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颞下颌关节紊乱疼痛的特征及其对下颌功能受限和口腔健康相关生活质量的影响。

Characteristics of painful temporomandibular disorders and their influence on jaw functional limitation and oral health-related quality of life.

机构信息

Center 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.

出版信息

J Oral Rehabil. 2024 Sep;51(9):1748-1758. doi: 10.1111/joor.13768. Epub 2024 Jun 6.

Abstract

BACKGROUND

There is limited knowledge about the impact of painful temporomandibular disorders (TMDs) and pain characteristics on jaw functional limitation and oral health-related quality of life (OHRQoL) in TMD patients.

OBJECTIVES

The influence of painful TMDs and pain characteristics on jaw functional limitation and OHRQoL was investigated. Inter-relationships between limitation in jaw function and various OHRQoL domains, along with facial pain attributes predicting impaired jaw function and diminished OHRQoL were also examined.

METHODS

TMD patients were recruited from a university-based hospital. A comprehensive questionnaire comprising demographic variables, the DC/TMD Symptom Questionnaire, Graded Chronic Pain Scale, Jaw Functional Limitation Scale-8 (JFLS-8) and Oral Health Impact Profile-TMD (OHIP-TMD) was administered. Participants underwent a protocolized physical examination, and TMD diagnoses were determined utilising the DC/TMD algorithms. Participants were subsequently stratified into intra-articular/pain-related/combined TMD groups, as well as no TMD pain, acute/chronic pain and low/high-intensity pain groups. Data were assessed using non-parametric and hierarchical linear regression analyses (α = .05).

RESULTS

The final sample consisted of 280 participants (mean age 31.2 (SD 11.8) years; 79.3% women). Significant differences in pain characteristics, JFLS-8, and global OHIP scores were observed across the various TMD subtypes, pain chronicity and pain intensity categories. Pain intensity and pain-related interference exhibited moderate correlations with JFLS-8 and global OHIP scores (rs = 0.53-0.60). Moderate associations were also noted between JFLS-8 and global OHIP, as well as most OHIP domains (rs = 0.42-0.64). Both jaw functional limitation and OHRQoL were predicted by sex, pain intensity and pain-related interference.

CONCLUSIONS

Sex, pain intensity and pain-related interference are key determinants for both impaired jaw function and diminished OHRQoL, with pain-related interference exerting a more pronounced effect.

摘要

背景

关于疼痛性颞下颌关节紊乱(TMD)及其疼痛特征对 TMD 患者的下颌功能受限和口腔健康相关生活质量(OHRQoL)的影响知之甚少。

目的

本研究旨在探讨疼痛性 TMD 及其疼痛特征对下颌功能受限和 OHRQoL 的影响。还研究了下颌功能受限与各种 OHRQoL 领域之间的相互关系,以及预测下颌功能障碍和 OHRQoL 下降的面部疼痛属性。

方法

从一所大学医院招募 TMD 患者。采用包含人口统计学变量、DC/TMD 症状问卷、分级慢性疼痛量表、下颌功能受限量表-8(JFLS-8)和口腔健康影响概况-TMD(OHIP-TMD)的综合问卷对参与者进行评估。参与者接受了标准化的体格检查,并利用 DC/TMD 算法确定 TMD 诊断。随后,参与者被分为关节内/疼痛相关/混合 TMD 组,以及无 TMD 疼痛、急性/慢性疼痛和低/高强度疼痛组。使用非参数和分层线性回归分析(α = .05)评估数据。

结果

最终样本由 280 名参与者组成(平均年龄 31.2(SD 11.8)岁;79.3%为女性)。在各种 TMD 亚型、疼痛持续性和疼痛强度类别中,疼痛特征、JFLS-8 和全球 OHIP 评分存在显著差异。疼痛强度和疼痛相关干扰与 JFLS-8 和全球 OHIP 评分呈中度相关(rs = 0.53-0.60)。JFLS-8 与全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。JFLS-8 和全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。JFLS-8 和全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。JFLS-8 和全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。JFLS-8 和全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。JFLS-8 和全球 OHIP 以及大多数 OHIP 领域之间也存在中度关联(rs = 0.42-0.64)。同时,下颌功能受限和 OHRQoL 均由性别、疼痛强度和疼痛相关干扰预测。

结论

性别、疼痛强度和疼痛相关干扰是下颌功能障碍和 OHRQoL 下降的关键决定因素,其中疼痛相关干扰的影响更为显著。

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