Cannatà Davide, Galdi Marzio, Caggiano Mario, Acerra Alfonso, Amato Massimo, Martina Stefano
Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Allende, 84081 Salerno, Italy.
Healthcare (Basel). 2025 Jun 12;13(12):1414. doi: 10.3390/healthcare13121414.
This cross-sectional study assessed the prevalence of temporomandibular disorders (TMD) among Italian university students and their association with emotional factors and parafunctional behaviors. A total of 321 students participated in this study. TMD signs and symptoms were evaluated using the DC/TMD criteria through clinical examinations and self-report questionnaires: physical (Symptom Questionnaire), psycho-emotional (PHQ-9, PHQ-15, PHQ-4, and GAD-7), and wake-state oral behaviors (Oral Behavior Checklist, OBC). The Mann-Whitney U test assessed associations between TMD, sociodemographic data, oral behaviors, and psychological vulnerability ( < 0.05). Pain-related symptoms were present in 37% of students (male/female ratio 1:2.7; < 0.001), and joint dysfunction in 28%, with no gender differences. The median score of PHQ-9 (2.0; interquartile range IQR 5.0), PHQ-15 (2.0; IQR 5.0), PHQ-4 (3.0; IQR 6.0), and GAD-7 (3.00; IQR 6.0) suggested negligible severity of anxious mood, depressed mood, and somatic symptoms among the university students. However, all scores were noticeably higher in students with pain-related TMD compared to pain-free ones ( < 0.05). OBC scores were significantly related to PHQ ( < 0.001), GAD-7 ( < 0.001), and pain symptoms ( < 0.001). Science faculty students (S) showed higher OBC scores than humanities ones (H; S: 20.0; IQR 13.0 vs. H: 16.0; IQR 14.0; < 0.001), and an H/S ratio of 1:2 was found in pain prevalence ( < 0.05). This study found a high prevalence of TMD signs and symptoms, particularly pain-related, among university students, strongly linked to emotional factors and oral behaviors.
这项横断面研究评估了意大利大学生颞下颌关节紊乱病（TMD）的患病率及其与情绪因素和副功能行为的关联。共有321名学生参与了本研究。通过临床检查和自我报告问卷，使用DC/TMD标准评估TMD的体征和症状：身体方面（症状问卷）、心理情绪方面（PHQ-9、PHQ-15、PHQ-4和GAD-7）以及清醒状态下的口腔行为（口腔行为检查表，OBC）。曼-惠特尼U检验评估了TMD、社会人口统计学数据、口腔行为和心理易感性之间的关联（P<0.05）。37%的学生存在疼痛相关症状（男女比例为1:2.7；P<0.001），28%存在关节功能障碍，无性别差异。PHQ-9（中位数为2.0；四分位间距IQR为5.0）、PHQ-15（中位数为2.0；IQR为5.0）、PHQ-4（中位数为3.0；IQR为6.0）和GAD-7（中位数为3.00；IQR为6.0）的得分表明大学生中焦虑情绪、抑郁情绪和躯体症状的严重程度可忽略不计。然而，与无疼痛的学生相比，有疼痛相关TMD的学生所有得分均显著更高（P<0.05）。OBC得分与PHQ（P<0.001）、GAD-7（P<0.001）和疼痛症状（P<0.001）显著相关。理科专业学生（S）的OBC得分高于文科专业学生（H；S：20.0；IQR为13.0，而H：16.0；IQR为14.0；P<0.001），且在疼痛患病率方面发现H/S比例为1:2（P<0.05）。本研究发现大学生中TMD体征和症状的患病率较高，尤其是与疼痛相关的，且与情绪因素和口腔行为密切相关。
