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颞下颌关节紊乱病患者的剖析:一家三级医疗中心的经验

Profiling of Patients with Temporomandibular Disorders: Experience of One Tertiary Care Center.

作者信息

Vrbanović Ema, Dešković Klara, Zlendić Marko, Alajbeg Iva Z

机构信息

Department of Removable Prosthodontics, School of Dental Medicine, University of Zagreb.

School of Dental Medicine, alumna.

出版信息

Acta Stomatol Croat. 2021 Jun;55(2):147-158. doi: 10.15644/asc55/2/4.

Abstract

OBJECTIVES

The aim of this study was to assess typical and most prevalent characteristics of patients suffering from temporomandibular disorders (TMD) by a retrospective assessment of their medical records.

MATERIAL AND METHODS

Demographic data and data on the characteristics of TMD were collected from the existing medical documentation of 304 TMD patients (250 females and 54 males) who had been referred to the Department of Dentistry, Clinical Hospital Center Zagreb from October 2016 to October 2020 due to temporomandibular pain. For the purpose of analysis, three age groups were formed: i) "children and adolescents" (up to 19 years of age); ii) "middle age" (from 20 to 50 years of age); iii) "older age" (>50 year- olds). A two-step cluster analysis was performed with the aim of classifying TMD patients into homogenous groups.

RESULTS

The mean age of patients whose data were included in the study was 33.8 ± 16.66, with a significantly higher age in the group of women (p<0.001). Most of the patients had chronic pain (67.4%), with the ratio in favor of chronic patients being significantly higher in women than in men (p=0.001). Data on parafunctional behavior were confirmed in 14.5% of patients. Data on the onset of symptoms during/just after orthodontic treatment were present in 14.5% of patients. Data on spontaneous pain, assessed with a visual analogue scale, were recorded in 87 patients, with a mean of 6.14 ± 1.79 and with the highest pain in the "older age" group. Physical therapy was the most common therapeutic modality (56.3%) followed by an occlusal splint (40.5%). The analysis revealed 5 different clusters in the TMD patient data set.

CONCLUSIONS

Our results are largely in line with current epidemiological knowledge on TMD. Women predominated in all age groups and most of the patients experienced chronic pain. Classifying patients into homogeneous groups using the clustering method could provide better identification of subgroups of conditions that mainly occur together in these patients, thus providing the basis for more specific management.

摘要

目的

本研究旨在通过回顾性评估颞下颌关节紊乱病(TMD)患者的病历,来评估其典型和最常见的特征。

材料与方法

从2016年10月至2020年10月因颞下颌关节疼痛转诊至萨格勒布临床医院中心牙科的304例TMD患者(250例女性和54例男性)的现有医疗记录中收集人口统计学数据和TMD特征数据。为了进行分析,划分了三个年龄组:i)“儿童和青少年”(19岁及以下);ii)“中年”(20至50岁);iii)“老年”(50岁以上)。进行了两步聚类分析,目的是将TMD患者分为同质组。

结果

纳入研究数据的患者平均年龄为33.8±16.66岁,女性组年龄显著更高(p<0.001)。大多数患者患有慢性疼痛(67.4%),女性慢性患者的比例显著高于男性(p=0.001)。14.5%的患者有副功能行为数据。14.5%的患者有正畸治疗期间/刚结束后出现症状的数据。用视觉模拟量表评估的自发痛数据记录在87例患者中,平均为6.14±1.79,“老年”组疼痛最严重。物理治疗是最常见的治疗方式(56.3%),其次是咬合板(40.5%)。分析揭示了TMD患者数据集中的5个不同聚类。

结论

我们的结果在很大程度上与当前关于TMD的流行病学知识一致。所有年龄组中女性占主导,大多数患者经历慢性疼痛。使用聚类方法将患者分为同质组可以更好地识别这些患者中主要共同出现的病症亚组,从而为更具体的管理提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef8c/8255039/83d34cf88e55/ASC_55(2)_147-158-f1.jpg

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