Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
School of Dentistry, University of Siena, Siena, Italy.
Clin Oral Investig. 2019 Dec;23(12):4411-4416. doi: 10.1007/s00784-019-02890-4. Epub 2019 Apr 13.
The aim was to determine the frequency of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD)-based pain diagnoses and dynamic/static tests-based pain diagnoses, and to assess the agreement of palpation tests with static/dynamic tests.
Eighty-six (N = 86) adult patients with Lyme disease (mean age 57.0 ± 14.3 years; male/female ratio was 42/44) were examined according to techniques described in the RDC/TMD. Additionally, dynamic/static tests were performed. For RDC/TMD-based pain diagnoses and dynamic/static tests-based pain diagnoses, descriptive frequencies were calculated. Differences between the frequency of palpation-based diagnoses and of dynamic/static-based diagnoses as well as the agreement between pain diagnoses established with the two diagnostic approaches were assessed.
RDC/TMD-based pain diagnoses were made in 61 patients for myofascial pain and in 11 patients for arthralgia and/or osteoarthritis. Based on dynamic/static tests, mainly myogenous pain was diagnosed in 6 patients, and a mainly arthrogenous pain in 5. The agreement of palpation tests with static/dynamic tests in Lyme disease population was poor.
A high prevalence of TMD symptoms was found in patients with Lyme disease. The results suggest that using palpation tests alone could overestimate primary TMDs when comorbid conditions are present.
Dynamic/static tests should be used as part of the routine TMD assessment. In case of Lyme disease as the actual cause of the facial pain, while the dentist might be suspecting TMD when dynamic/static TMD tests are negative, referral to an appropriate specialist for the diagnosis and treatment of Lyme disease needs to be made.
旨在确定基于研究诊断标准为颞下颌关节紊乱（RDC/TMD）的疼痛诊断以及基于动态/静态测试的疼痛诊断的频率，并评估触诊与静态/动态测试的一致性。
86 例（N=86）成人莱姆病患者（平均年龄 57.0±14.3 岁；男女比例为 42/44）按照 RDC/TMD 中描述的技术进行检查。此外，还进行了动态/静态测试。对于基于 RDC/TMD 的疼痛诊断和基于动态/静态测试的疼痛诊断，计算了描述性频率。评估了触诊诊断的频率与动态/静态诊断的频率之间的差异，以及两种诊断方法建立的疼痛诊断之间的一致性。
61 例患者被诊断为肌筋膜疼痛，11 例患者被诊断为关节炎和/或骨关节炎。基于动态/静态测试，主要诊断为肌源性疼痛 6 例，主要为关节源性疼痛 5 例。莱姆病患者触诊试验与静态/动态试验的一致性较差。
莱姆病患者存在较高的 TMD 症状发生率。结果表明，当存在合并症时，仅使用触诊测试可能会高估原发性 TMD。
动态/静态测试应作为 TMD 常规评估的一部分。如果莱姆病是面部疼痛的实际原因，而牙医在动态/静态 TMD 测试为阴性时可能怀疑为 TMD，则需要将患者转介给适当的专家进行莱姆病的诊断和治疗。
