Stegenga B, de Bont L G, Boering G
University of Groningen Hospital, The Netherlands.
J Orofac Pain. 1993 Winter;7(1):23-37.
The aim of this study was to evaluate pain characteristics of patients with temporomandibular joint-related pain and propose a rationale for the assessment of pain and its impact on patients with temporomandibular disorders. Based on anamnestic information, the 88 patients in the sample were classified according to pain grade: (1) acute/subacute nonrecurrent or recurrent pain, n = 41 (46.6%); (2) persistently recurring pain in relatively high frequency, or nonsevere persistent pain, n = 32 (36.4%); (3) persistent and impairing pain, n = 8 (9.1%); (4) persistent and disabling pain, n = 7 (7.9%); and (5) persistent and handicapping pain, n = 0. Regarding TMJ pain provoked during the clinical examination, there was a significant difference among diagnostic subgroups, subgroups with different pain intensity levels, and pain grade subgroups, but no significant differences could be found based on the duration of the pain symptoms. Subgroups also did not significantly differ in scores on the Multi-dimensional Pain Inventory and the General Health Questionnaire. Based on the results of the study, the assessment of nonchronic TMJ pain may generally be limited to an accurate description of the pain complaint and thorough clinical assessment. Multidimensional assessment may be useful when the TMJ pain persists or is persistently recurring. Depending on individual circumstances, additional assessment procedures may prove to be useful. A general strategy for pain assessment in temporomandibular disorders is proposed.
本研究的目的是评估颞下颌关节相关疼痛患者的疼痛特征,并为疼痛评估及其对颞下颌关节紊乱患者的影响提出理论依据。根据记忆信息,样本中的88例患者按疼痛程度分类:(1)急性/亚急性非复发性或复发性疼痛,n = 41(46.6%);(2)相对高频的持续性复发性疼痛,或非重度持续性疼痛,n = 32(36.4%);(3)持续性且有损害的疼痛,n = 8(9.1%);(4)持续性且致残的疼痛,n = 7(7.9%);(5)持续性且导致残疾的疼痛,n = 0。关于临床检查期间诱发的颞下颌关节疼痛,诊断亚组、不同疼痛强度水平亚组和疼痛程度亚组之间存在显著差异,但根据疼痛症状的持续时间未发现显著差异。亚组在多维疼痛量表和一般健康问卷上的得分也无显著差异。根据研究结果,非慢性颞下颌关节疼痛的评估通常可能仅限于对疼痛主诉的准确描述和全面的临床评估。当颞下颌关节疼痛持续或持续复发时,多维评估可能有用。根据个体情况,额外的评估程序可能会被证明是有用的。本文提出了颞下颌关节紊乱疼痛评估的一般策略。