在阿联酋沙迦市，根据《颞下颌关节紊乱诊断标准》（DC/TMD）诊断为颞下颌关节紊乱的患者中，牵涉痛的发生率和特征。

Prevalence and characteristics of referred pain in patients diagnosed with temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) in Sharjah, United Arab Emirates.

机构信息

Oral and Craniofacial Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.

Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, 27272, United Arab Emirates.

出版信息

F1000Res. 2022 Jun 14;11:656. doi: 10.12688/f1000research.109696.2. eCollection 2022.

DOI:10.12688/f1000research.109696.2

PMID:36249999

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9490275/

Abstract

BACKGROUND

Referred pain often complicates and delays the diagnosis of temporomandibular disorders (TMD). Elaborating the prevalence and characteristics of TMD-associated referred pain as well as the distribution of referred pain in different TMD classes will significantly improve the diagnostic process. The objectives of the present study were to assess the prevalence and to evaluate the characteristics of referred pain associated with TMD diagnosed according to the DC/TMD.

METHODS

A total of 252 patients were evaluated using the DC/TMD Axes-I and -II assessment tools. Different modalities were used to treat the diagnosed TMD. Referred pain was diagnosed when the location of the perceived pain in response to palpation extended beyond the boundary of the structure that was examined. For pain locations that were perceived as deep, patients were asked to locate the surface of the area of pain. The result of the assessment was identified as positive if the patient described his perceived pain during the clinical examination as being familiar pain that was experienced in the same location in the last 30 days. Results: TMD-associated referred pain was recorded in 153 patients (60.7%). The most common referred pain location was the temporal area (45.2%), followed by the ear (42.1%). The referred pain was recorded in disc displacement with reduction with intermittent locking and myofascial pain with referral in all patients (100%). The proportion of patients with referred pain was significantly different between the different TMD diagnostic subgroups (P < 0.001). The recorded percentage of improvement in the referred pain following the treatment was 50.41% after 3 months and 56.65% after 6 months.

CONCLUSIONS

Referred pain is a prominent feature of TMD. The prevalence of referred pain associated with TMD was 60.7%. A strong strength association between the different diagnostic subgroups and the presence of referred pain existed.

摘要

背景

牵涉痛常使颞下颌关节紊乱病（TMD）的诊断复杂化和延迟。阐述 TMD 相关牵涉痛的患病率和特征，以及不同 TMD 类别的牵涉痛分布，将显著改善诊断过程。本研究的目的是评估患病率，并评估根据 DC/TMD 诊断的 TMD 相关牵涉痛的特征。

方法

共评估了 252 名患者，使用了 DC/TMD 轴 I 和 II 评估工具。使用不同的方式来治疗诊断出的 TMD。当感知疼痛的位置在触诊时超出所检查结构的边界时，诊断为牵涉痛。对于被感知为深部疼痛的位置，患者被要求定位疼痛区域的表面。如果患者在临床检查中描述他的感知疼痛为在过去 30 天内同一位置经历过的熟悉疼痛，则将评估结果确定为阳性。

结果

153 名患者（60.7%）记录有 TMD 相关牵涉痛。最常见的牵涉痛部位是颞区（45.2%），其次是耳部（42.1%）。在所有患者中，均记录到有可复性关节盘前移位伴绞锁和肌筋膜痛的牵涉痛（100%）。在不同的 TMD 诊断亚组之间，牵涉痛患者的比例有显著差异（P<0.001）。治疗 3 个月后，牵涉痛改善的记录百分比为 50.41%，治疗 6 个月后为 56.65%。