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基于颞下颌关节紊乱病诊断标准简化症状问卷的颞下颌关节紊乱病患病率及其对7至14岁儿童和青少年的筛查可靠性

Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7-14 Years.

作者信息

Rentsch Mathias, Zumbrunn Wojczyńska Aleksandra, Gallo Luigi M, Colombo Vera

机构信息

Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland.

Public-School Dental Services of the City of Zurich, 8002 Zurich, Switzerland.

出版信息

J Clin Med. 2023 Jun 17;12(12):4109. doi: 10.3390/jcm12124109.

Abstract

The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7-14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7-10) and adolescents (aged 11-14) of both sexes were invited to participate in this study ( = 1468). Descriptive statistics for all observed variables and Mann-Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants ( = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low.

摘要

儿童和青少年颞下颌关节紊乱病(TMD)诊断方法的患病率及充分性仍是有争议的问题。本研究旨在确定7 - 14岁儿童和青少年中TMD及口腔习惯的患病率,并使用简化的TMD诊断标准(DC/TMD)轴I评估自我报告的TMD症状与临床检查结果之间的一致性。邀请了7 - 10岁儿童和11 - 14岁青少年参与本研究(n = 1468)。对所有观察变量进行描述性统计,并对临床检查进行曼 - 惠特尼U检验。共有239名受试者参与了研究(应答率16.3%)。发现自我报告的TMD患病率为18.8%。最常报告的口腔习惯是咬指甲(37.7%),其次是紧咬牙(32.2%)和磨牙(25.5%)。自我报告的头痛随年龄增加,而紧咬牙和磨牙则减少。根据对DC/TMD症状问卷的回答,建立了无症状和有症状参与者的亚组(n = 59;24.7%),并随机选择进行临床检查(n = 30)。简化症状问卷在临床检查中对疼痛的敏感性为0.556,特异性为0.719。尽管症状问卷表现出高特异性(0.933),但其对颞下颌关节弹响的敏感性(0.286)较低。可复性盘移位(10.2%)和肌痛(6.8%)是最常见的诊断。总之,本研究中儿童和青少年自我报告的TMD患病率与文献中报道的成人患病率相当。然而,发现简化症状问卷作为儿童和青少年TMD相关疼痛和颌关节弹响筛查工具的准确性较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c6e/10299335/65f94ab77246/jcm-12-04109-g001.jpg

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