Scholte A M, Steenks M H, Bosman F
Department of Oral-Maxillofacial Surgery, Faculty of Medicine, University of Utrecht, The Netherlands.
Community Dent Oral Epidemiol. 1993 Aug;21(4):215-20. doi: 10.1111/j.1600-0528.1993.tb00759.x.
The records of 193 randomly chosen patients with CMD referred 2.5 yr previously were examined retrospectively for anamnestic, clinical and radiological findings and observations related to treatment. These data were supplemented with information from questionnaires sent to all treated patients in which their opinion on the treatment outcome was asked. Within the patient group, four diagnostic subgroups were distinguished. Three subgroups consisted of patients with the diagnoses CMD with a mainly myogenous component, osteoarthrosis and internal derangement respectively, whereas the fourth subgroup consisted of patients who did not fit into one of these categories. Differences between the four groups were found concerning mean age, the prevalence of a limited range of motion, headache, psychosocial factors, loss of posterior tooth support and objective treatment outcome. The patients with CMD with a mainly myogenous component showed the highest percentages of CMD associated disorders, the least successful treatment outcome and the highest percentage of renewed treatment. The patients with internal derangement showed the lowest mean age, the highest prevalence of a limited range of motion and the best treatment outcome. The patients in the osteoarthrosis group showed the highest mean age and the highest percentage of loss of posterior tooth support. It may be concluded that the evaluation of diagnostic subgroups of CMD patients has to be preferred in the assessment of a heterogeneous group of patients with CMD.
对2.5年前转诊的193例随机选择的口颌面痛患者的记录进行回顾性检查，以获取与治疗相关的既往史、临床和影像学检查结果及观察资料。这些数据通过向所有接受治疗的患者发送问卷进行补充，问卷中询问了他们对治疗结果的看法。在患者组中，区分出四个诊断亚组。三个亚组分别由主要为肌源性成分的口颌面痛、骨关节炎和关节内紊乱患者组成，而第四个亚组由不属于这些类别的患者组成。发现四组之间在平均年龄、活动范围受限的患病率、头痛、心理社会因素、后牙支持丧失和客观治疗结果方面存在差异。主要为肌源性成分的口颌面痛患者显示出口颌面痛相关疾病的百分比最高、治疗结果最不理想以及再次治疗的百分比最高。关节内紊乱患者的平均年龄最低、活动范围受限的患病率最高且治疗结果最佳。骨关节炎组患者的平均年龄最高且后牙支持丧失的百分比最高。可以得出结论，在评估异质性口颌面痛患者群体时，对口颌面痛患者的诊断亚组进行评估更为可取。
