Department of Stomatology, Tungs' Taichung MetroHarbor Hospital, Wuchi, Taichung, Taiwan, Republic of China.
Institute of Genomics and Bioinformatics, College of Life Sciences, National of Chung Hsing University, Taichung, Taiwan, Republic of China.
PLoS One. 2019 Jun 14;14(6):e0217763. doi: 10.1371/journal.pone.0217763. eCollection 2019.
The prevalence of temporomandibular disorder (TMD) among elderly people with Parkinson's disease (PD) is relatively high, but a population-based study of the relationship between PD and TMD is still lacking. This study, therefore, sought to investigate the association between TMD and PD by using data for one million randomly sampled beneficiaries of Taiwan's National Health Insurance program, including 6,185 PD patients who were matched through propensity score matching with 18,555 non-PD patients. Both the PD and non-PD cohorts were followed until death, any diagnosis of TMD, or December 31, 2013, whichever occurred first. Each diagnosis of TMD was made by a qualified physician according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), using the diagnosis codes 524.60, 524.62, 524.63, and 524.69 while excluding tooth abscess, wisdom tooth eruption, herpes zoster and postherpetic neuralgia, mastoiditis, otitis externa, otitis media, parotitis, sialadenitis, and trigeminal neuralgia. We used Cox proportional hazard regression models to calculate the relative risk of TMD and found a 2.11-fold (95% CI: 1.35-3.30) increased risk of TMD overall in the PD group compared with the non-PD group. Stratified by follow-up period, there was a 4.25-fold (95% CI: 1.51-11.93) increased risk in the PD group in the first year after the initial PD diagnosis and a 3.88-fold (95% CI: 1.33-11.28) increased risk in the second year. Over the long-term (>5 years), PD was significantly associated with an increased risk of TMD. These findings suggest that it is important to closely monitor the temporomandibular joint health of PD patients.
颞下颌关节紊乱症（TMD）在帕金森病（PD）老年患者中的患病率相对较高，但仍缺乏基于人群的 PD 与 TMD 之间关系的研究。因此，本研究利用台湾全民健康保险计划的 100 万随机抽样受益人的数据，通过倾向评分匹配，选择了 6185 名 PD 患者与 18555 名非 PD 患者进行匹配，旨在探讨 TMD 与 PD 之间的关系。PD 和非 PD 队列均随访至死亡、任何 TMD 诊断或 2013 年 12 月 31 日，以先发生者为准。每位 TMD 诊断均由合格医师根据国际疾病分类，第 9 版临床修订版（ICD-9-CM），使用诊断代码 524.60、524.62、524.63 和 524.69 进行诊断，同时排除牙脓肿、智齿萌出、带状疱疹及疱疹后神经痛、乳突炎、外耳道炎、中耳炎、腮腺炎、唾液腺炎和三叉神经痛。我们使用 Cox 比例风险回归模型计算 TMD 的相对风险，发现与非 PD 组相比，PD 组总体 TMD 的风险增加了 2.11 倍（95%CI：1.35-3.30）。按随访时间分层，在 PD 诊断后的第一年，PD 组的风险增加了 4.25 倍（95%CI：1.51-11.93），第二年增加了 3.88 倍（95%CI：1.33-11.28）。在长期（>5 年）中，PD 与 TMD 的风险增加显著相关。这些发现表明，密切监测 PD 患者的颞下颌关节健康非常重要。
