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雅西牙医学院牙科学生颞下颌关节紊乱症状的患病率:一项基于DC/TMD标准的自我报告研究

Prevalence of Temporomandibular Disorder Symptoms Among Dental Students at the Faculty of Dental Medicine in Iași: A Self-Reported Study Based on DC/TMD Criteria.

作者信息

Tarevici Eugenia Larisa, Tanculescu Oana, Apostu Alina Mihaela, Solomon Sorina Mihaela, Rotaru-Costin Alice-Teodora, Doloca Adrian, Bodnar Petronela, Proca Vlad Stefan, Ciocan-Pendefunda Alice-Arina, Tatarciuc Monica, Fala Valeriu, Iordache Marina Cristina Iuliana

机构信息

Department of Odontology-Periodontology and Fixed Prosthodontics, Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania.

Department of Preventive Medicine and Interdisciplinarity, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania.

出版信息

Diagnostics (Basel). 2025 Jul 30;15(15):1908. doi: 10.3390/diagnostics15151908.

Abstract

Temporomandibular disorders (TMDs) encompass a heterogeneous group of musculoskeletal and neuromuscular conditions affecting the temporomandibular joint (TMJ) and masticatory system. Due to academic stress and parafunctional habits, dental students may be particularly vulnerable to TMD. To determine the prevalence of TMD symptoms and their psychosocial and functional correlates among students at the Faculty of Dental Medicine, UMPh Iasi, Romania, using the diagnostic criteria for TMD (DC/TMD) self-report axis and axis II instruments. In this cross-sectional survey, 356 volunteer students (66.0% female; mean age, 22.9 ± 3.6 years) out of a total population of 1874 completed an online DC/TMD-based questionnaire. Axis I assessed orofacial pain, joint noises, and mandibular locking. Axis II instruments included the Graded Chronic Pain Scale (GCPS), Jaw Functional Limitation Scale (JFLS-20), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Oral Behaviors Checklist (OBC). Descriptive statistics summarized frequencies, means, and standard deviations; χ tests and -tests compared subgroups by sex; Pearson correlations explored relationships among continuous measures (α = 0.05). A total of 5% of respondents reported orofacial pain in the past 30 days; 41.6% observed TMJ noises; 19.7% experienced locking episodes. Mean JFLS score was 28.3 ± 30.5, with 4.8% scoring > 80 (severe limitation). Mean PHQ-9 was 5.96 ± 5.37 (mild depression); 15.5% scored ≥ 10. Mean GAD-7 was 5.20 ± 4.95 (mild anxiety); 16.0% scored ≥ 10. Mean OBC score was 12.3 ± 8.5; 30.1% scored ≥ 16, indicating frequent parafunctional habits. Symptom prevalence was similar by sex, except temporal headache (43.4% females vs. 24.3% males; = 0.0008). Females reported higher mean scores for pain intensity (2.09 vs. 1.55; = 0.0013), JFLS (32.5 vs. 18.0; < 0.001), PHQ-9 (6.43 vs. 5.16; = 0.048), and OBC (13.9 vs. 9.7; = 0.0014). Strong correlation was observed between PHQ-9 and GAD-7 (r = 0.74; < 0.001); moderate correlations were observed between pain intensity and PHQ-9 (r = 0.31) or GAD-7 (r = 0.30), between JFLS and pain intensity (r = 0.33), and between OBC and PHQ-9 (r = 0.39) (all < 0.001). Nearly half of dental students reported TMD symptoms, with appreciable functional limitation and psychosocial impact. Parafunctional behaviors and psychological distress were significantly associated with pain and dysfunction. These findings underscore the need for early screening, stress-management interventions, and interdisciplinary care strategies in the dental student population.

摘要

颞下颌关节紊乱病(TMDs)是一组异质性的肌肉骨骼和神经肌肉疾病,影响颞下颌关节(TMJ)和咀嚼系统。由于学业压力和功能异常习惯,牙科学生可能特别容易患颞下颌关节紊乱病。为了使用颞下颌关节紊乱病诊断标准(DC/TMD)自我报告轴I和轴II工具,确定罗马尼亚雅西医科大学牙医学院学生中颞下颌关节紊乱病症状的患病率及其心理社会和功能相关性。在这项横断面调查中,1874名学生中的356名志愿者(66.0%为女性;平均年龄22.9±3.6岁)完成了一份基于DC/TMD的在线问卷。轴I评估口面部疼痛、关节弹响和下颌锁定。轴II工具包括分级慢性疼痛量表(GCPS)、下颌功能受限量表(JFLS-20)、患者健康问卷(PHQ-9)、广泛性焦虑障碍-7(GAD-7)和口腔行为检查表(OBC)。描述性统计总结了频率、均值和标准差;χ检验和t检验按性别比较亚组;Pearson相关性分析探讨连续测量指标之间的关系(α = 0.05)。共有5%的受访者报告在过去30天内有口面部疼痛;41.6%观察到颞下颌关节弹响;19.7%经历过锁定发作。JFLS平均得分为28.3±30.5,4.8%的得分>80(严重受限)。PHQ-9平均分为5.96±5.37(轻度抑郁);15.5%的得分≥10。GAD-7平均分为5.20±4.95(轻度焦虑);16.0%的得分≥10。OBC平均得分为12.3±8.5;30.1%的得分≥16,表明功能异常习惯频繁。除颞部头痛外(女性为43.4%,男性为24.3%;P = 0.0008),症状患病率在性别上相似。女性报告的疼痛强度平均得分更高(2.09对1.55;P = 0.0013)、JFLS(32.5对18.0;P < 0.001)、PHQ-9(6.43对5.16;P = 0.048)和OBC(13.9对9.7;P = 0.0014)。观察到PHQ-9与GAD-7之间存在强相关性(r = 0.74;P < 0.001);疼痛强度与PHQ-9(r = 0.31)或GAD-7(r = 0.30)之间、JFLS与疼痛强度(r = 0.33)之间以及OBC与PHQ-9(r = 0.39)之间存在中度相关性(均P < 0.001)。近一半的牙科学生报告有颞下颌关节紊乱病症状,伴有明显的功能受限和心理社会影响。功能异常行为和心理困扰与疼痛和功能障碍显著相关。这些发现强调了在牙科学生群体中进行早期筛查、压力管理干预和跨学科护理策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da94/12346232/6d060eb9d87c/diagnostics-15-01908-g001.jpg

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