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颞下颌关节紊乱患者可逆性治疗后的预后因素分析:中国前瞻性队列研究方案。

Prognostic factor analysis in patients with temporomandibular disorders after reversible treatment: study protocol for a prospective cohort study in China.

机构信息

Department of Rehabilitation, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.

Clinical Research Center, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.

出版信息

BMJ Open. 2021 Jul 2;11(7):e048011. doi: 10.1136/bmjopen-2020-048011.

Abstract

INTRODUCTION

Temporomandibular disorders (TMDs) are complex multifactorial disorders. Reversible treatment has been suggested for the initial management of TMD; however, comparable therapeutic effects of different reversible intervention modalities remain controversial. Various biopsychosocial factors, which may be putative prognostic factors that influence the response to reversible treatment for TMD, have been reported to increase the risk of developing first-onset TMD. However, there is a paucity of research that aims to identify prognostic factors associated with the clinical outcomes of reversible treatment in people with TMD. The objective of this prospective cohort study is to identify prognostic factors that are associated with clinical outcomes of reversible treatment in patients with TMD and to analyse the risk factors that influence the development of chronic TMD.

METHODS AND ANALYSIS

We plan to recruit 834 patients with TMD who meet the inclusion criteria. Once informed consent is obtained, baseline data, including anamnestic data, physical assessments and self-report questionnaires, will be collected from participants at their first clinic visit; subsequently, they will receive 1-4 weeks of reversible treatment. The primary treatment outcome measures will be a change in the anterior maximum mouth opening, worsening of TMD pain scores assessed using a visual analogue scale (VAS) and a reduction in characteristic pain intensity. A good outcome will be defined as an anterior maximal opening ≥35 mm and at least a 30% reduction in VAS scores 3 months after baseline. The association between candidate prognostic factors and clinical outcomes of reversible TMD treatment will be analysed.

ETHICS AND DISSEMINATION

The protocol has been approved by the Ethics Committee of Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, based on the guidelines outlined in the Declaration of Helsinki (SH9H-2019-T316-4). The results of this study will be reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement. The authors intend to publish the results in a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

ChiCTR2000033328.

摘要

简介

颞下颌关节紊乱病(TMD)是一种复杂的多因素疾病。对于 TMD 的初始管理,已经提出了可逆治疗;然而,不同可逆干预方式的可比治疗效果仍然存在争议。各种生物心理社会因素,这些因素可能是影响 TMD 可逆治疗反应的潜在预后因素,据报道会增加首发 TMD 的风险。然而,目前缺乏旨在确定与 TMD 患者可逆治疗临床结果相关的预后因素的研究。本前瞻性队列研究的目的是确定与 TMD 患者可逆治疗临床结果相关的预后因素,并分析影响慢性 TMD 发展的危险因素。

方法和分析

我们计划招募符合纳入标准的 834 名 TMD 患者。一旦获得知情同意,将从参与者的首次就诊时收集基线数据,包括病史数据、体格检查和自我报告问卷;随后,他们将接受 1-4 周的可逆治疗。主要治疗结局指标将是前最大开口的变化、使用视觉模拟量表(VAS)评估的 TMD 疼痛评分恶化以及特征性疼痛强度降低。良好的结果定义为前最大开口≥35mm,并且在基线后 3 个月 VAS 评分至少降低 30%。将分析候选预后因素与可逆 TMD 治疗的临床结果之间的关系。

伦理和传播

该方案已获得上海交通大学医学院第九人民医院伦理委员会的批准,该委员会是根据《赫尔辛基宣言》(SH9H-2019-T316-4)中的指南制定的。本研究的结果将按照《观察性研究的报告加强》声明进行报告。作者打算将结果发表在同行评议的期刊上。

临床试验注册号

ChiCTR2000033328。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d85/8256761/e1334fac02fa/bmjopen-2020-048011f01.jpg

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