Yap Adrian Ujin, Zhang Min-Juan, Zhang Xiao-Han, Cao Ye, Fu Kai-Yuan
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; National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore.
Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Jun;133(6):643-649. doi: 10.1016/j.oooo.2021.11.009. Epub 2021 Nov 28.
This study explored the viability of using the 5 temporomandibular disorder (TMD) symptoms (5Ts) of the Diagnostic Criteria for TMDs (DC/TMD) as a TMD screener.
A total of 1039 adults (≥18 years old) with a mean age of 32.65 ± 12.95 years (77.4% women) from a tertiary dental hospital were enrolled. The 5Ts questionnaire (involving items on TMD/facial pain, headaches, temporomandibular joint noises, and closed- and open-locking) was administered, and TMD diagnoses were derived through clinical interviews and examinations, radiographic investigations, and the DC/TMD diagnostic algorithms and diagnostic tree. Diagnostic accuracy of the 5Ts was assessed using the area under the receiver operating characteristics curve and various measures, including sensitivity, specificity, predictive values, and likelihood ratios.
Among the participants, 80.2% (n = 833) were 5Ts-positive, and 19.8% (n = 206) were 5Ts-negative, whereas 51.3% and 85.7% received at least 1 pain-related and intra-articular DC/TMD diagnosis, respectively. The 5Ts showed high accuracy for detecting all TMDs, pain-related and intra-articular, with area under the receiver operating characteristics curves of 0.98, 1.00, and 0.98, respectively. Sensitivity ranged from 96.1% to 99.2%, whereas specificity was 100.0%.
The 5Ts demonstrated high diagnostic accuracy for identifying pain-related and/or intra-articular disorders.
本研究探讨将颞下颌关节紊乱病(TMD)诊断标准(DC/TMD)中的5种颞下颌关节紊乱症状(5Ts)用作TMD筛查工具的可行性。
纳入了来自一家三级牙科医院的1039名成年人(≥18岁),平均年龄为32.65±12.95岁(77.4%为女性)。采用了5Ts问卷(涉及TMD/面部疼痛、头痛、颞下颌关节弹响以及闭口和开口绞锁等项目),并通过临床访谈与检查、影像学检查以及DC/TMD诊断算法和诊断树得出TMD诊断结果。使用受试者工作特征曲线下面积以及包括敏感性、特异性、预测值和似然比在内的各种指标评估5Ts的诊断准确性。
在参与者中,80.2%(n = 833)为5Ts阳性,19.8%(n = 206)为5Ts阴性,而分别有51.3%和85.7%的参与者至少获得了1项与疼痛相关和关节内的DC/TMD诊断。5Ts在检测所有TMD、与疼痛相关的TMD和关节内TMD方面显示出较高的准确性,受试者工作特征曲线下面积分别为0.98、1.00和0.98。敏感性范围为96.1%至99.2%,而特异性为100.0%。
5Ts在识别与疼痛相关和/或关节内疾病方面显示出较高的诊断准确性。