Li Xiang, Singh Vandana, Pacheco-Pereira Camila, Friesen Reid
Mike Petryk School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada.
Private Practice in Edmonton, Edmonton, AB T6G 1C9, Canada.
J Oral Facial Pain Headache. 2025 Mar;39(1):141-147. doi: 10.22514/jofph.2025.014. Epub 2025 Mar 12.
Motor vehicle accidents (MVA) are associated with the onset of temporomandibular disorder (TMD) symptoms. However, diagnosing TMD-related pain is challenging due to various entities that can refer pain to the region. This study aims to identify prevalent radiographic confounders to pain diagnosis in MVA patients who were subsequently referred for temporomandibular joint imaging using cone-beam computed tomography (CBCT) by comparing these patients to a cohort of patients without MVA history.
CBCTs of 738 temporomandibular joints were reviewed, with cases stratified by MVA history. This research explored the demographics and calculated the prevalence of radiographic confounders (RC) in each category, comparing the findings for both groups. The chi-square test was used to assess statistical significance.
Patients in the MVA cohort (n = 151, mean age = 41.3 years, S.D (Standard Deviation) = 13.3 years) averaged 1.10 confounders/patient compared to a significantly lower 0.68 confounders/patient in the non-MVA cohort (n = 218, mean age = 33.6 years, S.D = 18.2 years). The most frequently identified RCs include sinus pathologies (39.1% (MVA) 28.0% (non-MVA), = 0.025) and endodontic lesions (22.5% (MVA) 10.1% (non-MVA), = 0.001).
Clinicians must be vigilant about confounders when managing patients suspected of TMD. We recommend patients undergo a complete dental evaluation before being referred to a specialist to avoid unnecessary medical costs and treatment delays.
机动车事故(MVA)与颞下颌关节紊乱(TMD)症状的发作有关。然而,由于多种可将疼痛牵涉至该区域的情况,诊断与TMD相关的疼痛具有挑战性。本研究旨在通过将这些患者与无MVA病史的患者队列进行比较,确定在随后接受锥形束计算机断层扫描(CBCT)颞下颌关节成像的MVA患者中,疼痛诊断常见的影像学混杂因素。
回顾了738个颞下颌关节的CBCT,病例按MVA病史分层。本研究探讨了人口统计学特征,并计算了每类中影像学混杂因素(RC)的患病率,比较两组的结果。采用卡方检验评估统计学意义。
MVA队列中的患者(n = 151,平均年龄 = 41.3岁,标准差(SD)= 13.3岁)平均每位患者有1.10个混杂因素,相比之下,非MVA队列(n = 218,平均年龄 = 33.6岁,SD = 18.2岁)中每位患者的混杂因素明显较少,为0.68个。最常发现的RC包括鼻窦病变(39.1%(MVA)对28.0%(非MVA),P = 0.025)和牙髓病变(22.5%(MVA)对10.1%(非MVA),P = 0.001)。
临床医生在管理疑似TMD的患者时必须警惕混杂因素。我们建议患者在转诊至专科医生之前进行全面的牙科评估,以避免不必要的医疗费用和治疗延误。