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焦虑和错牙合与通过RDC/TMD诊断的青少年颞下颌关节紊乱症相关。一项横断面研究。

Anxiety and malocclusion are associated with temporomandibular disorders in adolescents diagnosed by RDC/TMD. A cross-sectional study.

作者信息

de Paiva Bertoli Fernanda Mara, Bruzamolin Carolina Dea, de Almeida Kranz Graciely Osternack, Losso Estela Maris, Brancher Joao Armando, de Souza Juliana Feltrin

机构信息

Dentistry Departament, Universidade Positivo, Curitiba, Brazil.

Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil.

出版信息

J Oral Rehabil. 2018 Oct;45(10):747-755. doi: 10.1111/joor.12684. Epub 2018 Jul 20.

Abstract

BACKGROUND

Temporomandibular Disorders (TMD) is a multifactorial condition, which could be associated to occlusal and psychological factors, such as anxiety.

OBJECTIVE

Investigate if anxiety and malocclusion are associated with the prevalence of TMD in adolescents.

METHODS

To ensure a population-based representative sample, 934 adolescents aged 10 to 14 years old from Curitiba-PR, Brazil were randomly selected and examined according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and malocclusion by a single-calibrated examiner (Kappa > 0.80). Anxiety was assessed according to trait anxiety (STAI-T), categorised as high, moderate and low levels. For occlusal exam, it was considered: Angel's molar relationship, anterior and posterior crossbite, excessive overjet, open and deep bite. The associations were analysed by the crude and adjusted prevalence ration (RP ) of TMJ, calculated by a Poisson multivariate regression with robust variance (α = 0.05).

RESULTS

The prevalence of at least one type of malocclusion was found in 52.3%. Anxiety was found in high level (12.2%), moderate (70.4%) and low (17.5%). Presence of high anxiety was significantly associated with the prevalence of TMD symptoms (RP  = 4.06, P < 0.001), as well as the prevalence of myofascial pain (RP  = 24.78; P < 0.001) and prevalence of disc displacement with reduction (RP  = 11.08, P < 0.001). Adolescents Class II had higher prevalence of myofascial pain (Class II RP  = 1.73; P < 0.015) than adolescents Class I. Adolescents Class III presented higher prevalence of myofascial pain (PR 2.53; P = 0.004) than adolescents Class I.

CONCLUSION

Anxiety is strongly associated with TMD in adolescents. Presence of Class II or III is associated with higher prevalence of myofascial pain in adolescentsPLESAE check and approve the edit made in the article title.

摘要

背景

颞下颌关节紊乱病(TMD)是一种多因素疾病,可能与咬合和心理因素有关,如焦虑。

目的

研究焦虑和错牙合畸形是否与青少年TMD的患病率相关。

方法

为确保有一个基于人群的代表性样本,从巴西库里蒂巴-巴拉那州随机选取了934名10至14岁的青少年,并由一名经过校准的检查者(kappa>0.80)根据颞下颌关节紊乱病研究诊断标准(RDC/TMD)和错牙合畸形进行检查。根据特质焦虑(STAI-T)评估焦虑程度,分为高、中、低水平。对于咬合检查,考虑了安氏磨牙关系、前后牙反牙合、前牙深覆盖、开牙合和深覆牙合。通过泊松多元回归和稳健方差(α=0.05)计算颞下颌关节的粗患病率比值(RP)和调整患病率比值,分析两者之间的关联。

结果

发现至少一种错牙合畸形的患病率为52.3%。焦虑程度为高水平(12.2%)、中等水平(70.4%)和低水平(17.5%)。高焦虑与TMD症状的患病率显著相关(RP=4.06,P<0.001),与肌筋膜疼痛的患病率(RP=24.78;P<0.001)和可复性盘移位的患病率(RP=11.08,P<0.001)也显著相关。安氏II类青少年的肌筋膜疼痛患病率(安氏II类RP=1.73;P<0.015)高于安氏I类青少年。安氏III类青少年的肌筋膜疼痛患病率(PR 2.53;P=0.004)高于安氏I类青少年。

结论

焦虑与青少年TMD密切相关。安氏II类或III类错牙合畸形与青少年肌筋膜疼痛的较高患病率相关。请检查并批准文章标题中的编辑内容。

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