Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.
Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore City, Singapore.
J Oral Rehabil. 2022 Mar;49(3):301-308. doi: 10.1111/joor.13288. Epub 2021 Dec 14.
This study evaluated the functional, physical and psychosocial impacts of TMJ degenerative joint disease (DJD). The bearing of TMJ osteoarthrosis/osteoarthritis and early/late TMJ DJD on oral health-related quality of life (OHRQoL) were also compared.
Participants were enrolled from a TMD/oro-facial pain centre. Those diagnosed with intra-articular conditions based on the Diagnostic Criteria for Temporomandibular disorders (DC/TMD) were subjected to CBCT assessment and categorised into four discrete groups: NN-no TMJ DJD and no arthralgia; NA-no TMJ DJD with arthralgia; TO-TMJ osteoarthrosis; and TR-TMJ osteoarthritis. The TO/TR groups were subdivided into early/late TMJ osteoarthrosis (EO/LO) and osteoarthritis (ER/LR). OHRQoL was examined using the OHIP-TMD, and data were appraised with the Kruskal-Wallis/Mann-Whitney U tests (α = 0.05).
The study participant (n = 358) had a mean age of 31.85 ± 12.39 years (85.6% women). Frequencies of the TMD groups were as follows: NN-23.2%; NA-27.1%; TO-19.0%; and TR-30.7%. Participants with TR/NA had significantly worse OHRQoL than those with TO/NN. Additionally, participants with ER/LR reported significantly poorer OHRQoL than their counterparts with EO/LO. For all TMD groups and TMJ DJD subgroups, the psychological discomfort domain was generally the most impaired. Differences in global OHIP scores were significant between participants with and without arthralgia (i.e., NA-NN, ER-EO and LR-LO).
The presence of TMJ pain appeared to impair OHRQoL more than the severity of TMJ DJD. As psychological domains were most impacted, psychosocial care should be incorporated when managing patients with painful TMJ DJD.
本研究评估了 TMJ 退行性关节疾病（DJD）的功能、身体和社会心理影响。比较了 TMJ 骨关节炎/骨关节炎和早期/晚期 TMJ DJD 对口腔健康相关生活质量（OHRQoL）的影响。
参与者从 TMD/颌面疼痛中心招募。根据颞下颌关节紊乱诊断标准（DC/TMD）诊断为关节内疾病的患者接受 CBCT 评估，并分为四个离散组：NN-无 TMJ DJD 且无关节痛；NA-无 TMJ DJD 但有关节痛；TO-TMJ 骨关节炎；和 TR-TMJ 骨关节炎。TO/TR 组进一步分为早期/晚期 TMJ 骨关节炎（EO/LO）和骨关节炎（ER/LR）。使用 OHIP-TMD 评估 OHRQoL，并使用 Kruskal-Wallis/Mann-Whitney U 检验（α=0.05）评估数据。
研究参与者（n=358）的平均年龄为 31.85±12.39 岁（85.6%为女性）。TMD 组的频率如下：NN-23.2%；NA-27.1%；TO-19.0%；和 TR-30.7%。TR/NA 组的 OHRQoL 明显差于 TO/NN 组。此外，ER/LR 组的 OHRQoL 明显差于 EO/LO 组。对于所有 TMD 组和 TMJ DJD 亚组，心理不适域通常是受损最严重的。有和无关节痛的参与者之间（即，NA-NN、ER-EO 和 LR-LO）的全球 OHIP 评分差异具有统计学意义。
TMJ 疼痛的存在似乎比 TMJ DJD 的严重程度更能损害 OHRQoL。由于心理域受影响最大，因此在管理患有疼痛性 TMJ DJD 的患者时，应纳入社会心理护理。
