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干燥综合征患者的口腔颌面部运动功能与颞下颌关节紊乱病。

Orofacial Motor Functions and Temporomandibular Disorders in Patients With Sjögren's Syndrome.

机构信息

University of São Paulo, São Paulo, Brazil.

出版信息

Arthritis Care Res (Hoboken). 2020 Aug;72(8):1057-1065. doi: 10.1002/acr.24001.

Abstract

OBJECTIVE

Sjögren's syndrome (SS) induces difficulty in chewing and swallowing due to low salivary flow. However, these symptoms may be associated with other factors, such as orofacial myofunctional disorders and temporomandibular disorder (TMD), which have not been comprehensively assessed in this population. The aims of this study were to investigate orofacial muscles and functions as well as the presence of TMD in patients with SS compared with a group without SS and to analyze whether the patients' experience of limitations in orofacial functioning is associated with the orofacial functional status and muscle pain related to TMD.

METHODS

Women with SS based on the 2002 American-European Consensus Group criteria and volunteers paired by age and sex were compared. The examinations included the orofacial myofunctional evaluation with scores (OMES) protocol, tongue and lip strength measures, and electromyography of the masticatory muscles. TMD investigations included clinical examination, self-report of symptoms, and assessment according to the Jaw Functional Limitation Scale.

RESULTS

Patients with SS present with impaired muscle and orofacial functions based on lower scores of all categories of OMES (P < 0.0001), tongue strength (P = 0.0003-0.0004), and masticatory muscle activity (P = 0.0002-0.007), as well as worse TMD signs and symptoms (P < 0.05) and jaw functional limitation (P < 0.0001-0.0003).

CONCLUSION

Patients' experiences with limitation in mastication and swallowing were associated with orofacial myofunctional status and muscle pain related to TMD. Those disorders should be monitored along with disease control and must be addressed in the clinical evaluation to prevent nutritional and metabolic comorbidities in patients with SS.

摘要

目的

干燥综合征(SS)由于唾液流量低而导致咀嚼和吞咽困难。然而,这些症状可能与其他因素有关,例如口面肌肉功能障碍和颞下颌关节紊乱(TMD),这些因素在该人群中尚未得到全面评估。本研究的目的是比较 SS 患者与无 SS 患者的口面肌肉和功能以及 TMD 的存在,并分析患者对口面功能受限的体验是否与口面功能状态和与 TMD 相关的肌肉疼痛有关。

方法

根据 2002 年美国-欧洲共识组标准确定的 SS 女性患者和按年龄和性别配对的志愿者进行比较。检查包括口面肌肉功能评估量表(OMES)评分、舌和唇力量测量以及咀嚼肌肌电图。TMD 检查包括临床检查、症状自我报告以及根据颌功能受限量表进行评估。

结果

SS 患者的肌肉和口面功能受损,表现在 OMES 的所有类别评分均较低(P < 0.0001)、舌力(P = 0.0003-0.0004)和咀嚼肌活动(P = 0.0002-0.007),以及更差的 TMD 体征和症状(P < 0.05)和颌功能受限(P < 0.0001-0.0003)。

结论

患者对口颌咀嚼和吞咽受限的体验与口面肌肉功能状态和与 TMD 相关的肌肉疼痛有关。这些疾病应与疾病控制一起监测,并在临床评估中加以解决,以防止 SS 患者发生营养代谢合并症。

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