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成人颞下颌关节紊乱患者的诊断类别、心理状态和口腔健康相关生活质量的年龄相关差异。

Age-related differences in diagnostic categories, psychological states and oral health-related quality of life of adult temporomandibular disorder patients.

机构信息

Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.

Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore.

出版信息

J Oral Rehabil. 2021 Apr;48(4):361-368. doi: 10.1111/joor.13121. Epub 2020 Nov 8.

Abstract

OBJECTIVES

The peak prevalence of temporomandibular disorders (TMDs) may occur in middle age. This study determined the proportion of matured adults seeking TMD treatment and compared their diagnostic, psychological and oral health-related quality-of-life (OHRQoL) profiles to younger patients.

METHODS

Adult subjects were recruited from a tertiary TMD centre and assigned to three age groups, namely 18-44 years (young adults [YA]), 45-64 (middle-aged adults [MA]) and ≥65 (old adults [OA]). TMD diagnoses were established with the Diagnostic Criteria for TMDs and categorised as pain-related (PT), intra-articular (IT) and combined (CT) TMDs. Psychological states and OHRQoL were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Oral Health Impact Profile-TMDs (OHIP-TMDs). Demographic, DASS-21, and OHIP-TMDs data were analysed using chi-square test, one-way ANOVA and Pearson's correlation (P < .05).

RESULTS

Middle-aged (19.7%; 136/692) and old (4.0%; 28/692) adults comprised about a quarter of the TMD patients. Although gender distribution was comparable, significant differences in TMD categories were observed (P < .001). Pain-related TMDs were more prevalent in the MA/OA groups while intra-articular TMDs were more frequent in the YA group. No significant difference in DASS-21 and total OHIP scores was noted among three groups. However, the MA and OA groups had significantly lower OHRQoL in the physical pain domain. Correlations between DASS-21 and OHIP-TMDs scores varied with age and ranged from r  = 0.47-0.92.

CONCLUSIONS

Matured patients constituted a quarter of TMD cohort and presented higher frequencies of painful TMDs. They have similar psychological profiles to younger patients but experienced lower OHRQoL in physical pain domain.

摘要

目的

颞下颌关节紊乱病(TMD)的发病高峰可能出现在中年。本研究旨在确定寻求 TMD 治疗的成年患者的比例,并将其诊断、心理和口腔健康相关生活质量(OHRQoL)特征与年轻患者进行比较。

方法

从一家三级 TMD 中心招募成年受试者,并将其分为三组,即 18-44 岁(年轻组 [YA])、45-64 岁(中年组 [MA])和≥65 岁(老年组 [OA])。使用 TMD 诊断标准对 TMD 进行诊断,并分为与疼痛相关的 TMD(PT)、关节内 TMD(IT)和混合性 TMD(CT)。采用抑郁、焦虑和压力量表 21 项(DASS-21)和口腔健康影响量表 TMD (OHIP-TMDs)评估心理状态和 OHRQoL。采用卡方检验、单因素方差分析和 Pearson 相关分析(P<.05)对人口统计学、DASS-21 和 OHIP-TMDs 数据进行分析。

结果

中年(19.7%,136/692)和老年(4.0%,28/692)成年人约占 TMD 患者的四分之一。尽管性别分布相似,但 TMD 类型存在显著差异(P<.001)。MA/OA 组中与疼痛相关的 TMD 更为常见,而 YA 组中关节内 TMD 更为常见。三组间 DASS-21 和总 OHIP 评分无显著差异。然而,MA 和 OA 组在生理疼痛方面的 OHRQoL 显著较低。DASS-21 和 OHIP-TMDs 评分之间的相关性因年龄而异,范围为 r=0.47-0.92。

结论

成熟患者构成了 TMD 患者的四分之一,表现出更高频率的疼痛性 TMD。他们的心理状况与年轻患者相似,但在生理疼痛方面的 OHRQoL 较低。

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