Department of Oral Medicine, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.
BMC Oral Health. 2024 Sep 16;24(1):1097. doi: 10.1186/s12903-024-04862-x.
Chronic systemic inflammation has been proposed as the underlying mechanism of pain chronicity in several pain conditions. In spite of the growing evidence supporting the role of systemic inflammatory markers as a diagnostic tool, their role has not been analyzed in a well-defined group of temporomandibular disorders (TMD) patients until now. This study aimed to investigate the association between various clinical features and comorbidity levels of TMD in relation to hematological markers and seek its association with long-term treatment response.
Clinical features and hematological indices including those for systemic inflammation were assessed in TMD patients (n = 154). Examinations were re-done after 6 months of conservative treatment. Patients were divided into pain improved and unimproved groups based on ≥ 2 numeric rating scale improvement in pain intensity at 6 months for final analysis.
The portion of patients with low lymphocyte-to-monocyte ratio (p = 0.026), total protein (p = 0.014), hemoglobin (p = 0.040), and mean corpuscular hemoglobin concentration (p = 0.042) values showed significant differences according to prognosis groups. Low hemoglobin levels were significantly associated with unfavorable response to long-term treatment (β = 1.706, p = 0.018). High pre-treatment pain intensity (β=-0.682, p < 0.001) and low Graded Chronic Pain Scale (β = 1.620, p = 0.002) could predict significant pain improvement with long-term treatment.
Hematologic assessment could be considered in addition to clinical examination to better determine long-term prognosis in TMD patients.
慢性系统性炎症被认为是几种疼痛病症疼痛持续性的潜在机制。尽管越来越多的证据支持系统性炎症标志物作为一种诊断工具的作用，但直到现在，它们在一个明确界定的颞下颌关节紊乱（TMD）患者群体中的作用尚未得到分析。本研究旨在调查 TMD 患者各种临床特征和共病水平与血液学标志物之间的关系，并研究其与长期治疗反应的关系。
评估 TMD 患者的临床特征和血液学指标，包括系统性炎症指标（n=154）。在 6 个月的保守治疗后重新进行检查。根据疼痛强度的数字评定量表改善≥2 分，将患者分为疼痛改善和未改善两组进行最终分析。
根据预后组，淋巴细胞与单核细胞比值（p=0.026）、总蛋白（p=0.014）、血红蛋白（p=0.040）和平均红细胞血红蛋白浓度（p=0.042）低值的患者比例存在显著差异。低血红蛋白水平与长期治疗的不良反应显著相关（β=1.706，p=0.018）。高治疗前疼痛强度（β=-0.682，p<0.001）和低分级慢性疼痛量表（β=1.620，p=0.002）可预测长期治疗后疼痛显著改善。
除临床检查外，血液学评估可用于更好地确定 TMD 患者的长期预后。
