Kothari Mohit, Alves-Costa Silas, Kumar Abhishek, Nascimento Gustavo G, Nielsen Jørgen Feldbæk, Svensson Peter, Kothari Simple F
Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.
Department of Audiology & Speech Language Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Kasturba Medical College, Manguluru, Karnataka, India.
Oral Dis. 2025 Jul;31(7):2251-2260. doi: 10.1111/odi.15281. Epub 2025 Feb 10.
To evaluate the presence, severity and progression of temporomandibular disorders (TMD) in acquired brain injury (ABI) population and determine the diagnostic accuracy of 3Q/TMD and Fonseca Anamnestic Index (FAI) against the gold standard, Diagnostic Criteria for TMD (DC/TMD).
ABI individuals were assessed using 3Q/TMD and FAI at admission (n = 73) and Week 4 (n = 52), while DC/TMD was conducted only at Week 4. Diagnostic accuracy, sensitivity and specificity of 3Q/TMD and FAI were calculated against DC/TMD.
TMD was detected in 66.0% (3Q/TMD) and 27.8% (FAI) at admission, with mild (75%) to moderate (25%) severity which was mostly pain-related. TMD frequency decreased to 11.3% (3Q/TMD) and 17.3% (FAI) by Week 4. Accuracy rates were 0.82 for 3Q/TMD and 0.83 for FAI. Sensitivity was 0.33 (3Q/TMD) and 0.50 (FAI), while specificity was high at 0.93 (3Q/TMD) and 0.90 (FAI).
TMD presence was higher in an ABI population compared to the general population however the frequency decreased over time. The high specificity and accuracy of 3Q/TMD and FAI indicate their potentials as screening tools but their low sensitivity limits their effectiveness in identifying all TMD cases. Patients with ABI should be assessed for TMD as part of their comprehensive care.
评估后天性脑损伤（ABI）人群中颞下颌关节紊乱病（TMD）的存在情况、严重程度及进展，并确定3Q/TMD和丰塞卡问诊指数（FAI）相对于颞下颌关节紊乱病诊断标准（DC/TMD）这一金标准的诊断准确性。
ABI个体在入院时（n = 73）和第4周（n = 52）使用3Q/TMD和FAI进行评估，而DC/TMD仅在第4周实施。计算3Q/TMD和FAI相对于DC/TMD的诊断准确性、敏感性和特异性。
入院时，通过3Q/TMD检测出TMD的比例为66.0%，通过FAI检测出的比例为27.8%，严重程度为轻度（75%）至中度（25%），主要与疼痛相关。到第4周时，TMD的发生率降至11.3%（3Q/TMD）和17.3%（FAI）。3Q/TMD的准确率为0.82，FAI的准确率为0.83。敏感性方面，3Q/TMD为0.33，FAI为0.50，而特异性较高，3Q/TMD为0.93，FAI为0.90。
与普通人群相比，ABI人群中TMD的发生率更高，但随着时间推移频率降低。3Q/TMD和FAI的高特异性和准确性表明它们有作为筛查工具的潜力，但其低敏感性限制了它们在识别所有TMD病例方面的有效性。ABI患者应作为综合护理的一部分接受TMD评估。
