J Am Dent Assoc. 2022 Jan;153(1):50-58. doi: 10.1016/j.adaj.2021.07.011. Epub 2021 Oct 29.
Studies have indicated the negative effects of temporomandibular disorders (TMDs) on oral health-related quality of life (OHRQoL). The authors investigated the OHRQoL of patients with acute and chronic TMD subtypes.
The authors recruited a total of 830 patients. They derived TMD diagnoses using the Diagnostic Criteria for TMDs protocol involving symptom history, physical examination, and diagnostic imaging as indicated. The authors categorized patients into acute (≤ 3 months) or chronic (> 3 months) pain-related TMD (PT), nonpainful intra-articular TMD (IT), and combined TMD (CT) groups. They also gathered sociodemographic information and assessed OHRQoL with the Oral Health Impact Profile (OHIP)-TMDs. The authors evaluated data using 2-way analysis of variance and Bonferroni test and multiple regression analysis.
Patients in the chronic PT and CT subgroups had significantly higher mean global OHIP scores than their acute counterparts. The authors observed significant acute-chronic differences in OHIP-TMDs domain scores in 5 and 2 domains for the PT and CT groups, respectively. Patients in the acute IT group had significantly higher functional limitation scores than those in the chronic IT group. The ranking of mean global scores, in descending order was CT, PT, and IT for acute TMDs and PT, CT, and IT for chronic TMDs, with significant differences observed among the 3 TMD subtypes (P < .001).
Both TMD chronicity and subtypes influenced OHRQoL. Painful TMDs (PT and CT) were associated with significantly poorer OHRQoL than nonpainful TMDs. TMD chronicity appeared to affect OHRQoL only for the painful TMD conditions. Future work on the impact of TMDs on OHRQoL should strive to stratify patients by TMD chronicity and subtypes.
TMD chronicity and subtypes influence the impact of TMDs on OHRQoL. Given that chronic painful TMDs impair quality of life, early biopsychosocial intervention of acute TMD pain is important for minimizing chronification and OHRQoL deterioration.
研究表明颞下颌关节紊乱（TMD）对口腔健康相关生活质量（OHRQoL）有负面影响。作者研究了急性和慢性 TMD 亚型患者的 OHRQoL。
作者共招募了 830 名患者。他们根据 TMD 诊断标准协议，通过症状史、体格检查和影像学检查等方式得出 TMD 诊断。作者将患者分为急性（≤3 个月）或慢性（>3 个月）疼痛相关 TMD（PT）、无痛性关节内 TMD（IT）和联合 TMD（CT）组。他们还收集了社会人口统计学信息，并使用口腔健康影响简表（OHIP）-TMD 评估 OHRQoL。作者使用双因素方差分析和 Bonferroni 检验以及多元回归分析评估数据。
慢性 PT 和 CT 亚组患者的平均全球 OHIP 评分明显高于急性组。作者观察到 PT 和 CT 组在 5 个和 2 个领域的 OHIP-TMD 领域评分方面存在显著的急性-慢性差异。急性 IT 组患者的功能受限评分明显高于慢性 IT 组。急性 TMD 中平均全球评分的降序排列为 CT、PT 和 IT，慢性 TMD 中为 PT、CT 和 IT，3 种 TMD 亚型之间存在显著差异（P<0.001）。
TMD 的慢性和亚型均影响 OHRQoL。疼痛性 TMD（PT 和 CT）与非疼痛性 TMD 相比，OHRQoL 明显较差。TMD 的慢性似乎仅对疼痛性 TMD 状况的 OHRQoL 有影响。未来关于 TMD 对 OHRQoL 影响的研究应努力根据 TMD 的慢性和亚型对患者进行分层。
TMD 的慢性和亚型影响 TMD 对 OHRQoL 的影响。鉴于慢性疼痛性 TMD 会降低生活质量，因此对急性 TMD 疼痛进行早期生物心理社会干预对于最小化慢性化和 OHRQoL 恶化非常重要。
