Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine, Viseu, Portugal.
Dentistry Faculty, Porto University, Portugal.
J Forensic Leg Med. 2021 Aug;82:102230. doi: 10.1016/j.jflm.2021.102230. Epub 2021 Aug 8.
Orofacial trauma can encompass, isolated or not, several anatomical regions, namely facial, dental and temporomandibular joint (TMJ), one of the most complex joints in the human body. Evidence-based knowledge in the field of TMJ trauma and in temporomandibular joint disorders (TMD) diagnosis and treatment, provides the necessary data for medico-legal assessment.
The aim of this study is to bring up epidemiological data referring to TMJ injuries and sequelae, in order to present a medico-legal approach of TMJ disability.
An observational longitudinal exploratory study was performed in the database of the National Institute of Legal Medicine and Forensic Sciences, Portugal, between 2000 and 2017, regarding inclusion and exclusion criteria.Statistical significance was set as P‹0.05, Fisher's exact test, Binomial test and Goodman and Kruskal's test were used.
Post-traumatic orofacial reports (n = 2622) included 234 TMJ-injury and 149 TMJ-sequelae.Epidemiological data was presented regarding age,gender, professional status and etiology. There was a statistically significant association between TMJ injury and TMJ sequela, despite a weak relation (ƛ = 0.170). No statistically significant association was identified between TMJ-injury/TMJ-sequelae and the professional status, etiology.
The TMJ sequela group is smaller than the TMJ-injury, reflecting that 2/3 of the injuries have been cured without a monetary compensation value and without Health costs. The association between TMJ injury and TMJ sequelae reinforces the necessity of preventive measures in TMJ trauma, namely in physical violence context and in medico-legal impairment.
口腔颌面部创伤可单独或同时累及面部、牙齿和颞下颌关节（TMJ）等多个解剖区域，TMJ 是人体最复杂的关节之一。TMJ 创伤和颞下颌关节紊乱（TMD）诊断与治疗领域的循证医学知识为法医学评估提供了必要的数据。
本研究旨在提出 TMJ 损伤及后遗症的流行病学数据，从而提出 TMJ 伤残的法医学评估方法。
本研究为 2000 年至 2017 年在葡萄牙国家法医学和法医科学研究所数据库中进行的观察性纵向探索性研究，纳入和排除标准如下。统计显著性设为 P‹0.05，使用 Fisher 确切检验、二项检验和 Goodman 和 Kruskal 检验。
外伤性口腔颌面部报告（n=2622）中包括 234 例 TMJ 损伤和 149 例 TMJ 后遗症。介绍了年龄、性别、职业状况和病因方面的流行病学数据。TMJ 损伤和 TMJ 后遗症之间存在统计学显著关联，尽管关联较弱（ƛ=0.170）。TMJ 损伤/TMJ 后遗症与职业状况、病因之间未发现统计学显著关联。
TMJ 后遗症组小于 TMJ 损伤组，这表明 2/3 的损伤未经治疗，没有金钱赔偿价值，也没有健康成本。TMJ 损伤和 TMJ 后遗症之间的关联强调了 TMJ 创伤，尤其是在身体暴力环境和法医学伤残方面采取预防措施的必要性。
