Bonotto Danielle Veiga, Cavalheiro Jessica Sarah, Firmino Ramon Targino, Stuginski-Barbosa Juliana, Scariot Rafaela, Sebastiani Aline Monise
Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
Department of Stomatology, School of Dentistry, Federal University of Paraná, Curitiba, Paraná, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Mar;139(3):279-288. doi: 10.1016/j.oooo.2024.09.001. Epub 2024 Sep 14.
To identify clusters of patients with DFD based on variables related to TMD, psychological aspects, somatization, oral habits, and sleep.
Ninety-two patients with DFD were evaluated before orthognathic surgery according to demographic data, facial profile, presence of painful TMD (DC/TMD), psychological aspects, oral habits, comorbidities, substance use, and sleep quality.
Eighty-six individuals comprised the final sample. The K-means cluster analysis identified two distinct but internally similar groups. One called "Vulnerable" with a higher prevalence of muscular TMD and associated factors with 43 (50%) participants, and another with 43 (50%) participants, called "Adaptive" with a lower prevalence of these variables (P<.01). The determining variables were signs and symptoms of anxiety and somatization, awake bruxism and self-reported sleep quality. The presence of arthralgia, comorbidities, or smoking did not influence the formation of the groups. The clusters were tested with gender, age, facial profile, maxillary excess, and deficiency. Only females were associated with the vulnerable group (P=.015). These results highlight the importance of multidimensional assessment of patients with DFD. The stratification of these individuals can help with personalized treatment, targeting specific strategies for each group, such as behavioral interventions and referrals to a multidisciplinary team.
基于与颞下颌关节紊乱病（TMD）、心理因素、躯体化、口腔习惯和睡眠相关的变量，识别DFD患者的聚类。
对92例DFD患者在正颌手术前根据人口统计学数据、面部轮廓、疼痛性TMD（DC/TMD）的存在情况、心理因素、口腔习惯、合并症、物质使用和睡眠质量进行评估。
86名个体组成最终样本。K均值聚类分析确定了两个不同但内部相似的组。一组称为“脆弱组”，有43名（50%）参与者，肌肉性TMD及相关因素的患病率较高；另一组有43名（50%）参与者，称为“适应组”，这些变量的患病率较低（P<0.01）。决定性变量为焦虑和躯体化的体征和症状、清醒时磨牙症和自我报告的睡眠质量。关节痛、合并症或吸烟的存在不影响组的形成。对聚类进行性别、年龄、面部轮廓、上颌前突和上颌后缩测试。只有女性与脆弱组相关（P = .015）。这些结果突出了对DFD患者进行多维评估的重要性。对这些个体进行分层有助于个性化治疗，针对每组制定特定策略，如行为干预和转介至多学科团队。
