞下颌关节紊乱病（TMD）的危险因素与疼痛相关症状及临床体征之间的关联。
共有1962名受试者（1050名女性，912名男性）参加了随访研究。问卷包括受试者关于生活条件和总体健康状况、社会经济因素以及口腔健康的背景信息。临床检查采用2010年国际牙科研究协会（IADR）会议上提出的颞下颌关节紊乱病诊断标准（DC/TMD）的改良方案。采用交叉表、卡方检验和Fisher精确检验分析组间差异。
女性与TMD的症状和体征存在统计学上的显著关联，而婚姻状况、生活条件和社会经济群体则无关联。自我报告的健康状况以及一般健康问题[即抑郁症、偏头痛、纤维肌痛（FM）、胃肠道疾病]与TMD疼痛相关症状以及咀嚼肌和颞下颌关节触诊疼痛之间存在强关联。
总之，一般健康问题和女性与TMD的疼痛相关症状及临床体征有很强的关联。在诊断和治疗TMD患者时，这些发现很重要，需要加以考虑。与之前公布的结果相反，本研究未显示婚姻状况、生活条件或社会经济群体与TMD疼痛相关症状及临床体征之间存在统计学上的显著关联。
