J Oral Facial Pain Headache. 2018;32(4):375-380. doi: 10.11607/ofph.2090.
To investigate whether a dose-response relationship exists between the intensity of pain-related temporomandibular disorders (TMDs) and the amount of self-reported bruxism activities in a group of TMD pain patients.
A total of 768 patients referred to a specialized clinic for complaints of orofacial pain and dysfunction were initially enrolled in the study. Of these patients, 293 who were diagnosed with at least one type of pain-related TMD according to the Diagnostic Criteria for Temporomandibular Disorders were selected. The questionnaire-based reports of TMD pain intensity, as assessed by an 11-point numeric rating scale (NRS), were subsequently compared to the reports of sleep bruxism (single question; 5-point Likert scale) and awake bruxism (mean score of six questions; 5-point Likert scale). Spearman correlations were used to assess associations, and possible confounding effects of depression, somatic symptoms, and anxiety were taken into account.
Spearman correlation tests provided no significant correlation between the amount of self-reported sleep bruxism and TMD pain intensity. On the other hand, the amount of awake bruxism was positively correlated with the intensity of TMD pain; however, the latter correlation was lost when the model was controlled for the effects of depression.
The assumption that there is a dose-response gradient association between bruxism and TMD pain, reflected in more bruxism leading to more overloading and thus to more pain, could not be justified.
研究一组颞下颌关节紊乱症（TMD）疼痛患者中，疼痛相关 TMD 的强度与自我报告的磨牙症活动量之间是否存在剂量反应关系。
共有 768 名因口腔颌面部疼痛和功能障碍就诊的患者最初被纳入该研究。这些患者中，根据颞下颌关节紊乱症诊断标准诊断出至少一种疼痛相关 TMD 的 293 名患者被选择。随后，根据 11 点数字评分量表（NRS）评估 TMD 疼痛强度的基于问卷的报告与睡眠磨牙症（单项问题；5 点 Likert 量表）和清醒磨牙症（六个问题的平均得分；5 点 Likert 量表）的报告进行比较。Spearman 相关系数用于评估关联，同时考虑抑郁、躯体症状和焦虑的可能混杂影响。
Spearman 相关检验未发现自我报告的睡眠磨牙症量与 TMD 疼痛强度之间存在显著相关性。另一方面，清醒磨牙症量与 TMD 疼痛强度呈正相关；然而，当模型考虑抑郁的影响时，后者的相关性消失。
不能证明磨牙症与 TMD 疼痛之间存在剂量反应梯度关联的假设，即磨牙症越多，负荷越大，疼痛越严重。
