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急性和慢性疼痛性颞下颌关节紊乱病的比较分析:对疼痛、行为及社会心理特征的见解

Comparative analysis of acute and chronic painful temporomandibular disorders: Insights into pain, behavioral, and psychosocial features.

作者信息

Yap Adrian Ujin, Jo Jung Hwan, Kim Sunghae, Lee Byeong-Min, Park Ji Woon

机构信息

Division of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore.

National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore.

出版信息

PLoS One. 2025 Feb 25;20(2):e0318946. doi: 10.1371/journal.pone.0318946. eCollection 2025.

Abstract

OBJECTIVE

The scarcity of literature necessitates further research to differentiate between acute and chronic painful temporomandibular disorders (TMDs). This study compared pain characteristics, oral behaviors, jaw function, and psychosocial distress between TMD patients with acute and chronic pain, examined correlations among variables, and identified factors associated with chronic pain-related TMDs (PT).

METHODS

Anonymized data were gathered from consecutive patients seeking TMD treatment at a university-based oral medicine clinic. Axis I diagnoses were made using the Diagnostic Criteria for TMDs, and patients with PT were categorized into acute (AP) and chronic pain (CP) groups. Axis II assessments were performed, evaluating pain characteristics, oral behaviors, jaw functional limitation, somatic symptoms, depression, and anxiety. Statistical analysis utilized chi-square/non-parametric tests and logistic regression (α =  0.05).

RESULTS

Among the 488 PT patients, 34.6% experienced AP and 65.4% had CP. Significant differences were observed in pain intensity, interference, disability, jaw overuse behavior, functional limitation, somatic symptom burden, depression, and anxiety. (CP>  AP). Moderate-to-strong correlations were found in both the AP (rs =  0.43-0.83) and CP (rs =  0.46-0.87) groups, although the specific relationships between pain, behavioral, and psychosocial factors differed somewhat. The multivariate regression model revealed that only pain intensity (OR =  1.01) and oral behaviors (OR =  1.06) significantly increased the odds of chronic PT.

CONCLUSION

Chronic pain was more prevalent in PT patients and associated with greater severity in pain, behavioral, and psychosocial variables. Pain intensity and oral behaviors were linked to an increased likelihood of chronic pain.

摘要

目的

由于相关文献稀缺,有必要开展进一步研究以区分急性和慢性疼痛性颞下颌关节紊乱病(TMD)。本研究比较了急性和慢性疼痛的TMD患者的疼痛特征、口腔行为、颌功能及心理社会困扰,检验了各变量之间的相关性,并确定了与慢性疼痛相关的TMD(PT)的相关因素。

方法

从一家大学口腔医学诊所连续就诊的TMD患者中收集匿名数据。使用TMD诊断标准进行轴I诊断,将PT患者分为急性(AP)和慢性疼痛(CP)组。进行轴II评估,评估疼痛特征、口腔行为、颌功能受限、躯体症状、抑郁和焦虑。统计分析采用卡方检验/非参数检验和逻辑回归(α = 0.05)。

结果

在488例PT患者中,34.6%经历急性疼痛,65.4%患有慢性疼痛。在疼痛强度、干扰、残疾、颌过度使用行为、功能受限、躯体症状负担、抑郁和焦虑方面观察到显著差异(CP>AP)。在AP组(rs = 0.43 - 0.83)和CP组(rs = 0.46 - 0.87)中均发现了中度至强相关性,尽管疼痛、行为和心理社会因素之间的具体关系略有不同。多变量回归模型显示,只有疼痛强度(OR = 1.01)和口腔行为(OR = 1.06)显著增加了慢性PT的几率。

结论

慢性疼痛在PT患者中更为普遍,并且与疼痛、行为和心理社会变量的更严重程度相关。疼痛强度和口腔行为与慢性疼痛可能性增加有关。

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