Department of Orthodontic, Hospital of Stomatology, Jilin University, No. 2699 Qianjin Street, Changchun, Jilin Province, 130012, P.R. China.
BMC Oral Health. 2024 Sep 6;24(1):1047. doi: 10.1186/s12903-024-04832-3.
Temporomandibular disorders (TMDs) have a relatively high prevalence among university students. This study aimed to identify independent risk factors for TMD in university students and develop an effective risk prediction model.
This study included 1,122 university students from four universities in Changchun City, Jilin Province, as subjects. Predictive factors were screened by using the least absolute shrinkage and selection operator (LASSO) regression and the machine learning Boruta algorithm in the training cohort. A multifactorial logistic regression analysis was used to construct a TMD risk prediction model. Internal validation of the model was conducted via bootstrap resampling, and an external validation cohort comprised 205 university students undergoing oral examinations at the Stomatological Hospital of Jilin University.
The prevalence of TMD among university students was 44.30%. Ten predictive factors were included in the model, comprising gender, facial cold stimulation, unilateral chewing, biting hard or resilient foods, clenching teeth, grinding teeth, excessive mouth opening, malocclusion, stress, and anxiety. The model demonstrated good predictive ability with area under the receiver operating characteristic curve (AUC) values of 0.853, 0.838, and 0.821 in the training cohort, internal validation cohort, and external validation cohort, respectively. The calibration curves demonstrated that the predicted results were consistent with the actual results, and the decision curve analysis (DCA) indicated the model's high clinical utility.
An online nomogram of TMD in university students with good predictive performance was constructed, which can effectively predict the risk of TMD in university students. The model provides a useful tool for the early identification and treatment of TMDs in university students, helping clinicians to predict the probability of TMDs in each patient, thus providing more personalized and accurate treatment decisions for patients.
颞下颌关节紊乱病(TMD)在大学生中较为常见。本研究旨在确定大学生 TMD 的独立危险因素,并建立有效的风险预测模型。
本研究纳入吉林省长春市四所大学的 1122 名大学生作为研究对象。在训练队列中,使用最小绝对值收缩和选择算子(LASSO)回归和机器学习 Boruta 算法筛选预测因素。使用多因素逻辑回归分析构建 TMD 风险预测模型。通过自举重采样对内模型进行验证,吉林大学口腔医院进行口腔检查的 205 名大学生组成外部验证队列。
大学生 TMD 的患病率为 44.30%。模型中纳入 10 个预测因素,包括性别、面部冷刺激、单侧咀嚼、咬硬或有弹性的食物、咬牙、磨牙、张口过度、错合、压力和焦虑。模型在训练队列、内部验证队列和外部验证队列中的受试者工作特征曲线下面积(AUC)值分别为 0.853、0.838 和 0.821,具有良好的预测能力。校准曲线表明预测结果与实际结果一致,决策曲线分析(DCA)表明该模型具有较高的临床实用性。
构建了一种具有良好预测性能的大学生 TMD 在线列线图,可以有效预测大学生 TMD 的风险。该模型为大学生 TMD 的早期识别和治疗提供了一种有用的工具,有助于临床医生预测每位患者 TMD 的概率,从而为患者提供更个性化和准确的治疗决策。