First Clinical Division and Center for Oral Function Diagnosis, Treatment and Research, Peking University School & Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
Center for TMD and Orofacial Pain, Peking University School & Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
J Oral Rehabil. 2020 Sep;47(9):1129-1141. doi: 10.1111/joor.13038. Epub 2020 Jul 10.
Somatosensory changes in Chinese temporomandibular disorders (TMD) arthralgia patients have not been fully studied by the latest technologies.
This study aims at assessing somatosensory changes in Chinese TMD arthralgia patients quantitatively.
Standardised quantitative sensory testing (QST) was performed on the pain sites and contralateral sites of 40 patients diagnosed with TMD arthralgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) before and after medication; similar measures were taken in 40 age- and gender-matched healthy controls. Differences within and between groups were assessed through Z-scores, two-way ANOVA and loss/gain coding system.
The pain sites of patients presented increased sensitivity to thermal stimuli and mechanical pain stimuli together with decreased sensitivity to mechanical tactile stimuli before medication (P < .001). Before treatment, 100% of patients had somatosensory abnormalities at the pain sites; the most frequent abnormalities were somatosensory gain to cold nociceptive, pinprick and pressure stimuli, and the most frequent loss/gain score was L0G3 (no somatosensory loss with a gain of thermal and mechanical somatosensory function; 70.0%). After treatment, although the clinical symptoms and signs of 40 patients disappeared, 80.0% of the patients' pain sites still showed multiple phenotype abnormalities. The most frequent loss/gain score was L0G2 (no somatosensory loss with a gain of mechanical somatosensory function; 35.0%).
Multiple phenotypes of facial somatosensory abnormalities were detected in Chinese TMD arthralgia patients before and after treatment, despite the disappearance of clinical signs and symptoms. Individual variations indicate a possible need for subgroup classification, individualised management and mechanism-based treatment.
最新技术尚未充分研究中国颞下颌关节紊乱（TMD）关节痛患者的感觉变化。
本研究旨在定量评估中国 TMD 关节痛患者的感觉变化。
根据颞下颌关节紊乱诊断标准（DC/TMD），对 40 例 TMD 关节痛患者在用药前后的疼痛部位和对侧部位进行标准化定量感觉测试（QST）；对 40 名年龄和性别匹配的健康对照者进行类似的测量。通过 Z 分数、双因素方差分析和损失/增益编码系统评估组内和组间差异。
患者的疼痛部位在用药前对热刺激和机械性疼痛刺激的敏感性增加，对机械性触觉刺激的敏感性降低（P<.001）。治疗前，100%的患者疼痛部位存在感觉异常；最常见的异常是冷伤害觉、刺痛和压力刺激的感觉增益，最常见的损失/增益评分是 L0G3（无感觉丧失，热和机械感觉功能增加；70.0%）。治疗后，尽管 40 例患者的临床症状和体征消失，但 80.0%的患者疼痛部位仍表现出多种表型异常。最常见的损失/增益评分是 L0G2（无感觉丧失，机械感觉功能增加；35.0%）。
尽管临床症状和体征消失，但在治疗前后，中国 TMD 关节痛患者均出现面部感觉异常的多种表型。个体差异表明可能需要亚组分类、个体化管理和基于机制的治疗。
